Background: The aim of this review was to evaluate the effects of periodontal disease (PD) treatment in pregnant women to reduce the risk of preterm birth (PB) and low birth weight (LBW) by conducting an umbrella review. Methods: A comprehensive search for the literature up to April 2024 was conducted across multiple databases including PubMed, Cochrane Library, Scopus, EMBASE, Scielo, Web of Science, Google Scholar, Proquest Dissertations and Theses, and OpenGrey. We specifically targeted systematic reviews (SRs) with or without meta-analyses, irrespective of language or time constraints, focusing on primary studies examining the effect of PD treatment in pregnant women to reduce the risk of PB and LBW. Various types of non-systematic reviews, intervention studies, observational studies, preclinical and basic research, summaries, comments, case reports, protocols, personal opinions, letters, and posters were excluded from consideration. The quality and overall confidence of the included studies were assessed using the AMSTAR-2 tool. Results: After the initial search, 232 articles were identified, of which only 24 met the selection criteria after exclusion. The majority of these studies indicated that periodontal treatment reduces the risk of PB and LBW. Conclusions: According to the findings and conclusions drawn from the SRs with a high overall confidence level, PD treatment in pregnant women reduces the risk of PB and LBW.

Background and Objectives: Multiple sclerosis (MS) is a chronic neurodegenerative disease often linked with systemic conditions such as periodontal diseases (PDs). This systematic review aims to explore the association between inflammatory markers in saliva and PDs in MS patients, assessing the use of saliva as a non-invasive tool to monitor disease progression. Materials and Methods: 82 publications were examined after a thorough search of scholarly databases to determine whether inflammatory markers were present in MS patients and whether they were associated with periodontal disease (PD). Quality and bias were assessed using the Newcastle-Ottawa Scale, resulting in eight articles that were thoroughly analyzed. Results: The results point to a strong correlation between MS and periodontal disorders, which may point to the same pathophysiological mechanism. It does, however, underscore the necessity of additional study to determine a definitive causal association. Conclusions: The findings indicate a strong association between MS and PDs, likely mediated by systemic inflammatory responses detectable in saliva. The review highlights the importance of oral health in managing MS and supports the utility of saliva as a practical, non-invasive medium for monitoring systemic inflammation. Further research is necessary to confirm the causal relationships and to consider integrating salivary diagnostics into routine clinical management for MS patients.

Oral disease interventions primarily focus on behavioral changes like dietary improvements and ensuring better oral hygiene. However, recognizing the influence of biological factors, including genetics and early-life nutrition, is crucial. Iron deficiency (ID) and its advanced form, iron deficiency anemia (IDA), affect nearly two billion people globally, especially children and pregnant women. We conducted a comprehensive search using Medline via EndNote and Web of Science, employing keywords related to iron deficiency anemia (IDA), and we identified 36 studies deemed relevant for inclusion in this literature review. IDA prevalence is notably high among pregnant women and young children. Both IDA and early-childhood caries (ECC) disproportionately affect impoverished populations, highlighting the socioeconomic dimension of this issue. IDA presents with various oral mucosal changes and is closely linked to candidiasis. Additionally, IDA can hinder tooth development and weaken the immune response. Multiple population surveys have revealed a significant association between ECC and IDA. While some studies have explored the IDA-periodontal disease link, the current evidence is relatively limited in its robustness. In conclusion, more comprehensive longitudinal studies are essential to deepen our understanding of the IDA-oral disease connection. Investigating the underlying biological mechanisms is critical to developing effective interventions, particularly for vulnerable populations affected by IDA.

Ginsenosides, bioactive compounds from the genus Panax, have potential therapeutic effects on diverse ailments, including diabetes. Emerging evidence suggests their involvement in bone metabolism. The present review summarizes the current understanding of the effects of ginsenosides on osteoporosis, periodontal disease, and osteoarthritis. Their mechanisms of action include effects on osteoblasts, osteoclasts, periodontal ligament fibroblasts (PDLFs), and chondrocytes, which are pivotal in maintaining bone, periodontal tissue, and cartilage homeostasis. Ginsenosides may exert their beneficial effects by enhancing PDLF and osteoblast activity, suppressing osteoclast function, augmenting chondrocyte synthesis in the cartilage matrix, and mitigating connective tissue degradation. Moreover, they possess antioxidant, anti-inflammatory, antimicrobial, and anti-pyroptotic properties. Their efficacy in increasing bone density, ameliorating periodontitis, and alleviating osteoarthritis symptoms has been demonstrated in preclinical studies using animal models. In terms of their mechanism of action, ginsenosides modulate cellular differentiation, activity, and key signaling pathway molecules, such as mitogen-activated protein kinases (MAPKs), while also regulating various mediators. Furthermore, the symptomatic relief observed in animal models lends further credence to their therapeutic utility. However, to translate these preclinical findings into clinical practice, rigorous animal and clinical investigations are imperative to ascertain the safety, efficacy, and optimal dosing regimens in human subjects.

