| 1. |
- Sayols-Baixeras, Sergi, et al.
(author)
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Streptococcus Species Abundance in the Gut Is Linked to Subclinical Coronary Atherosclerosis in 8973 Participants From the SCAPIS Cohort
- 2023
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In: Circulation. - : American Heart Association. - 0009-7322 .- 1524-4539. ; 148:6, s. 459-472
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Journal article (peer-reviewed)abstract
- BACKGROUND: Gut microbiota have been implicated in atherosclerotic disease, but their relation with subclinical coronary atherosclerosis is unclear. This study aimed to identify associations between the gut microbiome and computed tomography–based measures of coronary atherosclerosis and to explore relevant clinical correlates.METHODS: We conducted a cross-sectional study of 8973 participants (50 to 65 years of age) without overt atherosclerotic disease from the population-based SCAPIS (Swedish Cardiopulmonary Bioimage Study). Coronary atherosclerosis was measured using coronary artery calcium score and coronary computed tomography angiography. Gut microbiota species abundance and functional potential were assessed with shotgun metagenomics sequencing of fecal samples, and associations with coronary atherosclerosis were evaluated with multivariable regression models adjusted for cardiovascular risk factors. Associated species were evaluated for association with inflammatory markers, metabolites, and corresponding species in saliva.RESULTS: The mean age of the study sample was 57.4 years, and 53.7% were female. Coronary artery calcification was detected in 40.3%, and 5.4% had at least 1 stenosis with >50% occlusion. Sixty-four species were associated with coronary artery calcium score independent of cardiovascular risk factors, with the strongest associations observed for Streptococcus anginosus and Streptococcus oralis subsp oralis (P<1×10–5). Associations were largely similar across coronary computed tomography angiography–based measurements. Out of the 64 species, 19 species, including streptococci and other species commonly found in the oral cavity, were associated with high-sensitivity C-reactive protein plasma concentrations, and 16 with neutrophil counts. Gut microbial species that are commonly found in the oral cavity were negatively associated with plasma indole propionate and positively associated with plasma secondary bile acids and imidazole propionate. Five species, including 3 streptococci, correlated with the same species in saliva and were associated with worse dental health in the Malmö Offspring Dental Study. Microbial functional potential of dissimilatory nitrate reduction, anaerobic fatty acid β-oxidation, and amino acid degradation were associated with coronary artery calcium score.CONCLUSIONS: This study provides evidence of an association of a gut microbiota composition characterized by increased abundance of Streptococcus spp and other species commonly found in the oral cavity with coronary atherosclerosis and systemic inflammation markers. Further longitudinal and experimental studies are warranted to explore the potential implications of a bacterial component in atherogenesis.
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| 2. |
- Alrebdi, Abdulaziz, et al.
(author)
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Efficacy of fluoride varnish in treating orthodontically-induced white spot lesions : a systematic review and meta-analysis
- 2021
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In: Australasian Orthodontic Journal. - : Australian Society of Orthodontists. - 2207-7472 .- 2207-7480. ; 37:2, s. 147-156
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Research review (peer-reviewed)abstract
- Objectives: To systematically review the effectiveness of 5% sodium fluoride varnish (FV) in the treatment of orthodontically-induced white spot lesions (WSLs). Methods: A literature search of three independent databases (Medline, Cochrane Library and Web of Science) was performed from inception to November 2020. This systematic review included randomised/quasi-randomised clinical trials (RCTs) that used FV for patients who had at least one WSL as a result of fixed orthodontic treatment. Exclusion criteria were split-mouth study designs or studies that failed to report WSLs as the outcome variable or studies with less than 3 months follow-up. An Inverse Variance fixed-effect method was performed for continuous variables. Changes in the mean difference (MD) for the DIAGNOdent (DD) scores following FV application were calculated at the 95% confidence interval (CI). Results: Three of the four included studies showed significant improvement in the remineralisation of WSL after treatment with FV in comparison to control subjects. Three studies were conducted on patients after fixed orthodontic treatment and one study was conducted during treatment. The studies included a total of 284 participants with the majority in the age range of 10 to 25 years. The distribution of the participants was approximately equal in the FV and control group. When compared with the control group, there was a statistically significant reduction in the mean DD readings for the FV group at the 3-month (MD=-3.43; 95% CI:-4.72 to-2.15; p < 0.001) and at the 6-month (MD =-4.47; 95% CI:-4.72 to-2.15; p < 0.001) follow-up visit. Conclusions: Although few studies have shown the effectiveness of FV application in the treatment of orthodontically-induced WSLs, the limited number of robust clinical trials, makes it difficult to draw a definitive conclusion. (Aust Orthod J 2021; 37: 147 156. DOI: 10.21307/aoj-2021-016)
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| 3. |
- Alsuhaibani, Fatimah, et al.
