BACKGROUND:Several age-related changes contribute to deteriorating oral health and risk of tooth loss, with negative effects on oral function and physical and psychological well-being. To improve these aspects, fixed oral rehabilitation can be offered and has been indicated to also positively impact biopsychosocial parameters. OBJECTIVE:To explore how older adults with poor oral function experience their life situation, before, during, and after fixed oral rehabilitation, and their involvement in this therapeutic process. METHOD:A qualitative interview study with explorative design included eight older adults from a large intervention study of oral rehabilitation, all ≥ 65 years with an Eichner index <B2. Data were analysed with manifest content analysis. RESULTS:Our findings suggest that the participants had developed coping strategies regarding eating habits and experienced social detachment and emotional loneliness prior to the rehabilitation. During the oral rehabilitation, the person-centred approach by the dental team was highly valued, suggesting the need for individualized, tailored support. After completing the oral rehabilitation, a sense of relief, self-worth, satisfaction, and self-mastery were emphasised by the participants in addition to the obvious improvement in chewing ability. An unexpected finding following the oral rehabilitation was the participants' lack of post-care initiatives. CONCLUSIONS:This qualitative study emphasises the impact of poor oral health in older adults, also concerning their emotional well-being, before oral rehabilitation. To improve older persons' oral health and function late in life, we suggest a tailored person-centred approach during their oral rehabilitation, but also structured referral and dental care strategies post oral rehabilitation. TRAIL REGISTRATION:ClinicalTrials.gov identifier: NCT06783426.
BACKGROUND:Individuals with dysphagia exhibit impaired oral clearance and reduced airway protection, increasing oral biofilm accumulation and inflammatory burden. OBJECTIVE:To evaluate whether a structured, individualized oral care approach (MOHIT) was associated with changes in oral inflammatory and biofilm-related markers in dysphagic, care-dependent individuals with acquired brain injury (ABI) during inpatient neurorehabilitation. METHODS:Adults with ABI, who screened positive for dysphagia at week 1 (n = 44) were followed for 3 weeks in an exploratory predefined subgroup analysis of a cluster nonrandomized controlled trial. Three wards implemented a structured, individualized oral care protocol (MOHIT: n = 12), consisting of structured oral assessment and individualized nurse-delivered oral care including suction-assisted electric toothbrushing, while three wards continued standard oral care (EOCP: n = 32). Outcomes included behavioural indicators (brushing frequency and toothbrush type), modified Bedside Oral Examination (mBOE), and clinical parameters (plaque, bleeding on probing, tongue coating, and odour) assessed at baseline and week 4. Direction-of-change indicators were compared using the Mann-Whitney U test. RESULTS:Toothbrushing frequency did not differ between groups (p = 0.347). The MOHIT group showed more favourable exploratory changes in overall mBOE score (3.1 ± 2.2 vs. 0.8 ± 2.8; p = 0.007), bleeding on probing (22.7 ± 22.3 vs. -4.0 ± 20.2; p = 0.001), plaque (20.1 ± 14.0 vs. 2.7 ± 17.4; p = 0.009), and odour score (1.6 ± 1.7 vs. 0.3 ± 1.4; p = 0.019). Tongue-coating score showed a favourable but non-significant exploratory pattern (6.2 ± 5.5 vs. 1.4 ± 6.6; p = 0.057). CONCLUSION:Structured, individualized oral care delivered by trained nursing staff was associated with improvements in screening and clinical inflammatory markers among dysphagic, care-dependent ABI individuals. Given the cluster-level implementation, small sample size, and nonrandomized allocation, findings indicate feasibility and support hypothesis-generating evidence of potential clinical benefit but do not establish causal efficacy.