OBJECTIVE: Self-performed oral hygiene is essential for preventing dental caries, periodontal, and peri-implant diseases. Oral irrigators are adjunctive oral home care aids that may benefit oral health. However, the effects of oral irrigation on oral health, its role in oral home care, and its mechanism of action are not fully understood. A comprehensive search of the literature revealed no existing broad scoping reviews on oral irrigators. Therefore, this study aimed to provide a comprehensive systematic review of the literature on oral irrigation devices and identify evidence gaps.
METHODS: The Joanna Briggs Institute and Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews guidelines were utilized to prepare the review. Four databases and eight gray literature sources were searched for English publications across any geographical location or setting.
RESULTS: Two hundred and seventy-five sources were included, predominantly from scientific journals and academic settings. Most studies originated from North America. Research primarily involved adults, with limited studies in children and adolescents. Oral irrigation was safe and well-accepted when used appropriately. It reduced periodontal inflammation, potentially by modulating the oral microbiota, but further research needs to clarify its mechanism of action. Promising results were reported in populations with dental implants and special needs. Patient acceptance appeared high, but standardized patient-reported outcome measures were rarely used. Anti-inflammatory benefits occurred consistently across populations and irrigant solutions. Plaque reduction findings were mixed, potentially reflecting differences in study designs and devices.
CONCLUSIONS: Oral irrigators reduce periodontal inflammation, but their impact on plaque removal remains unclear. Well-designed, sufficiently powered trials of appropriate duration need to assess the clinical, microbiological, and inflammatory responses of the periodontium to oral irrigation, particularly those with periodontitis, dental implants, and special needs. Patient-reported outcome measures, costs, caries prevention, and environmental impact of oral irrigation need to be compared to other oral hygiene aids.

