Type 1 Diabetes Mellitus (T1DM) is a chronic autoimmune condition that alters salivary composition due to metabolic disturbances. Saliva provides a non-invasive means of detecting systemic changes. This pilot study compared salivary pH, sialic acid concentration, antioxidant capacity, and oral health indicators between children with and without T1DM. A comparative cross-sectional study was conducted among 40 children aged 6–15 years (20 with T1DM, 20 healthy controls). Sociodemographic and clinical data were collected, and unstimulated saliva was analysed for pH, sialic acid, and antioxidant capacity. Oral examinations included salivary flow rate, plaque index, and gingival index. Statistical analyses were performed using the Shapiro–Wilk test. As several variables demonstrated non-normal distributions and subgroup sample sizes were small, non-parametric statistical methods were applied for between-group comparisons. Children with T1DM demonstrated significantly lower salivary pH (6.70 ± 0.93 vs. 7.65 ± 0.27) and flow rate (3.93 ± 0.99 ml vs. 6.03 ± 1.18 ml), and higher sialic acid levels (78.13 ± 49.67 µg/ml vs. 36.84 ± 17.33 µg/ml) than controls. Plaque and gingival indices were also elevated in T1DM (p < 0.01). Antioxidant capacity was slightly higher but not statistically significant. Age-based analysis showed younger diabetic children (8–10 years) had elevated sialic acid and lower antioxidants, whereas older children (11–15 years) exhibited reduced flow rates and higher plaque/gingival indices, suggesting progressive oral changes with age. T1DM significantly affects salivary composition and oral health in children, with age-specific variations. Salivary biomarkers, particularly sialic acid and pH, show potential as non-invasive tools for monitoring metabolic and periodontal changes in pediatric diabetes. Larger longitudinal studies are needed to validate these findings.
Although Simarouba glauca DC. has been recognized for its therapeutic properties, its anticancer effects against oral cancer have not been adequately investigated. The present study aimed to evaluate the activity of S. glauca leaf extracts against oral squamous cell carcinoma (OSCC). S. glauca leaves were extracted using solvents of increasing polarity, and the resulting fractions were evaluated for their phytochemical composition, antioxidant activity, and cytotoxic effects. Among all extracts, the S. glauca hexane extract (SGHE) exhibited the most potent anticancer activity against cell lines representing OSCC (CAL-27), cervical cancer (HeLa), and mouse mammary tumors (4T1). Bioactivity-guided fractionation identified D-erythro-Sphinganine as a major constituent present in hexane extract, possibly contributing to anticancer activity. But since the anticancer activity of crude hexane extract is superior compared to isolated D-erythro-Sphinganine, we predict a synergistic interaction among the multiple bioactive compounds present in the crude hexane extract. Hence, further studies were carried out with crude hexane extract. Mechanistic studies have shown that the anticancer activity of hexane extract is due to its ability to (a) alter cell cycle progression, (b) trigger apoptosis, and (c) inhibit cell migration in CAL-27 cells. Overall, these findings indicate that the hexane extract of S. glauca leaf possesses multi-target anticancer potential and warrants further mechanistic and in vivo investigations.
With increasing life expectancy and multimorbidity, polypharmacy—commonly defined as the concurrent use of five or more medications—has become highly prevalent in older adults and poses substantial risks for oral health. This narrative review aimed to synthesize contemporary evidence on the epidemiology, pharmacological mechanisms, and oral manifestations of polypharmacy in geriatric populations, and to propose an interprofessional management framework for dental practitioners in 2025 care settings. Recent epidemiological data indicate that polypharmacy affects more than 30%–44% of older adults globally, with even higher rates among those with cardiovascular disease, diabetes, and multimorbidity. Medications with anticholinergic burden, as well as many antihypertensive and psychotropic agents, are strongly associated with salivary gland hypofunction and xerostomia, which in turn contribute to rampant caries, oral candidiasis, mucosal lesions, dysgeusia, periodontal complications, and drug-induced gingival overgrowth. Diagnostic and therapeutic challenges are amplified by underreporting of symptoms, cognitive impairment, and fragmented medical–dental care pathways. Evidence supports a preventive and interdisciplinary approach that includes structured medication review and deprescribing in collaboration with physicians and pharmacists, optimization of salivary function using sialogogues and saliva substitutes, prescription of high-fluoride toothpastes, and tailored oral hygiene and dietary counseling with caregiver engagement. Dentists are strategically positioned to detect medication-related oral conditions, trigger timely medication optimization, and coordinate ongoing care. A structured, multidisciplinary model integrating dental, medical, and pharmacy services is essential to mitigate the oral and systemic consequences of polypharmacy and to preserve function and quality of life in aging populations.
