Depression is a common disorder among the elderly; however, it is not a standard element of the ageing process. Depression can affect oral health as a result of neglecting oral hygiene procedures, cariogenic nutrition, avoidance of necessary dental care which leads to an increased risk of dental caries and periodontal disease.Assessment of the relationship of oral health parameters with depression.500 subjects aged ≥65 (mean 74.4 ± 7.4) were involved in the study. Dental condition (decay-missing-filled index [DMFT], number of missing teeth [MT], removable denture wearing, teeth mobility), periodontal condition (bleeding on probing [BoP], pocket depth [PD], loss of attachment), oral dryness (the Challacombe Scale) and depression according to the Patient Health Questionnaire-9 (PHQ-9) scale were assessed.Depression on a minimal level was detected in 60.2% of the subjects, mild—in 22.2%, moderate—in 6.0% and moderately—in 2.6%. The mean of the PHQ-9 scale was 3.56 ± 4.07. Regression analysis showed a positive relationship of the PHQ-9 value with DMFT, the number of MT, oral dryness and with age. No correlation was observed between other examined oral health indicators, such as periodontal condition (BoP, PD, clinical attachment level), periodontitis, removable denture wearing a PHQ-9.The results of our study have shown that among people aged 65 and over, the severity of depression increases with a higher number of MT, the number of decayed teeth, as well as prevalence of oral dryness.

Background. diabetes is a metabolic disease characterized by hyperglycemia, which results from relative or absolute insulin deficiency. One of the first oral symptoms of diabetes is xerostomia. Objectives. The aim of the study was to determine the prevalence of the xerostomia symptoms and salivary flow rate in diabetic patients according to the type of diabetes, the level of metabolic control and the duration of the disease. Material and Methods. The study involved 156 adult patients of both sexes including 34 patients with diabetes type 1 (group C1), 59 with diabetes type 2 (group C2), and 63 generally healthy individuals as two control groups, sex-and age-matched to the diabetic group. The patients suffering from both types of diabetes were additionally subdivided according to the level of metabolic control and the duration of the disease. Xerostomia was diagnosed with the use of a specially prepared questionnaire and fox's test. Moreover, the salivary flow rate of resting mixed saliva was measured. Results. In type 1 diabetics, a significantly lower salivary flow rate in comparison to the age-matched control group (0.38 ± 0.19 mL/min vs. 0.53 ± 0.20 mL/min, p < 0.01) was found. However in type 2 diabetics, a slight lower salivary flow rate was noticed (on average, 20% lower). dry mouth was far more frequently diagnosed in type 1 diabetics than in the control group. Conclusions. In type 1 diabetics, in comparison to healthy subjects, a significantly lower resting flow rate of saliva and significantly higher prevalence of xerosomia were observed, but in type 2 diabetics, only a trend of such variability was observed (Adv Clin Exp Med 2014, 23, 2, 225-233).

Diabetes mellitus (DM) is a group of metabolic diseases resulting from impaired insulin secretion and/or action. DM is characterized by hyperglycemia that can lead to the dysfunction or damage of organs, including the salivary glands.The aim of this study was to compare the levels of salivary lactate dehydrogenase (LDH), aspartate aminotransferase (AST), and alanine aminotransferase (ALT) in diabetic patients.The study was approved by the Bioethics Committee of Wroclaw Medical University (Poland). The study comprised 90 adults of both sexes, aged 21 to 57 years. The patients were divided into 3 groups: type 1 diabetics (D1), type 2 diabetics (D2), and a healthy control group (C). Each group consisted of 30 age- and sex-matched subjects. Total protein (P, by Lowry method), LDH, AST, ALT (with Alpha Diagnostics kits), and salivary flow rate were measured in unstimulated mixed saliva. The level of glycosylated hemoglobin (HbA1c) was measured with DCA 2000 Reagent Kit. The obtained data were analyzed using the Mann–Whitney U test and the Spearman rank at a significance level of P < 0.05 with the use of STATISTICA 9.0 software.In comparison with C, D1 presented a significantly higher activity of LDH (P < 0.001), AST (P < 0.001), and ALT (P < 0.01), whereas D2 indicated higher levels of LDH (P < 0.001) and ALT (P < 0.05) compared with C. Comparing D1 to D2, approximately 3-fold higher activity of AST (P < 0.01) and approximately 4.5-fold higher activity of ALT (P < 0.01) was observed.Higher levels of salivary LDH, AST, and ALT in D1 compared with D2 and C confirm that salivary glands of D1 might be attributed to autoimmunological damage associated with the pathomechanism of DM.

Introduction: Antimicrobial resistance has been one of the biggest global concerns.Dentists constitute an important group of antibiotic prescribers, and it was shown that their therapeutic decisions are not always rational. In this paper, we present knowledge of antibiotics prescription rules and antimicrobial resistance amongst graduating dentistry students from all dentistry faculties of medical universities in Poland, who will soon join the group of antibiotics prescribers. Materials and methods:A questionnaire consisting of 28 questions was developed.The survey was conducted in May-June 2015. Results:The study group comprised a total of 752 students. About 54% expressed the opinion that dentists overprescribe antibiotics. One-tenth thought that they can be used for the treatment of flu (7%) and common cold (11%). Respondents pointed to amoxicillin (46%) and clindamycin (44%) as the first-choice treatment of dentoalveolar abscess, if medically indicated. More than half of the students (58%) suggested using doxycycline and metronidazole in aggressive periodontitis in an individual allergic to penicillin. The vast majority of students (97%) indicated that penicillins and cephalosporins were suitable for treatment of dental infections in pregnant women.

