Individuals who regularly visit a primary care provider (PCP) may not see a dentist, creating opportunities for PCPs to improve oral health. However, a lack of expertise among PCPs may limit their impact to improve public oral health. Using a non-systematic literature review, this article summarises the relevant literature about periodontitis. Periodontitis affects 10% to -15% of the world's population. Caused by bacterial inflammation in gingival pockets, periodontal disease can destroy tissues surrounding the teeth. Factors linked to periodontal disease include diabetes, atherosclerosis and smoking. Good oral hygiene is important for both prevention and treatment. Mechanical removal of gingival irritants by scaling and root planing combined with adjunctive antimicrobial therapy are first-line treatment options. Surgery is indicated when healthy levels of gingival tissue are not attained from first-line treatments. By understanding the fundamentals of periodontitis the primary care provider can educate patients, promote healthy oral health behaviours and appropriately refer patients with signs and symptoms of periodontal disease.

Background Oral and pharyngeal cancers (OPC) represent the seventh most common type of cancer and the seventh leading cause of deaths by cancer worldwide. Few studies have assessed the occupational exposure risks associated with OPC and in many cases the results are conflicting. The aim of this study was to determine, through a systematic review, the association of OPC and exposure to different occupational carcinogenic substances. Methods The addressed focused question was “Is there an association of occupational carcinogenic substances with OPC?” PubMed, MEDLINE, EMBASE, and ISI Web of Science databases were searched between January 1995 up to and including July 2016 using the keywords “oral cancer,” “pharyngeal cancer,” “pharyngeal neoplasms,” “oral neoplasms,” “occupational disease,” “occupational exposure,” and “occupational risk factor” in various combinations. Letters to the Editor, review articles, case reports, and unpublished articles were excluded. Results Fourteen original articles were included. Majority of the studies were conducted in European countries and used a case‐control design. The results showed a significant association between formaldehyde, wood dust, coal dust, asbestos, welding fumes, and risk of developing OPC, while marginal association was observed with metal and leather dust. No associated risk was observed for textile fibers. Conclusion There is some evidence to suggest associations of occupational substances with OPC, particularly in the pharynx. Future well‐designed studies are required to confirm or rule out with confidence the associated exposure risk of these substances.

Purpose One strategy for treating cancer is to prevent metastatic spread. Matrix metalloproteinase are considered potential targets for cancer therapy because of their role in degrading the extracellular matrix and fostering tumor progression. In some cancer models, the small molecule 1,2,3,4,6-Penta-O-galloyl-β-d-glucose (PGG) exhibited inhibitory properties against matrix metalloproteinase (MMP) related metastatic activity. This study explored whether PPG may limit the potential for metastatic spread in oral squamous cell carcinoma. Materials and methods This study used Cal-27 cells, a cell line derived from a squamous cell carcinoma line of human tongue origin, and antibodies for MMP-1,-2,-3,-9,-13, MT1-MMP signal transducers and activators of transcription 3 (Stat3), and pStat3. Cells were treated with PGG at different concentrations to evaluate MMP and Stat3 activation. Expansion assays were performed using Matrigel matrixes to measure Cal-27 invasiveness in the presence of PGG. Results PGG decreased the expression of MMP-2,-9 and-13 in the Cal-27 cell line, decreased phosphorylation of Stat3 and reduced gene expression of MMP-2,-9 and-13. As observed in Matrigel expansion assays, PGG limited the invasiveness of Cal-27 cells in a dose-dependent manner. Conclusion PPG is a small molecule inhibitor with the potential to reduce the expression of the matrix metalloproteinases and to limit the invasiveness of the squamous cell carcinoma line, Cal-27. By controlling the expression of molecules responsible for metastasis, PPG may offer a new therapeutic option for treating oral squamous cell carcinoma.

This study assessed the longitudinal impact of early preventive dental visits on the number of dental operative procedures in a prevention-oriented pediatric dental practice. Inclusion criteria consisted of patients zero to four years of age with at least two years of preventive services provided by the practice. Early preventive visits were the intervention and dental operative procedures were the assessed outcome. The goal was to determine if preventive visits at an early age decreased the number of operative procedures needed by the patient. The patients were divided into two groups: those with older siblings in the practice and those without older siblings in the practice. A secondary outcome was to compare these two patient groups to determine if a child who had older siblings previously treated in this preventive practice had better outcomes than those without siblings in the practice. ANCOVA tests were used to compare the average number of operative procedures in two age groups (<2 years and ≥2 years), and for those with and without dental insurance, in addition to children being younger sibling versus children without sibling, adjusting for the effect of covariates. The study sample consisted of 363 pediatric patients. Patients’ age at first visit ranged from 0 to 4 years old (mean = 2.13; SD = 1.15). The average number of operative procedures per year increased as the age at first visit increased (p < 0.05). The average number of operative procedures in two age groups (<2 years and ≥2 years) differed (p < 0.05) with those whose age at first visit ≥2 years experiencing more dental operative procedures than the younger group. The average number of operative procedures was similar between younger siblings (mean = 1.91; SD = 7.44) and children without siblings (mean = 1.54; SD = 2.1) (p > 0.05). The difference in the average number of operative procedures in children with insurance (mean = 1.59; SD = 5.25) and children without insurance (mean = 1.58; SD = 2.38) was non-significant (p > 0.05). More dental cleaning examinations were associated with fewer dental operative procedures (p < 0.05). These findings demonstrate that dental examinations before two years of age and more dental cleaning examinations lead to a decrease in the number of dental operative procedures needed by children.