BACKGROUND:Temporomandibular joint (TMJ) discectomy and disc repositioning surgery (DRS) remain treatment options for disc displacement (DD) when conservative and minimally invasive treatments fail. DRS and discectomy with disc replacement are used, in part, to prevent osteoarthritis (OA) development. OBJECTIVE:To assess evidence for OA development after surgical treatment of TMJ DD by comparing OA development in surgically treated TMJs to OA development in conservatively treated patients with DD. METHODS:A systematic search (Medline, Embase and Cochrane up to 3 October 2024) was performed, and PRISMA was followed. A lack of effect sizes precluded meta-analysis; a descriptive statistical comparison between groups was made (Student's t-test, χ2 test, significance level p < 0.05). RESULTS:Eight observational studies, including discectomy of 117 TMJs (DD with/without reduction; without replacement), 206 comparison TMJs (DDwoR; observation) and one DRS study, met the eligibility criteria. An additional case report met the eligibility criteria but was not included in data synthesis. Heterogeneity in study designs, diagnostic methods and criteria, and mostly high Risk of Bias according to GRADE was found. OA and OA-related findings increased in all discectomy and comparison studies at follow-up. CONCLUSION:A consistent trend of increasing TMJ OA frequency was observed across the included studies in both operated and unoperated TMJs with DD. Most studies provided evidence of very low certainty. This systematic review could therefore not reliably evaluate whether TMJ discectomy is itself responsible for OA development. Further research is needed to determine the influence of surgical treatments of TMJ DD on OA.
BACKGROUND:Obstructive sleep apnea (OSA) is a common sleep disorder that is associated with comorbid diseases if untreated. Mandibular advancement devices (MADs) are a viable treatment option that offers good adherence, although they are not the gold standard. OBJECTIVE:Evaluation and comparison of three different MADs on sleep parameters AHI (apnea-hypopnea index) and ODI (oxygen desaturation index) while adjusting for demographic and clinical parameters. METHODS:In a private dental practice, patients previously diagnosed with OSA received an individually adjusted MAD. For each patient, one of three types of MAD was used, of which one was fabricated conventionally and two were CAD/CAM-fabricated. Polysomnographic parameters before and after treatment with MAD were extracted from patient files. Statistical analysis was conducted assessing the effect of MAD on AHI and ODI and evaluating the impact of clinical and demographic parameters on the reduction of AHI and ODI. RESULTS:A total of 300 patients were included, of which 40 received a conventionally manufactured MAD. Mean AHI and ODI reduction was 16.4 ± 17.9/h and 10.8 ± 15.2/h respectively, while patients with higher baseline AHI and ODI values experienced greater reductions. Female gender and younger age also led to greater reductions. Patients treated with the conventionally manufactured MAD displayed greater reductions. More prominent protrusion did not lead to greater mean reduction of AHI and ODI values. CONCLUSION:Mandibular advancement therapy led to significant reductions in AHI and ODI, with an average improvement of approximately 50%. Baseline severity strongly predicted treatment response, while age and gender also influenced outcomes.
BACKGROUND:Conventional complete dentures (CDs) fabrication involves multiple clinical and laboratory steps. Simplified protocols reduce treatment burden. However, their impact on patient-reported outcomes remains debated. OBJECTIVE:This systematic review and meta-analysis evaluated the oral health-related quality of life (OHRQoL), patient satisfaction, and masticatory ability of CDs fabricated using simplified versus traditional protocols. METHODS:Seven databases were searched up to July 2026 for randomised controlled trials (RCTs) comparing simplified and conventional CDs fabrication protocols. Two reviewers independently assessed records and risk of bias using the Cochrane RoB 2 tool. Mean differences and 95% confidence intervals were meta-analysed using random-effects models. Heterogeneity (I2), subgroup analyses according to follow-up periods, small-study effects/funnel plot asymmetry using Egger's test when applicable, and evidence certainty using GRADE were assessed. RESULTS:Twenty-two RCTs were included. Simplified procedures were typically characterised by single-stage impression procedures, absence of facebow records, and a single trial denture session. Most studies had some concerns or a high risk of bias. Meta-analyses showed no statistically significant differences between protocols regarding OHRQoL (p = 0.620; I2 = 0%), overall satisfaction (p = 0.440; I2 = 5%), and masticatory ability (p = 0.610). Evidence of funnel plot asymmetry/small-study effect was detected only for patient satisfaction (p = 0.033). The certainty of the evidence was rated as moderate to very low across outcomes. CONCLUSION:Greater procedural complexity in complete denture fabrication was not associated with superior OHRQoL, patient satisfaction, or masticatory ability. Within the certainty limits of the available evidence, simplified protocols may be a pragmatic alternative to conventional fabrication.