UNASSIGNED: Oral health conditions, such as dental caries, periodontal disease, tooth loss, dental fluorosis, dental trauma, and oral cancer, are prevalent in the WHO Eastern Mediterranean Region. However, there has been no systematic review of oral health promotion interventions in the region.
UNASSIGNED: To review existing literature on oral health promotion programmes in the Eastern Mediterranean Region and recommend improvements for the future.
UNASSIGNED: We reviewed on PubMed and Google Scholar 61 articles published in the Eastern Mediterranean Region between 2010 and 2023. Quality assessment of included studies was performed using established criteria. We used the content analysis approach to create appropriate themes from the studies and to document meaningful conclusions about oral health promotion.
UNASSIGNED: Majority of the studies were cross-sectional, a few were randomized controlled, quasi-experimental, longitudinal studies, or reviews. Oral health problems identified included poor oral health knowledge, dental caries, periodontal disease, tooth loss, dental fluorosis, and oral cancer. Although oral disorders were common in most of the countries, very few have implemented oral health promotion programmes.
UNASSIGNED: We recommend prioritization of oral health promotion programmes in the Eastern Mediterranean Region to tackle the diverse oral health challenges. To be effective, such programmes should be region- and context-specific. More studies on oral health promotion are needed in the region.
استعراض منهجي لبرامج تعزيز صحة الفم في إقليم شرق المتوسط.
نجاة عبد ربه اليافعي، بشرى ناز فاطمة جليل، حمد المضاحكة.
UNASSIGNED: تنتشر في إقليم منظمة الصحة العالمية لشرق المتوسط اعتلالات صحة الفم: مثل تسوس الأسنان، ومرض دواعم الأسنان، وفقدان الأسنان، وتسمم الأسنان بالفلور، ورضح الأسنان، وسرطان الفم. ومع ذلك، لم يُُجرَ استعراض منهجي للتدخلات الرامية إلى تعزيز صحة الفم في الإقليم.
UNASSIGNED: هدفت هذه الدراسة الى الاستعراض المنهجي للمؤلفات المتاحة التي تتناول برامج تعزيز صحة الفم في إقليم شرق المتوسط، والتوصية بتحسينات في المستقبل.
UNASSIGNED: استعرضنا على موقع PubMed وموقع 61 Google Scholar مقالة منشورة في إقليم شرق المتوسط بين عامَي 2010 و2023. وأُجريَ تقييم لجودة الدراسات المشمولة باستخدام معايير مُقرَّرة. واستخدمنا نهج تحليل المحتوى لإعداد مواضيع مناسبة مستمدة من الدراسات وتوثيق استنتاجات هادفة بشأن تعزيز صحة الفم.
UNASSIGNED: كانت غالبية الدراسات مقطعية، وكان قليل منها دراسات مضبوطة ذات عيِّنات عشوائية، أو دراسات شبه تجريبية، أو دراسات طولانية، أو مراجعات. وشملت مشكلات صحة الفم المرصودة: ضعف المعرفة بصحة الفم، وتسوس الأسنان، وأمراض اللثة، وفقدان الأسنان، وتسمم الأسنان بالفلور، وسرطان الفم. ورغم شيوع الاضطرابات الفموية في معظم البلدان، فإن عددًا قليلًًا جدًّا من تلك البلدان نفَّذ برامج لتعزيز صحة الفم.
UNASSIGNED: نوصي بإعطاء الأولوية لبرامج تعزيز صحة الفم في إقليم شرق المتوسط للتصدي للتحديات المتنوعة المتعلقة بصحة الفم. ولتكون هذه البرامج فعالة، ينبغي أن تكون محدَّدة المناطق والسياق. وتدعو الحاجة إلى مزيد من الدراسات عن تعزيز صحة الفم في الإقليم.
Revue des programmes de promotion de la santé bucco-dentaire dans la Région de la Méditerranée orientale.
UNASSIGNED: Les affections bucco-dentaires, telles que les caries dentaires, les parodontopathies, la perte de dents, la fluorose dentaire, les traumatismes dentaires et le cancer de la bouche, sont prévalentes dans la Région OMS de la Méditerranée orientale. Cependant, aucune revue systématique des interventions de promotion de la santé bucco-dentaire n\'a été effectuée dans la Région.
UNASSIGNED: Examiner la littérature existante sur les programmes de promotion de la santé bucco-dentaire dans la Région de la Méditerranée orientale et recommander des améliorations pour l\'avenir.
UNASSIGNED: Nous avons passé en revue 61 articles publiés sur PubMed et Google Scholar dans la Région de la Méditerranée orientale entre 2010 et 2023. L\'évaluation de la qualité des études incluses a été effectuée à l\'aide des critères établis. Nous avons utilisé l\'approche d\'analyse de contenu pour créer des thèmes appropriés à partir des études et pour documenter des conclusions significatives sur la promotion de la santé bucco-dentaire.
UNASSIGNED: La majorité des études étaient transversales, quelques-unes étaient des études contrôlées randomisées, quasi-expérimentales, longitudinales ou des analyses. Parmi les problèmes de santé bucco-dentaire recensés figuraient les connaissances insuffisantes dans ce domaine, les caries dentaires, les parodontopathies, la perte de dents, la fluorose dentaire et le cancer de la cavité buccale. Bien que les troubles bucco-dentaires soient courants dans la plupart des pays, très peu de pays ont mis en œuvre des programmes de promotion de la santé bucco-dentaire.
UNASSIGNED: Nous recommandons de prioriser les programmes de promotion de la santé bucco-dentaire dans la Région de la Méditerranée orientale afin de s\'attaquer aux différents défis dans ce domaine. Pour être efficaces, ces programmes doivent être spécifiques à la Région et au contexte. D\'autres études sur la promotion de la santé bucco-dentaire sont nécessaires dans la Région.

OBJECTIVE: To evaluate the efficacy of the adjunctive use of tea tree oil (TTO) for dental plaque control and nonsurgical periodontal treatment (NSPT).
METHODS: Three electronic databases were searched from 2003. The reference lists of the included articles and relevant reviews were also manually searched. Randomised controlled trials reporting the clinical outcomes of the topical use of TTO as an adjunct to daily oral hygiene or scaling and root planing (SRP) were included. Regarding the use of TTO as an adjunctive to daily oral hygiene, the primary outcome was plaque index (PI) reduction. Regarding the use of TTO as an adjunctive to SRP, probing pocket depth (PPD) reduction and clinical attachment level (CAL) gain were the primary outcomes. The secondary outcomes were adverse events.
RESULTS: Eleven studies were included for qualitative analysis, 9 studies were included for quantitative analysis, and 6 studies were included to examine the application of TTO mouthwash as an adjunctive to daily oral hygiene. In addition, three studies were included to analyse the subgingival use of TTO adjunctive to SRP at selected sites. The results indicated a nonsignificant improvement in PI reduction in the TTO mouthwash group compared with placebo. The incidence of adverse events was statistically significantly greater in the CHX group than in the TTO group. For subgingival use of TTO adjunctive to SRP, beneficial effects were observed in the TTO group compared with SRP alone in terms of PPD and CAL at both three and six months post-treatment. However, an unpleasant taste was reported in three out of four studies.
CONCLUSIONS: There is a lack of strong evidence to support the beneficial effects of TTO. Studies with larger sample sizes and standardised evaluation criteria are needed to further demonstrate the clinical relevance of TTO.