(author)
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Risk Factors for Dental Erosion After Bariatric Surgery : A Patient Survey
- 2021
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In: International Dental Journal. - : Elsevier. - 0020-6539 .- 1875-595X. ; 72:4, s. 491-498
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Journal article (peer-reviewed)abstract
- INTRODUCTION: Treatment of obesity by bariatric surgery has increased in recent years. Reported side effects that may predispose to dental erosion include reflux, vomiting, and an increased frequency of intake of food and drink.OBJECTIVE: The aim was to investigate long-term dietary behaviour and experiences related to symptoms of dental erosion at least 5 years after bariatric surgery.METHODS: An online questionnaire study was conducted amongst 250 patients who had undergone bariatric surgery at King Saud Medical City in Saudi Arabia 5 years ago or more. It comprised 36 questions on demographic data, dietary habits, general health, dental health, and oral symptoms. The data were analysed using Chi-square and sign tests (significance level P < .05).RESULTS: A significant increase in acidic reflux and vomiting was found after bariatric surgery and appeared to increase with time after surgery. Also, a significant association between presence of acidic reflux and symptoms of dental erosion was found. However, 68.5% reported improved overall well-being after surgery. The response rate was 21.6% (most were female, aged 30-59 years). Respondents were generally not advised to visit a dentist in connection with bariatric surgery.CONCLUSIONS: This long-term cross-sectional study suggests a time-dependent, increasing occurrence of vomiting and acidic reflux after bariatric surgery. Vomiting and reflux became even more common after 5 to 10 years. A significant relationship emerged between a high frequency of acidic reflux and a high frequency of oral symptoms related to dental erosion. Daily occurrence of general symptoms related to dumping syndrome were reported by the majority. However, in a 5- to 10-year perspective, general symptoms related to dumping syndrome and symptoms from dental erosion did not seem to detract from the respondents' overall satisfaction with daily living. Oral health problems might be reduced if patients who had bariatric surgery were referred to a dentist for prevention and monitoring.
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| 4. |
- Ericson, Dan, 1953-, et al.
(author)
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Effect of a single application of silver diamine fluoride on root caries after 12 months in institutionalised older adults-A randomised clinical trial
- 2022
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In: Gerodontology. - : Wiley. - 0734-0664 .- 1741-2358.
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Journal article (peer-reviewed)abstract
- ObjectiveSilver diamine fluoride (SDF) has been shown to be highly effective against caries, in particular for arresting root surface caries and for dentine caries in primary teeth. SDF may complement fluoride varnish routines for treatment of root caries in nursing home residents. The aim of this randomised, single-blinded, placebo-controlled trial was to evaluate the additive effect of a single annual application of SDF for prevention and treatment of incipient root caries in older adult nursing home residents. MethodFour hundred older adult nursing home residents (>= 70 years old) with at least one exposed root surface (on teeth 15, 14, 13, 23, 24, or 25) were identified during routine dental examination visits in the domiciliary dental care setting. Eligible patients, who were able to understand the implication of consenting to the study, were invited to participate. Their cleaned root surfaces were randomly allocated to treatment with SDF (Advantage Arrest Silver Diamine Fluoride 38%, Advantage Arrest, LLC, Redmond, OR 97756, USA, Lot 16 152) or with placebo (tap water), each for 1 minute. ResultsOf the 400 eligible individuals, 42 declined to participate and two forms were destroyed. The remaining 356 participants (89.0%; mean age 87.7 years) were randomly allocated, with 174 going to the SDF group and 182 to the placebo group. At 1 year, 273 participants (76.7%) were available for assessment: 135 in the SDF group and 138 in the placebo group. By that time, 109 individuals (39.9%) demonstrated root caries progression or regression. Among those 118 (16.7%) of the 708 included root surfaces had developed caries There were no statistically significant differences in the primary outcome related to treatment with SDF or placebo, at either patient or root surface level. ConclusionBased on the finding of this clinical trial, it is concluded that a single SDF application to complement a risk-based preventive programme including fluoride varnish applications did not have a statistically significant additional preventive effect on root caries development in a group of older adult nursing home residents with limited caries activity and cognitive capacity to cooperate in oral care activities.