BACKGROUND:Oral health in older adults is often compromised by age-related changes, such as oral frailty and systemic comorbidities. Consequently, older patients requiring home-visit dental care, mostly due to eating-related problems, may show stage-dependent differences in oral conditions and dental care priorities. OBJECTIVE:To clarify care phase-specific dental care needs among older patients receiving home-visit dental care. METHODS:This multicenter cross-sectional study included 356 older patients who received home-visit dental care for eating-related problems at acute-care (n = 119), convalescent-care (n = 144) and community-based care facilities (n = 93) between April 2016 and March 2020. Data collected at the initial visit included demographic and clinical characteristics, number of functional teeth, Oral Health Assessment Tool (OHAT) score, feeding and swallowing function, nutritional intake method, reasons for referral and dental care judged to be of the highest priority. Differences among care phases were analysed. RESULTS:Patient age increased significantly with care phase. The number of functional teeth and OHAT scores were most favourable in the convalescent phase. Feeding and swallowing function and nutritional intake improved significantly from the acute to community-based phases. Swallowing rehabilitation and oral hygiene management were the most common reasons for referral and priority interventions in the acute phase; removable prosthetic treatment predominated the convalescent phase, and diverse needs were observed in the community-based phase, where removable prosthetic treatment was most frequently prioritized. CONCLUSION:Dental care needs and priorities in home-visit dental care vary according to care phase, underscoring the importance of phase-specific dental management among older adults.
BACKGROUND:Temporomandibular disorders (TMD) encompass a group of musculoskeletal and neuromuscular conditions involving the temporomandibular joint (TMJ), masticatory muscles, and associated structures. As an emerging self-management approach, digital health interventions (DHIs) have demonstrated potential clinical value. OBJECTIVE:To investigate the effects of DHIs on pain, maximum mouth opening, and jaw function in individuals with TMD. METHODS:A literature search was performed in five electronic databases: PubMed, Web of Science, Embase, Cochrane Library, and MEDLINE, with the search date set to 18 January 2026. Inclusion criteria comprised randomised controlled trials (RCTs) evaluating DHIs for individuals with TMD that reported pain, jaw function, and maximum mouth opening (MMO) as primary outcomes. Risk of bias was assessed using the Risk of Bias 2 tool for all included studies. The certainty of evidence for each outcome was assessed using the GRADE approach. A narrative synthesis of the findings was subsequently performed. RESULTS:Six eligible RCTs were included, totaling 352 participants. The review assessed the effects of three types of DHIs, including mobile applications, internet-based behavioural therapy (IBT), and telerehabilitation, for individuals with TMD. Under the descriptive umbrella of this narrative synthesis, mobile applications and telerehabilitation may be associated with improvements in pain, jaw function, and MMO. The certainty of evidence was rated as very low per GRADE criteria. No such benefits have yet been identified for IBT. CONCLUSION:DHIs may be beneficial in reducing pain, increasing mouth opening, and improving jaw function in individuals with TMD. However, further high-quality research is warranted to confirm these findings. TRIAL REGISTRATION:PROSPERO Registration Number: CRD420261304970.
BACKGROUND:Temporomandibular joint (TMJ) disc repositioning (DR) is an effective treatment for anterior disc displacement (ADD). However, postoperative joint motion lacks comprehensive objective evaluation and comparison between different surgical methods. MATERIALS AND METHODS:Patients who need TMJ DR surgery at our center between November 2023 and September 2024 were enrolled and divided into 2 groups for comparison: arthroscopic group (AS) and open suturing (OSu) group. Mandibular and condyle movement, pain and quality of life were assessed preoperatively (T0), at 3 months (T1), and 6 months (T2) postoperatively using the ultrasonic Jaw Motion Analyser (JMA; zebris) system and Visual Analog Scale (VAS) scores. The differences between the 2 groups and at different time intervals were compared by generalized estimating equations. RESULTS:A total of 106 patients were included with the median age of 17 years. There were 35 patients in OSu group and 71 in AS group. After DR, maximum mouth opening (MMO) was significantly increased and pain VAS was decreased. However, condylar translation length (CTL) of the DR joint, laterotrusion and protrusion were decreased (p < 0.05), while condylar rotation (CR) was increased (p < 0.05). With no significant differences between AS and OSu groups at T0 (p > 0.05), MMO, CR and laterotrusion were superior in the AS group than OSu group at T1. There were no significant differences between the two groups at T2 (p < 0.05). CONCLUSION:DR surgery improves MMO by increasing condylar rotation but decreasing condylar translation. AS group demonstrated faster recovery in mandibular movement and pain relief than OSu group.
