Objectives Women undergo different physiological and oral changes during pregnancy and this may increase the risk of dental caries and other oral diseases. The aim of the present study was to investigate changes in biofilm acidogenicity and correlate them to sweet taste perception in pregnant and non-pregnant women. Methods Three groups of Saudi women participated in this cross-sectional study: (1) women in early pregnancy (n = 40/mean age 29.6 years/DMFT 10.7), (2) women in late pregnancy (n = 40/29.5 years/DMFT 10.8) and (3) non-pregnant women (n = 41/27.7 years/DMFT 12.3). Changes in plaque pH were determined by using colour-coded indicator strips before and after a 1-min rinse with a 10% sucrose solution. A taste perception test determining sweet preference and threshold levels was also performed. Results A significant difference regarding plaque pH was seen between the early, late and non-pregnant women when calculated as the area under the curve (p < 0.05). Regarding the taste perception tests, taste preference and threshold were correlated (p < 0.001, r = 0.6). Between the three groups, a statistically significant difference was seen in taste threshold and taste preference respectively (p = 0.001 and p < 0.001). Conclusions The findings in this study suggest that pregnant women may undergo taste changes and experience lower plaque pH, which may result in an increased risk of dental caries.

Background and Aims: Complications such as need for bowel resections and hospitalization due to Crohn's disease (CD) occur when disease activity persists due to ineffective therapy. Certain “high-risk” features require an early introduction of anti-tumor necrosis factor-α therapy to prevent such complications. We aim to evaluate the prevalence of “high-risk” features among a cohort of patients with CD and examine the association between discordance of early therapy with baseline risk stratification and disease outcome. Patients and Methods: All adult patients with CD were retrospectively identified and their medical records were reviewed. Clinical, endoscopic, laboratory, and radiological data were collected. Patients were divided into “low” and “high” risk groups according to the presence or absence of penetrating disease, perianal involvement, foregut involvement, extensive disease seen on endoscopy or cross-sectional imaging, young age at the time of diagnosis (<40), persistent cigarette smoking and frequent early requirements for corticosteroid therapy. Initial treatment selection and treatment approach (“step-up” vs. “accelerated step-up” vs. “top-down”) within 6 months of diagnosis were recorded. Rates of CD-related bowel resections and hospitalization within 5 years of diagnosis were calculated. Logistic regression analysis was used to examine the association between “discordance” of early treatment selections and risk stratification categories with outcomes. Results: Eighty-five CD patients were included. The median age and duration of disease were 25 (interquartile range [IQR] 19-32) and 5 (IQR 4-6) years, respectively. Sixty five percent were females and 66% were native Saudis. Smoking was reported in 12% of patients and perianal disease in 18%. “High-risk” features were identified in 43 (51%) patients, of which only 6 (14%) were treated with “top-down” therapy and 7 (16%) with “accelerated step-up” care. The risk of requiring a bowel resection, and hospitalization was higher for “high-risk” patients compared to “low-risk” patients (risk ratio [RR] 13.67, 95% CI 1.88-99.41; p = 0.003, and RR 1.86, 95% CI 0.03-0.43; p = 0.0312, respectively). “Discordance” occurred in 34% of cases. Bowel resection was required in 15/85 (18%) patients and 32/85 (38%) required at least one hospitalization within 5 years of diagnosis. Logistic regression analysis identified a statistically significant association between “discordance” and need for bowel resections (OR 6.50, 95% CI 1.59-26.27, p = 0.009), and hospitalizations (OR 3.01, 95% CI 1.08-8.39, p = 0.035) within 5 years of diagnosis. Conclusions: “Discordance” between patient risk-profile and treatment selection early in the course of CD has a significant impact on disease outcome, specifically need for bowel resection and hospitalization, which are more likely to occur in the presence of “high-risk” features. Early identification of “high-risk” features could help prevent long-term complications.

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