Abstract Objectives: Miniscrew-assisted rapid palatal expansion (MARPE) is increasingly used for adult transverse maxillary deficiency. This systematic review and meta-analysis aimed to quantify three-dimensional changes in the temporomandibular joint (TMJ) space and condylar position following MARPE. Methods: A systematic search of PubMed, Scopus, Embase, and Web of Science was conducted through May 2025. Inclusion criteria followed the PICOS framework: human participants (≥12 years) undergoing MARPE with pre- and post-treatment cone-beam computed tomography assessments. Data extraction and risk of bias (ROBINS-I) were performed independently by two reviewers. Pooled standardized mean differences (SMD) with 95% confidence intervals (CI) were calculated using a random-effects model. Results: Four studies comprising 95 patients were included. Meta-analysis revealed no statistically significant changes in condylar joint spaces: Anterior [SMD = −0.04 (95% CI: −0.35 to 0.26; P = 0.81; I 2 = 0%)], posterior [SMD = 0.31 (95% CI: −0.01 to 0.61; P = 0.06; I 2 = 0%)], and superior [SMD = 0.23 (95% CI: −0.05–0.42; P = 0.12; I 2 = 0%]. Narrative synthesis indicated transient clockwise mandibular rotation that largely relapsed during retention. The certainty of evidence was rated low-to-moderate due to the lack of randomized controlled trials. Conclusions: Current evidence suggests that MARPE does not induce clinically or statistically significant alterations in TMJ morphology or condylar position in the short term. MARPE appears to be a safe orthopedic procedure for the TMJ, although long-term studies with larger cohorts are needed to confirm these adaptive trends.
Abstract Objective: This study aims to characterize global scientific output on the use of hyaluronic acid (HA) for treating periodontal diseases. Methods: A descriptive and exploratory bibliometric analysis was conducted using the bibliometric analysis guidelines of the Reporting and Measurement of Items for Bibliometric or Scientometric Studies in Health Sciences for health sciences. Documents published from January 2020 to October 2025 were selected from Scopus using a combined formula with controlled and free-text terms. A total of 239 publications were selected, exported, and analyzed in. comma-separated values format. Then, productivity indicators, collaboration metrics, thematic evolution analysis, and impact benchmarking were assessed using Bibliometrix (R), VOSviewer, and SciVal. Results: The scientific output exhibited a consistent annual growth rate of 17.6%. Original research articles represented the largest proportion (87%), and a very high level of collaboration was observed, involving an average of 12.4 authors per publication. Data showed an international collaboration in 25.9% of publications, suggesting an increasing globalization of the discipline. Clinical Oral Investigations was the most productive and influential journal, while Anton Sculean and Yoshinori Shirakata showed high productivity and citation impact. The thematic analysis indicated a gradual change in emphasis from classic clinical thematic areas to regenerative strategies and biomaterials, while HA, bone regeneration, and hydrogels appeared to represent major areas of research emphasis. Conclusion: The evolution of research themes and the diversity of publications reflect a dynamic, interdisciplinary landscape progressively oriented toward biomedical innovation and regenerative solutions.
Abstract Objective: Habitual khat chewing is prevalent in East Africa and the Arabian Peninsula, but its long-term effects on oral health remain poorly defined. This review systematically evaluates the oral health complications associated with khat chewing, including periodontal disease, mucosal lesions, dental caries, tooth wear, tooth loss, and temporomandibular disorders (TMD). Methods: A systematic review of PubMed, Scopus, Web of Science, and Google Scholar was conducted for English-language studies published up to August 2024. Observational and interventional studies assessing oral outcomes in khat chewers were included. Screening and data extraction were performed independently by two reviewers. Quality assessment was conducted using National Institute of Health tools. A qualitative synthesis was performed due to high heterogeneity. Results: Fifty-seven studies were included. Khat chewing was associated with periodontal disease (gingival recession, clinical attachment loss), mucosal white lesions, tooth wear, and increased risk of TMD. A few studies reported reductions in plaque and gingival indices, but these benefits were inconsistent and outweighed by harmful effects. Variability in diagnostic criteria and study design limited causal inference. Conclusion: Khat chewing adversely affects oral health, with strong evidence for periodontal and mucosal damage. Preventive public health strategies and longitudinal studies are needed to mitigate these risks.
Abstract Objectives: To evaluate the evidence available in clinical success of bulk-filled and conventional composite restoration in primary molars. Methods: A thorough search was conducted in PubMed, Cochrane, Google Scholar, and TRIP until December 2023 based on the inclusion and exclusion criteria. Randomized controlled trials using bulk-fill composite as one of the restorative materials were among the selection criteria. Four studies met the inclusion and exclusion criteria of the intended research. The search results were depicted in the PRISMA flow chart. The Cochrane collaboration’s risk-of-bias Assessment Tool 2.0 (RoB 2) was used to evaluate the RoB in the included studies. A meta-analysis was not feasible due to substantial heterogeneity among the studies, including differences in research design, participant selection, study duration, questionnaires, and diagnostic methods. Results: The initial search yielded 571 articles, but only four articles met the inclusion and exclusion criteria. All the four studies selected for systematic review compared the clinical success of bulk-filled and conventional composite restoration for primary molars. On assessing the RoB, one of the four included articles have a low RoB and three of the four included articles have high RoB due to uncertain or high risk in allocation concealment and blinding of participants. Conclusion: Based on the studies evaluated and the limitations of this review, a similar clinical performance of conventional resins and bulk resins for carious lesion restorations can be concluded.