BACKGROUND:Temporomandibular disorders (TMD) have the potential to progress to a chronic form associated with various comorbidities. Prolonged symptoms may lead to central sensitization (CS), resulting in decreased treatment response and highlighting the need for personalized treatment strategies. OBJECTIVE:This study evaluated psychological conditions and comorbidities in TMD patients based on CS-related symptom levels measured by the Central Sensitization Inventory (CSI) and investigated the association between these levels and long-term treatment outcomes. MATERIALS AND METHODS:CS-related symptom levels were assessed using the CSI in 112 TMD patients (score ≥ 40 indicating significant levels of CS symptoms). Psychological, sleep, autonomic and pain-related comorbidities were evaluated by validated questionnaires. Participants received standardized conservative treatment, including behavioural, physical, stabilization splint and pharmacological therapies. After 6 months, patients were re-evaluated for clinical signs. Data were statistically compared between the high (n = 40) and low (n = 72) CSI groups and associations between clinical characteristics and CSI levels were analyzed. Longitudinal changes were analyzed using Generalized Estimating Equations. RESULTS:High CSI (35.7%) was associated with higher McGill Pain Questionnaire (MPQ) scores, widespread pain and higher levels of anxiety, depression, somatization and autonomic symptoms (all padj < 0.05 after Bonferroni correction). At 6-month follow-up, the high CSI group showed a trend toward a smaller reduction in pain (group × time interaction, χ2 = 5.587, p = 0.018), suggesting a potentially less favourable treatment response to conservative therapy. CONCLUSION:TMD patients with higher CSI scores exhibit more multidimensional comorbidities and diminished response to conservative therapy. Early identification of CS-related symptoms may be beneficial for establishing personalized treatment strategies.
PURPOSE:To assess the individual and combined associations of salivary flow rate and masticatory performance with instrumental activities of daily living (IADL) impairment in community-dwelling older adults, and investigate whether depressive symptoms modified these associations. METHODS:This cross-sectional study used baseline data from an ongoing prospective cohort study of 244 community-dwelling older adults in Yangon, Myanmar. IADL impairment was defined as a Lawton IADL scale score of ≤ 7. Low salivary flow rate was defined as < 0.1 mL/min and poor masticatory performance as a xylitol chewing gum score of ≤ 3. Participants were classified into four groups based on these two measures. Depressive symptoms were assessed using the Geriatric Depression Scale-15 (score ≥ 5). Multivariable binary logistic regression, interaction terms, and stratified analyses were conducted. RESULTS:The prevalences of IADL impairment and depressive symptoms were 46.3% and 50.4%. Low salivary flow rate was independently associated with IADL impairment after adjustment (aOR: 1.89, 95% CI: 1.08-3.28), while poor masticatory performance alone was not. In the combined four-group model, participants with any oral impairment had higher odds of IADL impairment compared with those with normal salivary flow rate and masticatory performance. In stratified analyses, the association between low salivary flow rate and IADL impairment was more apparent among participants with depressive symptoms (aOR: 2.04, 95% CI: 1.09-4.47). CONCLUSION:Low salivary flow rate was associated with IADL impairment in community-dwelling older adults. The association appeared more pronounced among those with depressive symptoms, but this potential modifying role requires confirmation in larger longitudinal studies.
