Investigating the perspectives of older adults in residential aged care on oral health-related quality of life

Objective The objective of the study was to explore how older people living in a residential aged care facility perceived that their oral health influenced their food preferences and attitudes towards food, their social interactions and their self-esteem. Background Poor oral health can have biological, behavioural and social impacts on quality of life among older adults (aged 65+ years). In terms of biological impacts, oral health impairments may cause older adults to avoid many types of foods. This shift in dietary pattern can lead to malnutrition among older people, undermine general health and negatively impact quality of life (QOL). Materials and Methods Using a mixed methods approach, quantitative data from the General Oral Health Assessment Index (GOHAI) were explored and supported by data from semi-structured interviews with 10 older adults from a residential aged care facility in Perth, (Australia) to provide insights into their oral health-related quality of life. Thematic analysis of qualitative data was guided by the conceptual framework informed by Locker. Results The average GOHAI score was 32.9 ± 3.6, which indicated that participants had an average oral health-related quality of life. Participants coped with oral functional problems by adopting personal strategies and seeking organisational assistance. Some participants appeared to have accepted associated changes to their physical appearance, while others reported significant dissatisfaction and low self-esteem. Perceptions differed on their social interactions at the facility, from being self-conscious about their own oral health problems, to distaste at others\u27 eating behaviours. Conclusions Poor oral health had negative biological, behavioural and social impacts on daily activities and quality of life among some participants. However, changes at the organisation level may help to support participant QOL

Association of serum fibroblast growth factor 23 with calcium metabolism in patients with end-stage renal disease undergoing hemodialysis

Background: The association between the function of fibroblast growth factor 23 (FGF23) and different components of calcium metabolism has remained unclear in patients with renal dysfunction undergoing hemodialysis. Objectives: The present study aimed to assess the association of the level of FGF23 and calcium metabolism status in hemodialysis patients. Patients and Methods: This cross-sectional study conducted on 90 consecutive patients suffering end-stage renal disease (ESRD) who underwent hemodialysis. The serum levels of FGF23 and intact parathyroid hormone (iPTH) levels were measured using the ELISA technique. Results: The serum levels of FGF23 were directly associated with iPTH level (r = 0.251, P = 0.020) and slightly with the duration of dialysis (r = 0.203, P = 0.063). However serum FGF23 was not significantly related to other indices including levels of calcium, phosphorus, magnesium, vitamin D, albumin, and even body mass index (BMI). No difference was found in the level of FGF23 between men and women with ESRD under hemodialysis. Conclusions: In ESRD patients undergoing hemodialysis, the association of FGF23 with iPTH was detected, while there was not any relationship of FGF23 with other indices including calcium, phosphorus, and vitamin D

Effect of Different Bleaching Techniques on Microleakage under orthodontic Brackets: In Vitro Study

Statement of problem: Numerous studies report significant changes in tooth color that occur during orthodontic treatment. The adverse effects of bleaching procedures during orthodontic treatments have not been studied comprehensively. Objectives: This study investigated the effects of two methods of dental bleaching on the degree of microleakage beneath orthodontic brackets. Materials and Methods: We selected 45 extracted premolar teeth and bonded them to orthodontic brackets. These teeth were stored in normal saline for 24 hours and thermocycled. We randomly divided the samples into 3 groups of 15 teeth per group. The first group (control) received no bleach treatment; the second group (office bleaching) was treated with 35% hydrogen peroxide (Whiteness HP Maxx); and the third group (home bleaching) was treated with 22% carbamide peroxide (Whiteness Perfect). The apices were sealed with sticky wax, rinsed in tap water, and air-dried. We applied nail varnish to the entire surface of each tooth, except for an area approximately 1 mm away from the brackets. The samples were immersed in basic fuchsine and cleaned after 24 hours. Microleakage was determined by direct measurement using a stereomicroscope. Kruskal-Wallis and Dunn post-hoc statistical tests, and SPSS software were used for statistical analysis. The significance level was set at P≤0.05. Results: The office bleaching group had significantly more microleakage scores under the brackets at both the occlusal (P=0.04) and gingival (P =0.040) margins of the brackets compared to the home bleaching group. The home bleaching group showed statistically more significant microleakage scores than the control group in both the gingival (P=0.006) and occlusal (P=0.014) margins of the brackets. All three groups had statistically more significant microleakage at the gingival margins of the brackets than the occlusal margins. Conclusions: Office bleaching caused the most microleakage under the brackets and home bleaching caused more microleakage than the control group. We observed more microleakage at the gingival margins of the brackets compared to the occlusal margins