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Background. The Oral Health Impact is an example of a specific questionnaire used for assessing the quality of life in relation to oral health. Objectives. The aim of this study was to validate the Polish version of the original English Short-Form OHIP-14 questionnaire. Material and Methods. The Polish version of the OHIP-14 instrument had been prepared in accordance with generally accepted standards. The main study was conducted among a group of 150 subjects of both genders, aged from 35 to 91 who were randomly selected. Statistical analysis was made by STATISTICA software using the Cronbach alpha reliability test, Mann-Whitney U test, multiple comparison post-hoc test -LSD and Spearman`s correlation coefficient. Results. The total OHIP-14 score was 8.72 ± 13.39, out of which the highest value was for item 4 (uncomfortable to eat 0.89 ± 1.19). The value of the alpha Cronbach coefficient was above 0.9 for all 14 items of the OHIP-14 instrument indicating excellent internal consistency. Positive relationships between all items of the matrix of the inter-items correlation coefficients were found. The value of coefficients ranged from 0.56 to 0.90 at a significance level of p < 0.01. Construct validity was supported by the fact that oral health condition was correlated with total OHIP score. It was observed that there is a correlation between the quality of life evaluated with the OHIP-14 test and dental condition, dental needs, wearing removable dentures and self-assessment of general health and oral health condition. Conclusions. The obtained data indicated the reliability and validity of OHIP-14 instrument for the assessment of oral health-related quality of life for in Polish adult population (Adv Clin Exp Med 2015, 24, 1, 129-137).

PurposeDental anxiety is a common phenomenon influencing the relationship between a patient and a doctor as well as the course of treatment. The aim of the study was to assess the oral health status and hygienic habits among adult patients with respect to their level of dental anxiety.Material and methodsIn the study we included 117 consecutive adult patients referred to the Department of Conservative Dentistry and Pedodontics of Wroclaw Medical University. There were 58 women (49.57%) and 59 men (50.43%). The mean age of the patients was 36.57±16.76 years. The level of dental anxiety was assessed by Modified Dental Anxiety Scale (MDAS). To evaluate dental health status and oral hygiene the following indices were used: total number of decayed, missing and filled teeth (DMF/T) as well as surfaces (DMF/S), Approximal Plaque Index (API), Oral Hygiene Index (OHI) - Debris Index (DI) and Calculus Index (CI).ResultsThe higher was the level of dental anxiety measured by MDAS, the lower was the number of filled teeth (F/T) and the number of filled dental surfaces (F/S) and the higher was the Calculus Index (CI). There was no significant difference between dental anxiety measured by MDAS and age, gender or level of education; however, smokers had significantly higher anxiety level than non-smokers.ConclusionsDental anxiety has disadvantageous influence on oral health status. Low dental and periodontal health status may have many somatic as well as psychosocial consequences, both lowering quality of life of the patient.

Background The study aims to evaluate the impact of socioeconomic status, general health and oral health parameters on Health-Related Quality of Life (HRQoL), Oral Health-Related Quality of Life (OHRQoL) and mental health in elderly urban residents of South-Western Poland. Methods The 500 residents of Wroclaw, aged 65 and older provided demographic and personal information as well as their medical history. A patient's oral condition were determined based on the clinical oral examination.Quality of Life was assessed using Euro-Quality of Life (EQ-5D), Oral Health Impact Profile-14 (OHIP-14) and Patient Health Questionnaire (PHQ-9).The association between exposure (socioeconomic status, general health and oral health) and outcome (HRQoL, OHRQoL and mental health variables) were analyzed with the use of four models: P – Poisson model, NB-Negative Binomial model, ZIP – Zero Inflated Poisson model, ZINB – Zero Inflated Negative Binomial model. Results The best model turned out to be the ZINB model, in which a negative binomial distribution in the count equation is assumed. In this model, only 13 independent variables had a significant effect on HRQoL, OHRQoL, and mental health. HRQoL assessed with the EQ-5D is significantly influenced by: living conditions 0.133 (95% CI: 0.001, 0.267, p = 0.049), income -0.348 (95%CI: -0.466, -0.230, p < 0.001), diabetes mellitus 0.437 (95%CI: 0.250, 0.624, p < 0.001), myocardial infarction 0.454 (95% CI: 0.151, 0.757, p = 0.003), stroke 0.543 (95%CI: 0.094, 0.992, p = 0.018) and renal disease 0.466 (95% CI: 0.206, 0.726, p < 0.001). Factors negatively affecting OHRQOL are: the need for oral treatment 0.278 (95%CI: 0.104, 0.452, p = 0.002), the number of missing teeth 0.053 (95%CI: 0.039, 0.067, p < 0.001) and gender 0.271 (95%CI: 0.015, 0.527, p = 0.038) and age -0.025 (95%CI: -0.042, -0.008, p = 0.003). An important factor influencing the level of depression assessed by the PHQ-9 questionnaire may be the material condition -0.225 (95%CI: -0.349, -0.101, p < 0.001). It should be emphasized that living with other people may be a factor that significantly increases the probability of avoiding the occurrence of depression symptoms. Conclusion The study concerning elderly residents of the macroregion in Poland found the impact of socioeconomic, general health and oral health parameters on Health-Related Quality of Life, Oral Health-Related Quality of Life and mental health. Research on the quality of life of the elderly at the local level allowed to assess the factors linked to quality of life of older adults.