BACKGROUND:Aspiration pneumonia is the leading cause of morbidity and mortality in oculopharyngeal muscular dystrophy (OPMD), yet non-muscular contributors to aspiration risk are poorly defined. Thick saliva is frequently reported but has never been quantitatively characterised. OBJECTIVES:The primary objective was to compare salivary kinematic viscosity in genetically confirmed patients vs. household controls. Secondary hypothesis-generating exploratory objectives were to examine associations between viscosity, dysphagia severity, and aspiration risk. METHODS:In this observational, cross-sectional study, we compared genetically confirmed OPMD patients with matched household controls. Salivary kinematic viscosity was the primary outcome. Exploratory assessments examined associations between viscosity and validated dysphagia measures (Swallowing Disturbance Questionnaire, Penetration-Aspiration Scale, Functional Oral Intake Scale) and oral health (number of decayed, missing, and filled teeth). RESULTS:Among 57 participants (30 OPMD, 27 controls), salivary viscosity was higher in patients (difference 0.85 cSt; 95% CI 0.27-1.44; p = 0.007) and remained independently associated with the disease status after adjustment for age, oral health, and "xerogenic" medications. Higher viscosity was independently associated with higher aspiration risk (adjusted OR 2.5 per 1 cSt; 95% CI 1.1-6.1; p = 0.040), and discriminated patients with high risk for aspiration (Area Under the Curve of 0.76 and a positive likelihood ratio of 10.0). Salivary flow rates were preserved, indicating a compositional rather than hyposecretory rheological shift. CONCLUSION:Oculopharyngeal muscular dystrophy is associated with a flow-independent shift in salivary rheology quantitatively linked to dysphagia severity and aspiration risk. These cross-sectional findings nominate salivary viscosity as a non-invasive candidate biomarker warranting prospective validation for clinical application.
BACKGROUND:Oral rehabilitation in adults with functional limitations is increasingly encountered in prosthodontic practice; however, evidence on whether planned removable pathways can be maintained in this population is limited. OBJECTIVES:To evaluate early maintenance of planned removable prosthodontic treatment pathways in adults with functional limitations and to identify factors associated with early pathway change. METHODS:This retrospective cohort study included adults with functional limitations who underwent removable prosthodontic treatment planning at a tertiary referral centre. Treatment pathways were classified as maintenance, conversion to implant-based rehabilitation, or abandonment. Early pathway change was defined as conversion or abandonment during the early treatment phase. Clinical, functional, and caregiver-related variables were analysed using logistic regression models, and time-to-event patterns were evaluated using Kaplan-Meier analysis and the log-rank test. RESULTS:Early pathway change occurred in 45 of 201 patients (22.4%). Functional limitation categories were associated with early pathway change in univariate analysis but not after multivariable adjustment. In multivariable analysis, impression feasibility under outpatient conditions (OR 0.07, 95% CI 0.02-0.17, p < 0.001) and high caregiver support (OR 0.14, 95% CI 0.03-0.48, p = 0.003) were independently associated with a lower likelihood of early pathway change. Dual-arch (vs. single-arch) rehabilitation showed a borderline protective association in the parsimonious model (OR 0.45, 95% CI 0.17-1.15, p = 0.094). CONCLUSION:Early treatment pathway change was more closely associated with procedural feasibility and caregiver support than with structural clinical variables. These findings may help identify patients in whom modification of the planned treatment pathway should be considered early.
BACKGROUND:Bruxism and temporomandibular disorders (TMD) are multifactorial conditions in which cognitive and behavioural traits may play an underrecognised role. Hyperfocus, defined as intense and sustained attentional engagement, has been proposed as a potential driver of heightened sensorimotor activity and pain vulnerability, yet its relevance to bruxism and painful TMD remains poorly understood. OBJECTIVES:To examine whether hyperfocus is associated with probable bruxism and painful TMD (pTMD), and to determine whether probable bruxism mediates the relationship between hyperfocus and pTMD. METHODS:This cross-sectional observational study included eighty-five adults attending a university dental clinic who underwent standardised assessments for probable bruxism, pTMD, anxiety, depression, hyperactivity, and hyperfocus. Logistic regression models were used to identify factors associated with probable bruxism and pTMD. Mediation analyses tested whether probable bruxism explained the association between hyperfocus and pTMD. RESULTS:Higher hyperfocus scores were significantly associated with both probable bruxism and pTMD. Each one-point increase in hyperfocus was linked to a 6.5% increase in the odds of PB and a 5.5% increase in the odds of pTMD. Hyperfocus was also associated with self-reported probable bruxism frequency in a dose-response pattern. Probable bruxism did not remain independently associated in the final multivariable model and therefore did not statistically explain the observed association between hyperfocus and pTMD, indicating that hyperfocus may act as an independent factor linked to both conditions. CONCLUSION:Hyperfocus emerged as a trait associated with probable bruxism and painful TMD in this exploratory cross-sectional study. Longitudinal and mechanistic studies are needed to determine whether these associations reflect causal relationships.