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| 5. |
- Ericson, Dan, 1953-, et al.
(author)
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Response to professor Milgrom
- 2023
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In: Gerodontology. - : John Wiley & Sons. - 0734-0664 .- 1741-2358. ; 40:3, s. 407-407
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Journal article (peer-reviewed)
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| 6. |
- Larsson, Kerstin, 1965-, et al.
(author)
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Salivary fluoride concentration and retention after rinsing with 0.05 and 0.2% sodium fluoride (NaF) compared with a new high F rinse containing 0.32% NaF
- 2020
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In: Acta Odontologica Scandinavica. - : Taylor & Francis. - 0001-6357 .- 1502-3850. ; 78:8, s. 609-613
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Journal article (peer-reviewed)abstract
- OBJECTIVE: To compare salivary fluoride (F) concentration and F retention after rinsing with a new 0.32% sodium fluoride (NaF) rinse and conventional 0.05 and 0.2% NaF rinses.METHODS: Seventeen subjects (aged 22-26 years), with normal salivary secretion rates, participated in a double blind, cross-over study. In three separate sessions with a minimum washout period of 48 h, they rinsed for 1 min with 10 ml of 0.05, 0.2 or 0.32% NaF mouthrinse. Unstimulated whole saliva was collected before (baseline: 0 min) and after 1, 3, 5, 10, 20, 30, 45 and 60 min. The F concentration was plotted against time, and the area under the curve (AUC) calculated. Salivary F concentration and F retention for the three mouthrinses were compared by a randomized block test, followed by Tukey's test and a paired 2-tailed test.RESULTS: < .05).CONCLUSIONS: The higher salivary F concentration over time and the higher F retention after rinsing with an 0.32% NaF solution suggests a potential application in prevention of caries and dental erosion.
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| 7. |
- Nordström, Marie, et al.
(author)
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Common resilience factors among healthy individuals exposed to chronic adversity : a systematic review
- 2023
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In: Acta Odontologica Scandinavica. - : Taylor & Francis. - 0001-6357 .- 1502-3850. ; 81:3, s. 176-185
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Research review (peer-reviewed)abstract
- Objective: To identify common resilience factors against non-communicable diseases (dental caries, diabetes type II, obesity and cardiovascular disease) among healthy individuals exposed to chronic adversity.Materials and methods: The databases MEDLINE (via PubMed), Scopus and CINAHL were searched. Observational studies in English assessing resilience factors among populations living in chronic adversity were included. Intervention studies, systematic reviews, non-original articles and qualitative studies were excluded. There were no restrictions regarding publication year or age. No meta-analysis could be done. Quality assessments were made with the Newcastle-Ottawa scale (NOS).Results: A final total of 41 studies were included in this systematic review. The investigated health resilience factors were divided into the following domains: environmental (community and family) and individual (behavioural and psychosocial). A narrative synthesis of the results was made according to the domains.Conclusions: Individual psychosocial, family and environmental factors play a role as health resilience factors in populations living in chronic adversity. However, the inconclusive results suggest that these factors do not act in isolation but interplay in a complex manner and that their interaction may vary during the life course, in different contexts, and over time.
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| 8. |
- Nordström, Marie, et al.
(author)
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Karies : världens vanligaste icke smittsamma sjukdom
- 2024
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In: Läkartidningen. - 0023-7205 .- 1652-7518. ; 121
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Journal article (peer-reviewed)abstract
- More than 2.8 billion individuals worldwide suffer from untreated caries. Over ninety-five percent of all 50-year-olds in Sweden have caries experience. Caries is the most common cause of dental restorations and tooth loss. Tooth loss is associated with cardiovascular diseases, dementia, and death. Periapical tooth infections caused by caries can spread and cause severe infection, however rarely with lethal outcome. Sugars are a common risk factor for caries and other noncommunicable diseases such as cardiovascular diseases, diabetes, and obesity. Caries is a consequence of sugar-provoked acid production and dysbiosis in the tooth biofilm (dental plaque). There are several conditions which may increase the risk for dental caries, such as different medical conditions and medications which may cause dry mouth. Treatment costs for caries are high.
