Public health interventions to promote oral health and well-being in patients with type 2 diabetes: a systematic review

Background and objective: Poor oral health and type 2 diabetes mellitus (T2DM) are chronic conditions affecting a wide proportion of the population. Both conditions share many risk factors and are linked by a chronic inflammation state. This review aimed at identifying public health interventions that could promote oral health and diabetes control in patients with poor oral health and T2DM. Methods: The systematic review was performed according to the PRISMA Statement and registered in the International Prospective Register of Systematic Reviews (PROSPERO registration: CRD42022310974). Seven electronic databases were searched (PubMed, Scopus, Embase, Web of Science, CINAHL, PsycInfo, Cochrane Library) from inception to 21 January 2022, and additional hand searching was performed across reviews’ references. A qualitative analysis was conducted, including all primary studies on diabetic patients, about interventions whose effectiveness and/or feasibility was measured for at least one outcome related to oral health or T2DM. Results: Of the 3153 records obtained after deduplication, 89 studies were considered eligible for inclusion. The most frequently evaluated outcomes were HbA1c and fasting glucose for T2DM, and parameters such as probing depth, bleeding on probing and clinical attachment loss for periodontitis. Most studies assessed the use of non-surgical periodontal treatment (especially scaling and root planing, sometimes corroborated by antibiotics): evidence confirmed effectiveness on periodontal parameters, but was more contrasting regarding T2DM outcomes. Three studies evaluated interventions involving group education for lifestyle modification, which showed to be effective on both outcomes. Also, community-based oral hygiene interventions and glycaemic control appeared to improve T2DM and periodontal outcomes. Conclusions: A variety of interventions are described in the literature. Of those included in this review, many indicated that there is a potential opportunity to promote good oral health alongside T2DM. An integrated approach involving health education, oral hygiene and glycaemic control may offer synergic improvement of both conditions

Contrasting hydrodynamic regimes of submerged pinnacle and emergent coral reefs

Hydrodynamics on coral reefs vary with depth, reef morphology and seascape position. Differences in hydrodynamic regimes strongly influence the structure and function of coral reef ecosystems. Submerged coral reefs on steep-sided, conical bathymetric features like seamounts experience enhanced water circulation as a result of interactions between currents and the abrupt physical structure. There may also be similar interactions between smaller pinnacles and regional water currents in offshore locations (crests > 10 m), while shallow reefs (crests <10 m) may be more subject to surface currents driven by wind, waves and tide. Here we tested whether coral pinnacles experienced stronger and more variable currents compared to emergent reefs at the same depth in both nearshore and offshore positions. Current speeds and temperature were monitored for 12 months at 11 reefs, representing the three different reef categories: submerged offshore pinnacles, emergent offshore reefs and emergent nearshore reefs. We found different patterns in current speeds and temperature among reef types throughout the year and between seasons. Submerged pinnacles exhibited stronger, more variable current speeds compared to both near and offshore emergent reefs. We found seasonal changes in current speeds for pinnacle and nearshore reefs but no variation in current strength on offshore reefs. Whilst instantaneous current directions did reflect the seascape position of individual sites, there was no difference in the directional variability of current speeds between reef types. Annual daily average temperatures at all reef types were not strongly seasonal, changing by less than 2 °C throughout the year. Daily temperature ranges at specific sites however, exhibited considerable variability (annual range of up to 6.5 °C), particularly amongst offshore emergent reefs which experienced the highest temperatures despite greater exposure to regional-scale circulation patterns. Additionally, we found a consistent mismatch between satellite sea surface temperatures and in-situ temperature data, which was on average 2 °C cooler throughout the annual study period. Our results suggest that distinct hydrodynamic processes occur on smaller submerged structures that are physically analogous to seamounts. Our findings highlight important nuances in environmental processes that occur on morphologically distinct coral reef habitats and these are likely to be important drivers for the community dynamics of organisms that inhabit these reefs