BACKGROUND: Chlorhexidine gluconate has been considered the criterion standard of oral care for patients receiving mechanical ventilation because of its ability to reduce the incidence of ventilator-associated events. Optimal concentrations and frequencies remain unclear, as do adverse events related to mortality in various intensive care unit populations.
OBJECTIVE: To examine the current evidence for the efficacy of chlorhexidine gluconate in reducing the incidence of ventilator-associated events, mortality, intensive care unit length of stay, and duration of mechanical ventilation in patients receiving ventilator support.
METHODS: In this integrative review, CINAHL (Cumulative Index to Nursing and Allied Health Literature), MEDLINE, and Health Source: Nursing/Academic Edition were searched using terms related to mechanical ventilation and chlorhexidine gluconate oral care with dates ranging from 2012 to 2023.
RESULTS: Seventeen articles were included in this review: 8 systematic reviews, 8 randomized clinical trials (3 of which were not included in any systematic review), and 1 quasi-experimental study. Chlorhexidine gluconate oral care was associated with a reduced incidence of ventilator-associated events, but efficacy depended on concentration and frequency of administration. With stratification by intensive care unit population type, a nonsignificant trend toward increased mortality was found among non-cardiac surgical patients who received this care.
CONCLUSIONS: The evidence regarding the efficacy of chlorhexidine gluconate oral care in reducing ventilator-associated events in specific intensive care unit populations is contradictory. Recently published guidelines recommend de-implementation of chlorhexidine gluconate oral care in all patients receiving mechanical ventilation. Such care may be beneficial only in the cardiac surgical population.

UNASSIGNED: This study investigated the effect of photodynamic therapy on chronic periodontitis patients and then evaluated the microbial, immunological, periodontal, and clinical outcomes. The significant effects of photodynamic therapy obtained by in vitro and in vivo studies have made it a popular treatment for periodontal diseases in recent years. Photodynamic therapy is a novel bactericidal strategy that is stronger, faster, and less expensive than scaling and root planing.
UNASSIGNED: This study registered on PROSPERO (CRD42021267008) and retrieved fifty-three randomized controlled trials by searching nine databases (Medline, Embase, Scopus, Open Gray, Google Scholar, ProQuest, the Cochrane Library, Web of Science, and ClinicalTrials.gov) from 2008 to 2023. Of 721 records identified through database searches following title and full-text analysis, and excluding duplicate and irrelevant publications, 53 articles were included in this systematic review. Fifty of the 53 eligible studies fulfilled all the criteria in the Joanna Briggs Institute\'s (JBI\'s) Checklist for RCTs; the remaining articles met 9-12 criteria and were considered high quality.
UNASSIGNED: The present study showed that photodynamic therapy in adjunct to scaling and root planing has the potential to improve periodontal parameters such as clinical attachment loss or gain, decrease in bleeding on probing, and probing pocket depth. In addition, photodynamic therapy decreases the rate of periodontal pathogens and inflammation markers, which, in turn, reduces the progression of periodontitis.
UNASSIGNED: Photodynamic therapy is considered a promising, adjunctive, and low-cost therapeutic method that is effective in tissue repair, reducing chronic periodontitis, reducing inflammation, and well-tolerated by patients.

BACKGROUND: This review aimed to chart the landscape of literature concerning the precise applications of traditional medicine in managing specific oral diseases and, in doing so, to pinpoint knowledge gaps surrounding the use of traditional medicine for oral disease management in the African context.
METHODS: A systematic search of the literature was conducted on PubMed, Web of Science, Scopus, and CINAHL. The search was conducted from the inception of the database till September 2023. A search of related citations and references was also carried out. Only English language publications were included. A summary of studies that met the inclusion criteria was conducted.
RESULTS: Of the 584 records identified, 11 were duplicates and 12 studies, published between 2006 and 2021, met the inclusion criteria. The studies were published from eight countries located in the five sub-regions on the continent. All the studies were either experimental designs or ethnobotanical surveys and they all utilized plant-based remedies. The five experimental studies aimed to assess the impact of whole plants or plant extracts on the three microorganisms responsible for dental caries and seven responsible for periodontal diseases. The number of plant species identified by the seven ethnobotanical surveys ranged from 29 to 62 while the number of plan families ranged from 15 to 29. The remedies were either topical applied, use as mouth rinses, gargled, or chewed. The systemic routes of administration identified were inhalation and drinking. The remedies were used for the treatment of hard such as dental caries and tooth sensitivity, to soft tissue lesions such as mouth ulcers, gingival bleeding, and mouth thrush. Other oral disorders managed include halitosis, jaw fracture, and oral cancer.
CONCLUSIONS: Given the increasing prevalence of oral diseases within the region, the shortage of oral healthcare professionals and limited access to financial resources, it becomes imperative to support the generation of empirical evidence to enhance the provision of traditional medicine for oral healthcare in Africa.