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| 9. |
- Nordström, Marie, et al.
(author)
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Some young adults can maintain good oral health despite socioeconomic challenges
- 2024
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In: European Journal of Oral Sciences. - : Wiley-Blackwell. - 0909-8836 .- 1600-0722. ; 132:3
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Journal article (peer-reviewed)abstract
- The association between dental caries experience and socioeconomic status, as reflected in income and educational level, is well known. However, some individuals maintain good health despite socioeconomic disadvantage. The aim of this qualitative study was to explore salutogenic (health-promoting) factors among healthy caries-free young adults of low socioeconomic status. Seventeen participants (11 women), 19–23 years of age, who were caries-free and of low socioeconomic status were interviewed in-depth. The interviews were transcribed verbatim and analysed using qualitative content analysis with an inductive approach. The theme revealed was ‘Building trust and shifting responsibility from parent to child throughout children's development lays the salutogenic foundation for oral health’, comprising three categories: (i) a basis for health; (ii) creating one's own path by testing wings; and (iii) developing resources for health. A feeling of trust was expressed, participants were confident in the unconditional support of their caregivers, and caregivers were trusting participants to be able to take control over their own oral health. Health-promotive factors were established not only by instilling healthy habits during childhood, but also by parental guidance through adolescence, enabling young adults to develop resources and assets to take control over their own health independently.
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| 10. |
- Shmarina, Elena, et al.
(author)
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Dental professionals' perception of their role in the practice of oral health promotion : a qualitative interview study
- 2023
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In: BMC Oral Health. - : BioMed Central (BMC). - 1472-6831. ; 23:1
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Journal article (peer-reviewed)abstract
- ObjectiveTo explore dental professionals’ perceptions of their role in the practice of oral health promotion.Material and methodIn-depth interviews were conducted with three dentists, one specialist dentist and seven dental hygienists. All were employed in the public dental service in Kalmar County, Sweden and had at least two years’ work experience. The interview questions addressed the experience and views of dental professionals with reference to their role in the practice of health promotion. The interview data were subjected to qualitative content analysis.ResultsAnalysis revealed two themes which capture the essence of the dental professionals’ perception of their role in the practice of oral health promotion. One theme, having person-focused approach, comprised four categories: ‘considering the patient’s life situation’, ‘establishing a trusting relationship with patients’, ’strengthening patients’ commitment to oral health’ and ‘health education’. The other theme, perceiving social responsibility for oral health, comprised three categories: ‘dissemination of oral health knowledge’, ‘interprofessional collaboration’ and ‘equality in oral health care’.ConclusionDental professionals perceived promotion of oral health to be an important aspect of their professional role. They aspired to patient participation in the decisionmaking process and educational activities, as well as practising and evaluating skills development. Although the dental professionals perceived that they undertook health promotion activities, they did not clearly distinguish between oral health promotion and disease prevention. There was intra- and interprofessional agreement among the dentists and dental hygienists with respect to expected outcomes for health promotion activities.
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| 11. |
- Shmarina, Elena, et al.
(author)
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Exploring salutogenic factors supporting oral health in the elderly
- 2022
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In: Acta Odontologica Scandinavica. - : Taylor & Francis. - 0001-6357 .- 1502-3850. ; 80:4, s. 241-251
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Journal article (peer-reviewed)abstract
- Aim To explore associations between salutogenic factors and selected clinical outcome variables of oral health in the elderly, combining Antonovsky's salutogenic theory and the Lalonde Health Field concept. Methods The subjects comprised 146 individuals, aged 60 years and older, who had participated in a population-based epidemiological study in Sweden, 2011-2012, using questionnaire and oral examination data. A cross-sectional analysis used the selected outcome variables, such as number of remaining teeth, DMFT-index and risk assessment, and salutogenic factors from the questionnaire, clustered into domains and health fields, as artifactual-material, cognitive-emotional and valuative-attitudinal. This selection was based on findings from our previous analysis using a framework cross-tabulating two health models. The purpose was to facilitate analysis of associations not previously addressed in the literature on oral health. Bivariate and Multiple Linear Regression analyses were used. Results Numerous salutogenic factors were identified. Significant associations between outcome variables and salutogenic factors previously unreported could be added. Regression analysis identified three contributing independent factors for 'low DMFT'. Conclusions This study supports the usefulness of a salutogenic approach for analysing oral health outcomes, identifying university education, the importance of dental health organization recall system and close social network, as important salutogenic factors. The large number of salutogenic factors found supporting oral health among the elderly indicates the complexity of salutogenesis and the need for robust analysing tools. Combining two current health models was considered useful for exploring these covariations. These findings have implications for future investigations, identifying important research questions to be explored in qualitative analyses.