Editorial: Nutrition and oral biology in health and disease

Daily food choices have an impact on global human health as good nutrition allows the body to function properly. People with healthy eating patterns are less likely to develop serious illnesses such as heart disease, type 2 diabetes, obesity, and some types of cancer, which can translate into a longer life expectancy. Healthy lifestyles, including balanced and nutritionally adequate diets, can also help prevent diseases of the oral cavity, such as tooth decay, gingivitis, periodontal disease, and oral cancer. Recent research on the relationship between diet and dental caries emphasize the importance of limiting free sugars in the diet, including sucrose, glucose, and lactose, for the prevention of tooth decay; in addition, studies have pointed out the importance of soft drinks as the most important dietary factor related to enamel erosion. In this sense, dietary guidelines suggest the adoption of a diet low in fats and free sugars, but rich in fruit, vegetables, and fibers as a protective measure against the development of oral diseases. Proteins and vitamins (both fat- and water-soluble), as well as calcium, phosphorus, and fluoride, are essential nutrients for the development, maturation, and protections of oral tissues at all stages of life. It is worth mentioning that this is a two-way relationship: oral health can also affect nutrition. Healthy oral tissues—teeth, bones, mucosa, muscles and joints—are vital for proper chewing of food and ensure that ingested food is broken down into small pieces and prepared for digestion. The first steps of digestion occur in the mouth, with the humidification of the bolus by the saliva, digestion of starch, and its buffering effect. Taste receptors have a direct influence on sensory capacities, with an impact on food choice and acceptance and, consequently, on nutrition. Saliva also plays a role in maintaining oral health helping to keep the integrity of soft and hard tissues, mastication, taste, and texture perception, swallowing and initial digestion. On the contrary, oral problems influence nutrition by limiting food choices: tooth decay and tooth loss can lead to limited masticatory function and reduced food intake, increasing the risk of chronic diseases, malnutrition, and low wellbeing and quality of life, especially in the elderly population

How Does Citizen Science Compare to Online Survey Panels? A Comparison of Food Knowledge and Perceptions Between the Zooniverse, Prolific and Qualtrics UK Panels

With an increasing focus on the uptake of healthy and sustainable diets, a growing body of research has explored consumer perceptions and understanding of the environmental impacts and safety of foods. However, this body of research has used a wide range of methods to recruit participants, which can influence the results obtained. The current research explores the impact of different recruitment methods upon observed estimations of the carbon footprint (gCO2e), energy content (Kcal), food safety and animal using three different online recruitment platforms; Qualtrics (N = 397), Prolific (N = 407), Zooniverse (N~601, based on unique IP addresses). Qualtrics and Prolific participants rated the carbon footprint, energy content, food safety and animal welfare of all foods in the survey. Zooniverse citizens rated the carbon footprint or energy content then food safety or animal welfare of all foods in the survey. Kruskal-Wallis and Chi-square analyses compared the energy content and carbon footprint estimations with validated values, and differences in estimate accuracy and perceptions between recruitment methods. Participants were unable to accurately estimate the carbon footprint and energy content of foods. The carbon footprint of all foods were overestimated, with the exception of beef and lamb which was underestimated. The calorie content of fruits and vegetables are typically overestimated. Perceptions of animal welfare and food safety differed by recruitment method. Zooniverse citizens rated animal welfare standards to be lower for meat products and eggs, compared to Qualtrics and Prolific participants. Overall, Qualtrics participants typically held the highest food risk perceptions, however this varied by food type. The lack of knowledge about the carbon footprint and energy content of foods demonstrates the need for consumer education and communication to enable the move toward healthier and more sustainable diets. Perceptions of food safety and animal welfare demonstrate a baseline from which to develop consumer focused communications and governance. We have shown that different recruitment tools can result in differences in observed perceptions. This highlights the need to carefully consider the recruitment tool being used in research when assessing participant knowledge and perceptions

The Importance of Citizen Scientists in the Move Towards Sustainable Diets and a Sustainable Food System

To enhance sustainability, the food system requires significant shifts in the production, processing and supply of food. Ideally, a sustainable food system should operate, not only to protect the biosphere, but also to provide nutritious, high-quality food, and to support social values, an equitable economy, and human and animal health. It should also be governed responsibly within a supportive policy environment. Implementing these shifts is a task of immense scale; but citizen participation/engagement has the potential to help make sustainability a reality through distributed learning, dynamic sensing, and knowledge generation. Technological advancements in sensing and data processing have enabled new forms of citizen participation in research. When food system research is embedded within society it can help us to understand which changes towards sustainability work and which do not. Indeed, citizen engagement in food systems research has the potential to help bring citizens on side, supporting the growth of a food culture of resilience and of sustainable practises (including dietary change). This commentary provides examples of how existing research and alternative food production systems and agroecological practises may provide possible frameworks for citizen participation in food system studies. We highlight potential future food and citizen science approaches. Widening citizen participation and encouraging the involvement of other food system actors, including those in local, national and international governance, is essential to capture the full potential of citizen science in enabling transition to a sustainable food system. For the research community citizen science offers engagement and empowerment of wider communities with science; collecting and analysing data; and creating viable solutions to food system and diet issues