Background Despite controversy over their possible health consequences, manufacturers of e-cigarettes employ a variety of marketing media to increase their popularity among adolescents. This study analyzed the relationship between adolescent e-cigarette harm perception and five types of e-cigarette advertising exposures: social media, radio, billboard, newspaper, and television. Methods This study used data from Wave 4.5 of the Population Assessment of Tobacco and Health Study (PATH). PATH collects demographic data and interview individuals about issues pertaining to tobacco use, health outcomes, attitudes, and behaviors. This study applied factor analysis to three individual PATH harm perception items to develop a composite harm perception score. Using linear regression, the study explored the relationship of harm perception and participant responses to their recalled viewing of five different types (i.e., newspaper, radio, billboard, television and social media) of advertisements within the past 30 days. A second analysis explored if adjusting for exposure to anti-tobacco messaging and environmental factors such as family approval mitigated the association of harm perception and advertisement types. Results The study sample consisted of 12,570 (weighted N = 23,993,149) individuals aged 12 to 17 years old. Unadjusted past 30-day exposure to newspaper, radio, billboard, and social media advertising all correlated with a reduced harm perception, but only the associations for newspaper and social media were statistically significant (p<0.05). After adjusting for environmental support factors, exposure to warning labels, and anti-tobacco advertisements, the analysis yielded statistically significant associations between increased e-cigarette harm perception and exposure to radio, billboard, and television advertisements (p<0.05). Adjusting for covariates also reduced the association of marketing and harm perception for all forms of media. Conclusion E-cigarette advertising influences adolescent perceptions of harm in e-cigarette use, particularly for social media and newspaper advertisements. This association weakens when adjusted for covariates such as environmental support and exposure to anti-tobacco marketing. These findings provide evidence for policy makers to continue anti-tobacco marketing and incorporate environmentally supportive strategies such as holistic, family-centered educational approaches to reduce e-cigarette use among adolescents.

Introduction The 21st century was marked by a dramatic increase in adolescent e-cigarette use in the United States (US). The popularity of non-traditional flavor types, including fruit and pastry, is thought to contribute toward growing product use nationally, leading to a variety of federal and state regulations limiting the use of non-traditional flavors in the US. The relationship between flavor type and increased adolescent use suggests a possible link between flavor use and addiction and harm perception. This study assessed if the flavor type used when initiating e-cigarette use predicted addiction and harm perceptions. Methods The study utilized data from the multi-wave youth Population Assessment of Tobacco Health Study. It explored the impact initiating e-cigarette use with traditional versus non-traditional flavor types among cigarette users on the outcome variables: e-cigarette addiction and harm perception. Both e-cigarette addiction and harm perception were measured using self-report, Likert scale questionnaires. Descriptive statistics characterized the study variables and linear regression analyses performed to test whether flavor initiation type is associated with addiction and harm perception. Results The study sample consisted of 1,043 youth (weighted N = 1,873,617) aged 12 to 17 years who reported at least one instance of e-cigarette use. After adjusting for age, age of onset, sex, race and annual household income there was no statistically significant difference in addiction levels between those initiating with traditional versus non-traditional flavors (p = 0.294). Similarly, traditional versus non-traditional flavor initiation did not show a statistically significant difference in adolescent e-cigarette harm perceptions (p = 0.601). Conclusions Traditionally flavored e-cigarette initiation produces similar risk for addiction and harm perceptions as non-traditionally flavored initiation. These findings suggest that banning non-traditional flavors alone may be ineffective in curbing e-cigarette addiction and harm perception. Additional research is needed to better understand which e-cigarette product characteristics and behaviors may be associated with greater addiction and reduced harm perceptions.

Defects within the long bones of patients from serious complications can carry extensive damage. The design and implantation of a biofabricated biocompatible implant into the nonunion plays an important role in promoting bone and vasculature. Microcomputed tomography (micro‐CT) is a fundamental apparatus for evaluating biomaterial‐osteo remodeling and regeneration. It can provide information about the biocompatibility of an implant as well as the 3D microarchitecture and distribution of tissue in the region of interest (ROI). This study was performed to evaluate the in vivo biocompatibility, and osseointegration of novel biofabricated graphene‐based scaffolds. Two scaffold iterations of poly (lactic‐co‐glycolide) (PLGA) [Mix 1 ‐ 50:50+65:35] and [Mix 2 50:50+75:25] were blended with two forms of graphene. A 5mm segmental femur defect created in 6‐8 week old female Sprague Dawley rats was used as the test model. Defects were monitored radiographically at days 7, 14, 21, 30 and 60. Rats were sacrificed at 60 days post‐treatment and their femurs were harvested for micro‐CT and histological analyses. Micro‐CT provided visualization of full femur prior to histology and helped to define ROI which facilitated proper orientation for sectioning. Subsequently, the bone volume to tissue volume ratios for each bone were compared at four different thresholds in order to capture the new trabecular and cortical bone throughout the defect. All of the rats were weight bearing within 3 days of surgery. Evaluation of the decalcified samples using hematoxylin/eosin and Masson Trichrome staining demonstrated healthy osseointegration of the implant with the natural tissue. There was no evidence of any adverse reaction at the surgery site, confirming the in vivo biocompatibility of the polymer and the nanoparticles. This study demonstrates that implants fabricated with blended PLGA polymers containing graphene‐based nanoparticles can be used safely in weight‐bearing rodent bone defects. Implants can be used to deliver mesenchymal stem cells and growth factors as therapeutic modalities.