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| 12. |
- Shmarina, Elena
(author)
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Oral health-related salutogenic factors : reviewing factors promoting oral health in older people and exploring dental professionals' perspective
- 2023
-
Doctoral thesis (other academic/artistic)abstract
- The overarching aims of this thesis were to study oral health-related salutogenic factors among older people and explore dental professionals’ perceptions of their role in the practice of oral health promotion.Study I was an integrative review describing salutogenic factors reportedly associated with oral health and oral health-related quality of life in older people. A framework for identifying salutogenic factors, combining two theories of health, was developed. 58 papers were included in the review and 77 salutogenic factors were identified. However, there is a lack of studies with specific reference to salutogenic factors among older people.Study II was a cross-sectional study based on data for patients 60 years or older derived from a previous population-based epidemiological study. Several significant associations between outcome variables and salutogenic factors were identified. Of those, 13 previously unreported salutogenic factors could be added to the framework developed in Study I.Studies III and IV were qualitative interview studies using in-depth interviewsfor data collection and qualitative content analysis methodology for data analysis.Study III focused on exploring salutogenic factors related to oral health in twelve orally healthy patients 75 years or older. The findings highlighted the importance of patients’ internal resources, dental professionals, family, and society in supporting and reinforcing lifelong oral health.Study IV focused on exploring dental professionals’ perceptions of their role in the practice of oral health promotion and included eleven dentists and dental hygienists. The participants perceived promotion of oral health to be an important aspect of their professional role. They aspired to patient participation in the decision-making process and educational activities, as well as practicing and evaluating skills development.In conclusion, there is a need for consistency in definition of outcomes measures and hypothesis-driven research within salutogenic research in oral health field. The large number of salutogenic factors found supporting oral health among older people indicates the complexity of salutogenesis and the need for robust analyzing tools. Combining two theories of health was useful for exploring salutogenic factors related to oral health and for providing a plain overview of areas lacking knowledge, which in turn can facilitate the generation of hypotheses and therefore relevant salutogenic research.This combination could contribute to a more balanced image of factors influencing oral health, including dental professionals’ roles, and help identify critical next steps in determining priorities and allocating resources promoting good oral health in individuals and populations. Moreover, oral health-related salutogenic factors identified in the qualitative studies; i.e., categories, merit further exploration in quantitative research.
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| 13. |
- Shmarina, Elena, et al.
(author)
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Salutogenic factors for oral health among older people : an integrative review connecting the theoretical frameworks of Antonovsky and Lalonde
- 2021
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In: Acta Odontologica Scandinavica. - : Taylor & Francis. - 0001-6357 .- 1502-3850. ; 79:3, s. 218-231
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Journal article (peer-reviewed)abstract
- Objective The aim of this integrative review was to describe salutogenic factors associated with oral health outcomes in older people, from the theoretical perspectives of Antonovsky and Lalonde. Material and methods This study was based on a primary selection of 10,016 articles. To organize reported salutogenic factors, the Lalonde health field concept and Antonovsky's salutogenic theory were cross tabulated. Results The final analysis was based on 58 studies. The following oral health outcome variables were reported: remaining teeth, caries, periodontal disease, oral function and oral health related quality of life (OHRQoL). We could identify 77 salutogenic factors for oral health and OHRQoL. Salutogenic factors were identified primarily within the fields of Human Biology (such as 'higher saliva flow', 'BMI < 30 kg/m(2)' and 'higher cognitive ability at age 11'), Lifestyle (such as 'higher education level', 'social network diversity' and 'optimal oral health behaviour') and Environment (such as 'lower income inequality', 'public water fluoridation' and 'higher neighbourhood education level'). In the age group 60 years and over, there was a lack of studies with specific reference to salutogenic factors. Conclusions The results provide an overview of salutogenic factors for oral health from two theoretical perspectives. The method allowed concomitant disclosure of both theoretical perspectives and examination of their congruence. Further hypothesis-driven research is needed to understand how elderly people can best maintain good oral health.