Abstract Objectives: Pain assessment in pediatric dentistry remains challenging because children may have limitations in communication, cognition, and emotional expression. This narrative review examines the validity, reliability, and clinical utility of commonly used and emerging pediatric dental pain assessment scales. Methods: A structured literature search was performed across PubMed, Google Scholar, and EBSCOHost up to June 30, 2025. Six full-text randomized controlled trials evaluating validated pediatric dental pain scales were included. The methodological quality of included studies was assessed with respect to psychometric robustness and clinical usability. Results: Facial expression-based scales, such as the Wong-Baker FACES Pain Scale, were consistently found to be practical and easily understood by most children. Among digital pain assessment tools, the Simplified Pictorial Grading Pain Scale and animated visual face-based scales demonstrated superior reliability and user engagement compared to traditional static facial scales. Behavioral observation tools such as Face, Legs, Activity, Cry, Consolability (FLACC) Scale and Sound-Eye-Motor (SEM) Scale remained valuable for younger or non-verbal children, although their accuracy depended on clinician interpretation skills. Due to heterogeneous outcome reporting and restricted access, quantitative pooling of data was not feasible. Conclusion: Based on the reviewed evidence, emoji-based and animated digital pain scales appear most suitable for cognitively mature, digitally familiar pediatric cohorts, whereas observational tools such as the SEM and FLACC Scales remain more appropriate for younger or non-verbal children. Further high-quality research is required to improve standardization and to expand cultural applicability across diverse populations.
Abstract Objectives: This systematic review aims to evaluate the antibacterial potential of amino acids in managing endodontic biofilms. Methods: The protocol was registered with OSF https://doi.org/10.17605/OSF.IO/AH879 and is reported in accordance with the Preferred Reporting Items for Systematic Reviews and Meta‑Analyses 2020 guidelines for systematic reviews. Comprehensive searches were performed across databases including PubMed, Scopus, and Web of Science for relevant studies published until March 2025. The inclusion criteria focused on studies investigating the antibacterial activity of amino acids against endodontic biofilms. Search strategies were developed based on the Population, intervention, comparison, and outcomes framework and incorporated Boolean operators (AND; OR) to refine results. MeSH terms such as “endodontic biofilm,” “amino acid,” and “antimicrobial activity” were employed. From an initial pool of 751 articles, seven studies met the inclusion criteria. The quality of the selected studies was appraised using the QUIN TOOL. Results: Quality assessment revealed predominantly low-to-moderate risk of bias (4 low, 2 medium, and 1 high). Specific D-amino acids, particularly D-leucine, D-tyrosine, D-tryptophan, and D-methionine, consistently disrupted E. faecalis and B. subtilis biofilms in a concentration- and timing-dependent manner. L-forms often reversed or attenuated the inhibitory effects of their D-counterparts, underscoring the stereochemical specificity of biofilm inhibition pathways. Non-proteinogenic amino acids demonstrated dose-dependent inhibition against S. aureus and methicillin resistant S. aureus biofilms. Conclusion: Amino acids tested in this systematic review exhibited antibacterial effects against endodontic biofilms either individually or synergistically, thus suggesting their potential use as adjuncts in endodontic treatment strategies and improving oral health outcomes.
Abstract Objectives: The purpose of this systematic review was to summarize the current evidence regarding the utilization and influencing factors of denture treatment within Indonesia’s National Health Insurance (BPJS Health) system. Methods: This systematic review, conducted in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, searched in PubMed, ScienceDirect, Scopus, and Garuda databases for original studies published between 2014 and 2025 addressing denture treatment coverage under BPJS Health. The findings were synthesized qualitatively. Results: Three studies fulfilled the inclusion criteria. The reported utilization rates of denture treatment under BPJS Health varied considerably across regions. Demographic analysis revealed that the majority of denture users were females aged 51–60 years. Predisposing factors associated with service utilization included income level, knowledge about dentures, and awareness of BPJS Health benefit. Variation in denture utilization across regions, suggesting unequal access to prosthodontic services under BPJS Health. Socioeconomic and educational factors, particularly income and knowledge about dentures and BPJS Health benefits, appear to play a crucial role in influencing service utilization. Policy efforts focusing on public education and equitable service distribution are needed to optimize denture treatment coverage. Conclusion: The utilization of denture services under BPJS Health remains limited and regionally uneven. Socioeconomic and knowledge-related factors were found to strongly influence service utilization. These findings provide an initial evaluation of BPJS Health implementation for denture treatment and highlight the need to improve public awareness and ensure equitable access to optimize program effectiveness.