BACKGROUND:Psychosocial and behavioural factors shape temporomandibular disorders (TMDs), yet integrated phenotyping in Southeast Asian young adults remains limited. University students, a vulnerable subgroup of young adults, face heightened risk. OBJECTIVES:To identify latent psychosocial-behavioural classes in this cohort and assess associations with sociodemographic factors and TMD severity. METHODS:A cross-sectional study of participants aged 18-30 years used validated instruments to assess distress (Patient Health Questionnaire-4; PHQ-4), somatic symptoms (PHQ-15), oral behaviours (Oral Behaviours Checklist; OBC), and TMDs (Short-form Fonseca Anamnestic Index; SFAI). Latent class analysis (LCA) was performed on PHQ-4, PHQ-15, and OBC scores, estimating one- to five-class models. Class differences were tested using χ2 and Kruskal-Wallis/Dunn's procedures. Predictors of class membership were evaluated using multinomial logistic regression (α = 0.05). RESULTS:Three classes emerged: Resilient (56.1%), Moderate-Vulnerability (30.4%), and High-Risk (13.5%). TMD prevalence was highest in High-Risk (45.0%), intermediate in Moderate-Vulnerability (25.6%), and lowest in Resilient (10.0%). Depression (OR = 12.34), anxiety (OR = 13.03), somatic burden (OR = 4.91), and oral behaviours (sleeping-state OR = 1.77; waking-state non-functional OR = 1.70; waking-state functional OR = 1.44) significantly predicted High-Risk membership. Sociodemographic factors and TMD severity differentiated classes descriptively but lacked predictive strength. CONCLUSION:LCA delineated three psychosocial-behavioural phenotypes, with depression, anxiety, and somatic burden most strongly defining High-Risk membership, and oral behaviours adding incremental risk. Findings underscore upstream psychosocial-behavioural determinants as key prevention targets, while downstream outcomes guide tailored interventions in young adults.
OBJECTIVE:This study evaluated the prevalence of self-reported awake bruxism and self-reported sleep bruxism among elementary and middle school students and its association with stress and primary headache. METHODS:Three questionnaires were applied: questions about parafunction and behavioural habits for bruxism diagnosis, International Headache Society questionnaire for headache prevalence analysis, Lipp's inventory symptoms of stress (ISSL) for stress assessment. For the analysis of the data, the chi-square test was performed to compare proportions with 95% CI and the relative risk ratio test was also applied to study association with age and race. The level of significance was 5%. RESULTS:A total of 209 adolescents participated in the study. The prevalence was 3.8% for self-reported sleep bruxism, 8.13% for self-reported awake bruxism and 49.3% for bruxism, regardless of the frequency. There was an association among self-reported sleep bruxism, headache (p = 0.037) and stress (p = 0.000); self-reported awake bruxism, age (p = 0.024) and stress (p = 0.007); as well as similarly for the simultaneity of self-reported awake bruxism and sleep bruxism. CONCLUSION:There was also an association among stress, some symptoms of sleep bruxism and parafunctional and occupational habits. The findings suggest a significant association between self-reported sleep bruxism, self-reported awake bruxism, stress and self-reported headache.