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| 14. |
- Shmarina, Elena, et al.
(author)
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Self-perceived oral health-related salutogenic factors in orally healthy older Swedes. A qualitative interview study.
- 2022
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In: Acta Odontologica Scandinavica. - : Taylor & Francis. - 0001-6357 .- 1502-3850. ; 80:5, s. 354-362
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Journal article (peer-reviewed)abstract
- OBJECTIVE: This study aimed to explore oral health-related salutogenic factors in orally healthy older Swedish people, applying the three components of Antonovsky's Sense of Coherence (SOC) concept: comprehensibility, manageability and meaningfulness.MATERIAL AND METHOD: Interviews were conducted with 12 orally healthy patients, aged 75 years and older, enrolled at public dental clinics. The interviews were subjected to qualitative content analysis, applying the SOC concept as the theoretical framework.RESULTS: Three themes were formulated under the predefined SOC components, describing the central meaning of the informants' perception of factors favourable to their good oral health. The theme 'comprehension of cause and effect' consisted of three categories, for example importance of oral hygiene, and reflected the component comprehensibility. The theme 'living in confidence and trust in supporting society' consisted of five categories, for example self-esteem, and reflected the component manageability. The theme 'good oral health as a basis for satisfaction and social confidence' consisted of two categories, for example social norms, and reflected the component meaningfulness.CONCLUSION: This study discloses how orally healthy elderly Swedish people perceive the lifelong impact of salutogenic factors in response to lifelong stressors on their oral health and highlights the important roles of their internal resources, dental professionals, family and society in supporting and reinforcing lifelong oral health.
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| 15. |
- Wallengren, Marie Louise, et al.
(author)
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HLA-DR4 and number of mutans streptococci in saliva among dental students and staff.
- 1997
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In: Acta Odontologica Scandinavica. - : Informa UK Limited. - 0001-6357 .- 1502-3850. ; 55:5, s. 296-8
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Journal article (peer-reviewed)abstract
- Our aim was to corroborate previous findings that HLA-DR4 carriers are characterized by higher levels of mutans streptococci in saliva than are individuals expressing other HLA-DR types. Of 68 subjects (dental students, staff, and faculty) who were sampled for salivary counts of mutants streptococci, 13 subjects with the lowest counts of mutans streptococci and 15 subjects with the highest counts were selected for HLA-typing. Of the 13 who expressed HLA-DR4, 8 were heavily colonized by mutants streptococci. Although a trend towards a relationship was found between HLA-DR4 carriage and high levels of mutans streptococci, it was not statistically significant. In this selected population, knowledge of how to minimize the risk of caries and mutans streptococci level may have influenced the results.
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| 16. |
- Wallengren, Marie Louise, et al.
(author)
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Human leukocyte antigens in relation to colonization by mutans streptococci in the oral cavity
- 1991
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In: Oral Microbiology and Immunology. - : Wiley. - 0902-0055 .- 1399-302X. ; 6:5, s. 292-4
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Journal article (peer-reviewed)abstract
- Mutans streptococci are well established as caries-inducing microorganisms in man. Most humans carry the bacteria, but in highly different numbers. This cannot be explained by environmental factors only. The aim of this study was to investigate a possible association between levels of colonization by mutans streptococci and the presence of certain B and DR human leukocyte antigens (HLA). Altogether, 170 subjects who had their HLA antigens determined (76 renal transplant patients and 94 healthy blood donors) were selected for the investigation. Paraffin-stimulated saliva samples were taken using the wooden spatula method with subsequent cultivation of mutans streptococci on mitis salivarius bacitracin agar plates. An association between the absence of HLA-DR 4 antigens and low, or undetectable, levels of mutans streptococci was found. This was statistically significant for the immunosuppressed renal transplant subjects. The same trend was observed among the healthy blood donors.
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