BackgroundIndia has one of the world's largest burdens of cleft lip and palate (CLP), yet lacks a national outcomes registry or standardized system for cleft care evaluation. The Cleft Care India Study is a multicentric national initiative to assess current treatment outcomes for patients with non-syndromic unilateral CLP for 5-, 12-, and 20-year-old age groups.MethodsFourteen cleft care centers across India participated in this cross-sectional study. Standardized protocols for collecting data were formulated with input from the Study Steering Committee, validated through pilot testing, and employed for data collection. Data collected included intra-oral and extraoral photographs, study models, radiographs, surgical information, oral health assessments, speech recordings, hearing evaluations, psychosocial measures, and the intelligibility in context scale questionnaire. In this paper, we present the dentofacial outcomes. Skeletal relationships were analyzed using ANB, SNA, and SNB angles derived from cephalometric radiographs; dental arch relationships were evaluated using the 5-year or modified GOSLON indices; and nasolabial esthetics were assessed with the Asher-McDade index.ResultsData from 294 non-syndromic unilateral cleft lip and palate (UCLP) patients aged 5 (n = 72), 12 (n = 155), and 20 years (n = 67) were analyzed. Reliability testing showed strong intra and inter-rater agreement for all indices and cephalometric data (class correlation coefficient > 0.9). Nearly half of 12 year olds (46.5%) and more than half of 20 year olds (58.7%) demonstrated a Class III skeletal relationship (ANB < 0). Poor to very poor dental arch relationships (score > 3) were observed in 45%, 48%, and 43% of the 5-, 12-, and 20-year groups, respectively. Nasolabial esthetic outcomes were rated poor to very poor in 24.3% of 5 year olds, 25% of 12 year olds, and 55.4% of 20 year olds.ConclusionThis multicentric cleft outcomes audit in India demonstrated suboptimal skeletal, dental, and nasolabial outcomes when benchmarked against international standards. These findings highlight an urgent need for the centralization of cleft services, implementation of systematic national outcome monitoring, and adoption of standardized multidisciplinary care pathways to improve the quality and consistency of cleft management across India.
INTRODUCTION:During the course of orthodontic treatment, a proper hygiene protocol is advised to all patients. Maintenance of oral hygiene prevents potential damage to hard tissue along with soft tissue. Despite preventive oral hygiene measures during fixed orthodontic therapy, some patients develop white spot lesions (WSL), compromising aesthetics and posing a potential risk of developing a carious lesion. Tooth remineralisation using calcium, fluoride, phosphate and other biocompatible agents is a potential solution. AIMS:This study aimed to compare the remineralising potential of Remin Pro (hydroxyapatite), Sensodyne Pronamel (sodium fluoride) and Pur O3 Olive (ozonated olive oil) on artificially created WSLs using quantitative light-induced fluorescence (QLF) and polarised light microscopy (PLM). METHODOLOGY:An in vitro study was conducted over 1 year using 75 extracted premolars, divided into three groups (n = 25). Artificial carious lesions were created with a demineralising solution, followed by a 21-day pH cycling regime with respective agents. QLF assessed lesion volume (∆Q), fluorescence loss (∆F) and maximum fluorescence loss (∆F Max), while PLM was used to evaluate the enamel subsurface changes qualitatively. RESULTS:Statistically significant improvements were noted in ∆Q, ∆F and ∆F Max across all groups (P <0.001). Intergroup comparison revealed highly significant changes from pre-test to post-test (P = 0.001). There was no statistically significant difference in treatment effect between Remin Pro and Pur O3 Olive. CONCLUSION:Remin Pro demonstrated greater remineralisation potential compared to Sensodyne Pronamel and Pur O3 Olive under in vitro conditions. There was no statistically significant difference in treatment effect between Remin Pro and Pur O3 Olive.