OBJECTIVES:To clinically validate a self-administered Wax Bite Test (WBT) for counting posterior functional units (PFU) by assessing its agreement with the articulating-paper reference method, reliability, feasibility and acceptability. METHODS:In this cross-sectional study, 44 adults were enrolled. PFU were assessed using the reference method (PFU-reference) and the self-administered WBT (PFU-WBT) with pre-sized modelling wax. Two calibrated evaluators independently interpreted each wax record twice. Agreement with the reference method was assessed using Bland-Altman analysis and method-comparison regression using orthogonal distance regression (ODR). Equivalence was evaluated using TOST with a predefined margin of ±1 PFU. Intra- and inter-rater reliability were quantified using intraclass correlation coefficients (ICC). Feasibility was assessed by the frequency and determinants of unreadable records. Acceptability was evaluated using visual analogue scales. RESULTS:Participants completed two successive rounds of the WBT, generating 176 wax bites records, read twice by two investigators (704 assessments). Overall, 22.2% of records were unreadable, but this limitation was concentrated mainly among fully edentulous participants (p < 0.001) due to insufficient bite force. Bland-Altman analysis showed a bias of 0.20 PFU (95% CI: -0.11 to 0.51) with limits of agreement from -1.66 to 2.06 PFU. ODR indicated a slope near unity and TOST confirmed equivalence within the predefined ±1 PFU margin. Reliability was good to excellent in fully dentate and partially dentate participants (ICC > 0.826). Acceptability was high for all participants. For severe impairment (PFU ≤ 4), the WBT showed high specificity (97%) and good sensitivity (80%) compared with the reference method. CONCLUSIONS:In nutritional research, simple and reliable tools to assess oral functional capacity are essential for understanding dietary choices and nutritional risk. The WBT appears to be a practical, self-administered tool for monitoring PFU in clinical and community settings. However, adaptations are required for fully edentulous individuals wearing complete dentures, in whom unreadable records were frequent because of reduced bite force. TRIAL REGISTRATION:IRB00013412, December 19th, 2024 CLINICAL SIGNIFICANCE: WBT provides a low-cost, participant-friendly way to monitor PFU in clinical and community settings.
OBJECTIVE:This systematic review aimed to evaluate the effectiveness of myofascial release therapy (MFR) on pain in patients affected by myogenous temporomandibular disorders (TMD). METHODS:PubMed, Scopus, and Web of Science were searched from inception until 31 January 2026, to identify RCTs including patients affected by TMD as participants, MFR therapy as intervention, and pain intensity as outcome. The risk of bias of studies was assessed with the Version 2 of the Cochrane risk-of-bias tool for randomized trials (RoB 2). The Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach was used to assess the certainty of evidence. RESULTS:Out of 857 articles, 7 studies were included. All subjects had a diagnosis of TMD performed according to the RDC/TMD or DC/TMD. The rehabilitation period ranged from 10 days to 5 weeks. Treatment frequency ranged from a minimum of one session per week to a maximum of 3 sessions per week. Medium/long-term follow-up was performed in four studies. The Cochrane RoB 2 tool showed that zero studies had a low risk of bias, six had some concerns, and one had a high risk of bias. The GRADE assessment showed a low certain of evidence for pain reduction and mouth function, and a very low certain of evidence in improving QoL. CONCLUSIONS:MFR seemed to reduce pain and improve mouth function in patients with myogenous TMD. However, when benchmarked against established clinical thresholds, clinically meaningful efficacy (surpassing the 15-22 mm MCID) is only supported by a subset of the included trials. In this context, MFR could be considered as part of a multidisciplinary approach for patients with TMD. More rigorous isolated-MFR trials are needed to better characterize the efficacy of MFR in patients affected by myogenous TMD.
