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BackgroundThis study was performed to assess oral and nutritional status of nursing home residents in a region of Lower Saxony, Germany. The aim was to show potential associations between oral status (dentate or edentulous), further anamnestic factors (dementia, age, smoking) and the risk for malnutrition in this population.MethodsIn this observational cross-sectional pilot study of residents from four nursing homes Mini Nutritional Assessment (MNA), Body-Mass-Index (BMI), dental status (DMF-T) and periodontal situation (PSR®/PSI) were recorded. Associations of recorded factors with oral health and nutritional status were examined in univariate and multivariate analysis.ResultsEighty-seven residents participated in the study (mean age: 84.1 years; female: 72%, demented: 47%). Average BMI was 26.2 kg/m2; according MNA 52% were at risk for malnutrition. 48% of the residents were edentulous, and the average DMF-T of dentulous was 25.0 (3.7) (D-T: 2.0 [3.1], M-T: 15.0 [8.3], F-T: 8.0 [7.4]); PSR®/PSI 3 and 4 (need for periodontal treatment) showed 79% of residents. In univariate analysis dementia (OR 2.5 CI95 1.1–5.6) but not being edentulous (OR 2.0 CI95 0.8–5.8) were associated with being at risk for malnutrition. Dementia remained associated in multivariate analysis adjusting for age and sex, (OR 3.1 CI95 1.2–8.2) and additionally being edentulous (OR 2.8 CI95 1.1–7.3) became associated significantly. Furthermore, nursing home residents with dementia had more remaining teeth (OR 2.5 CI95 1.1–5.9).ConclusionDementia was a stronger predictor for risk of malnutrition in nursing home residents than being edentulous. Further studies to elucidate the possible role of oral health as cofactor for malnutrition in dementia are needed.

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BackgroundAim of this single center cross-sectional study was to investigate oral behavior, dental, periodontal and microbiological findings in patients undergoing hemodialysis (HD) and after kidney transplantation (KT).MethodsPatients undergoing HD for end-stage renal failure and after KT were investigated. Oral health behavior was recorded using a standardized questionnaire, e.g. dental behavior, tooth brushing, oral hygiene aids. Oral investigation included screening of oral mucosa, dental findings (DMF-T) and periodontal situation (Papilla bleeding index [PBI] periodontal probing depth [PPD] and clinical attachment loss [CAL]). Additionally, microbiological analysis of subgingival biofilm samples (PCR) was performed. Statistical analysis: Student’s t-test or Mann–Whitney-U-test, Fisher’s exact test (α = 5 %).ResultsA total of 70 patients (HD: n = 35, KT: n = 35) with a mean age of 56.4 ± 11.1 (HD) and 55.8 ± 10.9 (KT) years were included. Lack in use of additional oral hygiene (dental floss, inter-dental brush) was found. KT group presented significantly more gingivial overgrowth (p = 0.01). DMF-T was 19.47 ± 5.84 (HD) and 17.61 ± 5.81 (KT; p = 0.21). Majority of patients had clinically moderate and severe periodontitis; showing a need for periodontal treatment of 57 % (HD) and 71 % (KT; p = 0.30). Significantly higher prevalence of Parvimonas micra and Capnocytophaga species in the HD group were found (p < 0.01).ConclusionPeriodontal treatment need and lack in oral behavior for both groups indicate the necessity of an improved early treatment and prevention of dental and periodontal disease, e.g. in form of special care programs. Regarding microbiological findings, no major differences between KT and HD patients were found.

Patients with RA had worse periodontal conditions than HC participants. Although a trend for higher F. nucleatum and P. gingivalis concentrations in aCCP-positive patients with RA was found, importance of periodontal pathogenic bacteria and rheumatoid parameters in the interrelationship between periodontitis and RA remains unclear.

Improvement in dental care of HD and KTx patients is required. OHIP G14 values provide a subjectively considered low importance of oral health in HD and KTx patients, leading to need of motivation and sensitisation of these patients.

This paper provides recommendations for dentists for the treatment of dental caries in children, with an emphasis on early childhood caries (ECC), primary teeth, and occlusal surfaces in permanent teeth. A consensus workshop followed by an e-Delphi consensus process was conducted with an expert panel nominated by the European Organization for Caries Research (ORCA) and European Federation of Conservative Dentistry (EFCD)/German Association of Conservative Dentistry (DGZ) boards. Based on 3 systematic reviews and a nonsystematic literature search, recommendations were developed. The caries decline has led to a more polarized disease distribution in children and adolescents along social gradients which should be taken into account when managing the caries process at all levels, such as the individual, the group, or a population. The control or reduction of caries activity is the basis for successful caries management. In children, caries management requires adequate daily oral hygiene and fluoride application via toothpaste, ensured by caregivers, and especially for ECC prevention an emphasis on sugar intake reduction is needed. These noninvasive interventions are also suitable to arrest or control initial or even cavitated dentine caries lesions in the absence of irreversible pulpitis. Fluoride varnish or silver diammine fluoride can be added as supplementary agents. In pits and fissures, composite resin materials can be used as preventive sealants and for defect-oriented minimally invasive restorations. In primary molars, preformed metal crowns are more successful than multisurface fillings, especially in caries-active patients. With persisting high caries activity, multiple lesions, and limited cooperation, caries control should consist of robust measures with high success rates, even including extraction in selected cases. This applies especially to treatments performed under general anesthesia.

The purpose of the present investigation was to compare the accuracy of treatment decisions in proximal sites using three intra–oral radiographic systems. Additionally, the impact of an automated non–linear grey–level display was evaluated. Ten observers assessed 84 surfaces on bitewing radiographs for their requirement of restorative treatment using a 6–rank confidence scale. Radiographs were taken with conventional film images (Ultraspeed), a storage phosphor plate (Digora) and a CCD system (Dexis). Additionally, the Dexis software was expanded by a contrast enhancement routine (Dexis+). The restorative treatment threshold was defined as presence of macroscopic cavitation. Regarding the areas below mean ROC curves no significant differences were detected between the groups (p>0.05). Likelihood ratios for positive test results were: 5.29 (Ultraspeed), 8.14 (Digora), 9.67 (Dexis) and 11.37 (Dexis+). The accuracy of restorative treatment decisions based on digital and conventional radiographs is comparable. If a dichotomous treatment decision was requested, the digital systems demonstrated a notable tendency towards higher likelihood of true–positive decisions.