Making a complex dental care tailored to the person: population health in focus of predictive, preventive and personalised (3P) medical approach

Abstract

An evident underestimation of the targeted prevention of dental diseases is strongly supported by alarming epidemiologic statistics globally. For example, epidemiologists demonstrated 100% prevalence of dental caries in the Russian population followed by clinical manifestation of periodontal diseases. Inadequately provided oral health services in populations are caused by multi-factorial deficits including but not limited to low socio-economic status of affected individuals, lack of insurance in sub-populations, insufficient density of dedicated medical units. Another important aspect is the “participatory” medicine based on the active participation of population in maintaining oral health: healthcare will remain insufficient as long as the patient is not motivated and does not feel responsible for their oral health. To this end, nearly half of chronically diseased people do not comply with adequate medical services suffering from severely progressing pathologies. Noteworthy, the prominent risk factors and comorbidities linked to the severe disease course and poor outcomes in COVID-19-infected individuals, such as elderly, diabetes mellitus, hypertension and cardiovascular disease, are frequently associated with significantly altered oral microbiome profiles, systemic inflammatory processes and poor oral health. Suggested pathomechanisms consider potential preferences in the interaction between the viral particles and the host microbiota including oral cavity, the respiratory and gastrointestinal tracts. Since an aspiration of periodontopathic bacteria induces the expression of angiotensin-converting enzyme 2, the receptor for SARS-CoV-2, and production of inflammatory cytokines in the lower respiratory tract, poor oral hygiene and periodontal disease have been proposed as leading to COVID-19 aggravation. Consequently, the issue-dedicated expert recommendations are focused on the optimal oral hygiene as being crucial for improved individual outcomes and reduced morbidity under the COVID-19 pandemic condition. Current study demonstrated that age, gender, socio-economic status, quality of environment and life-style, oral hygiene quality, regularity of dental services requested, level of motivation and responsibility for own health status and corresponding behavioural patterns are the key parameters for the patient stratification considering person-tailored approach in a complex dental care in the population. Consequently, innovative screening programmes and adapted treatment schemes are crucial for the complex person-tailored dental care to improve individual outcomes and healthcare provided to the population.

Characterization of oral and gut microbiome and plasma metabolomics in COVID-19 patients after 1-year follow-up

“…In the context of 3PM, accurate prediction and treatment based on key biomarkers are particularly important [24,25]. S1P, which is a signaling molecule, exerts multiple functions, including regulating the cytokine storm through its specific G protein-coupled receptors.…”

Sleep quality and COVID-19 outcomes: the evidence-based lessons in the framework of predictive, preventive and personalised (3P) medicine

“…As the generalised anti-COVID-19 prevention, the evidence-based periodontal healthcare is strongly recommended [ 5 ].…”

“…Diagnosed periodontitis is associated with high risk of admission to intensive care units and increased COVID-19-related death [ 88 ]. To this end, educational measures play a pivotal role, conducting principles of participatory medicine as an essential element of 3PM and promoting an active participation of patients in the treatment procedure and taking great responsibility for their health status [ 5 ].…”

“…To this end, 3PM knowledge towards the COVID-19 pandemic is regularly updated in the literature [1,2]. Unique research data towards individual outcomes in COVID-19-affected patient cohorts accompanied by potent predictive and preventive approaches have been presented and acknowledged as a great contribution of 3P medicine to the global challenge by COVID-19 [3][4][5].…”

Targeting phytoprotection in the COVID-19-induced lung damage and associated systemic effects—the evidence-based 3PM proposition to mitigate individual risks

“…optimal oral hygiene crucial for improved individual outcomes and reduced morbidity under the COVID-19 pandemic condition, anti-inflammatory medication, dual anti-microbial and anti-viral therapeutic effects as particularly effective for tertiary care to avoid severe complications linked to COVID-19 [4,[6][7][8].…”