BACKGROUND:The pathophysiology of burning mouth syndrome (BMS) remains unclear. OBJECTIVES:To compare the clinical characteristics of patients with lingual BMS according to pain distribution. METHODS:The medical records of patients with lingual BMS who visited the oral clinic of Kyung Hee University Korean Medicine Hospital between January 2023 and December 2024 were retrospectively reviewed. Patients were classified according to tongue pain distribution as follows: laterality (unilateral vs. bilateral), extent (localised vs. generalised) and central tongue involvement (non-central vs. central involvement). Group differences and associations among clinical characteristics, including pain intensity (visual analog scale [VAS]), quality of life, salivary flow and taste disturbance, were assessed. RESULTS:In total, 256 patients were included. Patients with bilateral pain showed significantly higher pain intensity than those with unilateral pain. Patients with generalised pain reported significantly higher pain intensity than those with localised pain. Patients with central involvement showed significantly higher pain intensity than those with non-central involvement. Pain intensity was negatively associated with quality of life in most subgroups, except the unilateral subgroup. Taste disturbance was associated with clinically significant pain (VAS ≥ 4) in the unilateral and localised subgroups, whereas reduced salivary flow was associated with clinically significant pain in the central involvement subgroup. CONCLUSIONS:Pain distribution may help identify clinical subtypes of lingual BMS and support individualised assessment. Herein, pain distribution was associated with differences in pain intensity, quality of life, taste disturbance and salivary flow, underscoring the heterogeneous and multifactorial pathophysiology of lingual BMS and the need for tailored management.
BACKGROUND:Tooth loss is common in older adults and a recognized risk factor for malnutrition, compromising chewing ability and restricting food choices. The Geriatric Nutritional Risk Index (GNRI), based on serum albumin and body weight, provides an objective and validated measure for malnutrition, yet its relationship with clinically assessed remaining teeth has not been fully explored. OBJECTIVES:The objective of this study was to examine the association between clinically assessed remaining teeth and GNRI-defined malnutrition risk in a large cohort of older adults. RESULTS:We analysed data from 3717 subjects aged≥ 60 years in the 2009-2014 National Health and Nutrition Examination Survey, representing approximately 42.37 million non-institutionalized U.S. individuals in this age group. Dentition status was determined by standardized dental examinations, and nutritional risk was classified using GNRI (< 98 vs. ≥ 98). Weighted logistic regression models assessed associations, adjusting for demographics, socioeconomic status, lifestyle, and multimorbidity. Tooth loss was consistently associated with higher malnutrition risk. In unadjusted models, participants with 10-19 teeth odds ratio (OR):1.75, 95% confidence interval (CI):1.14-2.69, 1-9 teeth (OR:2.24, 95% CI:1.43-3.51), and edentulism (OR:2.45, 95% CI:1.77-3.39) had significantly greater odds of low GNRI compared with those with ≥ 20 teeth. After full adjustment, the association remained significant for edentulous individuals (OR:1.72, 95% CI:1.11-2.66). CONCLUSION:Complete tooth loss appeared to be a robust marker of nutritional vulnerability in older age, underscoring the need to integrate oral health into geriatric nutrition screening. Preserving or restoring dentition may play a critical role in preventing malnutrition and supporting healthy aging.
BACKGROUND:Temporomandibular disorders (TMD) present diverse signs and symptoms and often require clinical evaluation. OBJECTIVE:To investigate variation in the volume of TMD treatment among adult patients in Finnish private oral healthcare between 2006 and 2024. METHODS:This retrospective register-based study used annual aggregate data from the Social Insurance Institution of Finland on patients aged 20 years or older. Per year, an average of 56 500 patients received TMD-related procedures, which were primarily coded by visit duration; only splint therapy was coded as a single, specific procedure. TMD treatment volume was described as the number and proportion of TMD patients and procedures, overall in each year from 2006 to 2024 and in detail, by 5-year age groups in selected years (2012, 2014, 2017, 2020, 2022 and 2024). Linear regression assessed associations between treatment year, age group and treatment volume. RESULTS:From 2006 to 2024, TMD patients constituted 4.1%-6.7% of all patients, peaking in 2015-2019 and in age groups 25-55 years. TMD procedures accounted for 1.2% of all clinical procedures in 2006, 2.4% in 2020 and 2.0% in 2024. Short- and medium-duration TMD procedures predominated; splint therapy was more common in younger patients (in 2024, 28%-32% of TMD patients aged 20-39 years and 25%-27% aged 40-54 years). Linear regression showed strong, negative associations between age group and TMD treatment volume (p < 0.001). CONCLUSION:TMD therapy is more common among younger adults. Register-based data indicate increasing use of splint therapy, particularly among younger patients. Recent declines in overall volume after peak years may reflect changes in clinical decision-making and promote a more nuanced understanding of treatment risks.