Abstract Aim: The present scoping review assessed the ability of deep learning (DL) models to determine the relationship between the third mandibular molar (MM3) and the inferior alveolar nerve (IAN) using panoramic radiographs and cone-beam computed tomography (CBCT). The aim was to examine the potential of these models to enhance dental diagnoses of MM3 risk to the nerve. Methods: A systematic literature search encompassed studies published between January 2015 and September 2025 in PubMed, Wiley Online Library, and ScienceDirect. The review included 27 studies which used DL algorithms including the convolutional neural networks, You Only Look Once, ResNet50, AlexNet, and RetinaNet to detect and analyze images. Results: The results showed that these models have high accuracy in predicting anatomical relationships with increased diagnostic efficiency compared with manual methods, reducing nerve complication risks from the MM3. The datasets included between 74 and 4516 X-ray images. The performance metrics included accuracy, F1 score, specificity and sensitivity (Recall). Data heterogeneity including image type, DL architecture, and dataset size makes direct comparison of model performance across studies challenging. Conclusion: DL methods in panoramic radiography and CBCT analysis can improve the accuracy and the efficiency of analyzing the relationship between the MM3 and the IAN, aiding clinical diagnosis and reducing nerve compression risk from wisdom teeth.
Abstract Aim: Children with autism spectrum disorder (ASD) often struggle with oral hygiene due to behavioral and motor difficulties that limit effective toothbrushing. Video modeling offers a practical approach to teaching proper techniques. This narrative review describes its role in improving oral hygiene among children with ASD. Methods: Relevant literature published from 2013 onward was identified through PubMed, Google Scholar, and ScienceDirect using the keywords “autism,” “toothbrushing,” “oral hygiene,” and “video modeling.” Studies involving children with ASD (Levels 1–3) and video-modeling interventions for toothbrushing were included. Results: Nine relevant studies were reviewed. Video-modeling interventions showed positive outcomes, notably improved toothbrushing performance and significantly reduced Plaque Index scores, supported by the benefits of structured audiovisual media. Conclusion: The findings of this review indicate that video-modeling interventions significantly improve toothbrushing skill acquisition and foster sustained behavioral change in children with ASD. Collectively, the evidence supports video modeling as an evidence-based, practical, and cost-effective strategy that can be readily integrated into both clinical practice and home-based oral health education.
Abstract Aim: To determine whether airway obstruction increases the prevalence of malocclusion in children aged 0–18 years. Materials and Methods: Following Preferred Reporting Items for Systematic Reviews and Meta-Analyses 2020, PubMed, Web of Science, and Scopus were searched from inception to April 2024 using predefined terms. Two reviewers independently screened titles/abstracts and full texts with third-reviewer arbitration as needed; data were extracted in duplicate, and risk of bias was assessed using the Newcastle–Ottawa scale. Due to substantial heterogeneity in populations, definitions, and outcome measures, no meta-analysis was performed, and results were synthesized narratively; numerical figures in the abstract refer to individual studies and are not pooled estimates. Results: Seven observational studies were included, comprising 3689 children. Overall, airway obstruction was associated with a higher prevalence of malocclusion; one hospital-based study (D’Ascanio 2010, n = 196) reported posterior crossbite at 48.0% in mouth breathers versus 3.1% in nasal breathers, and another study (Souki 2009, n = 401) reported Angle Class II at 66.3% versus 17.3%. Adenoid/tonsil hypertrophy was the most common condition; one community-based study (Tong 2022, n = 715) found no clear dose–response relationship between tonsil size and malocclusion. All numerical values are study-specific and not pooled estimates; no meta-analysis was performed. Conclusion: Airway obstruction is strongly associated with posterior crossbite and Class II malocclusion in children. Screening for malocclusion in children with documented structural obstruction may be warranted during active growth. However, evidence supporting the therapeutic benefit of airway treatment for preventing malocclusion is absent; intervention studies are needed before treatment recommendations can be made. Emerging technologies and theoretical frameworks offer promising avenues for precision diagnosis and personalized treatment approaches.
Objective:Head and neck neoplasms (HNNs) impose a significant global health burden, yet epidemiological data from the Ha'il region of Saudi Arabia remain limited. This study aimed to analyze the clinicopathological distribution of histopathologically confirmed HNNs recorded from two tertiary hospital pathology services in the Ha'il region.Methods:A retrospective, hospital-based observational study was conducted using a complete case sampling approach of all eligible histopathologically confirmed cases within the study period. Histopathology records from two tertiary referral hospitals in Ha'il were reviewed from 2016 to 2024. Of the 742 head and neck specimens screened, non-neoplastic and inconclusive cases were excluded, yielding 49 patients with histopathologically confirmed neoplasms. Cases were grouped by tumor behavior (benign vs. malignant), anatomical site, and demographic characteristics. The extracted variables included age, sex, clinical presentation, lesion location, lifestyle factors, and medical history. Data were analyzed descriptively, and Fisher's exact test was applied for exploratory analysis of relationships between categorical variables, with statistical significance set at P <= 0.05.Results:Sex distribution was nearly equal (51% male and 49% female), with the highest case frequency among individuals aged <40 years. Salivary gland tumors, particularly of the parotid gland, were most common. Malignant neoplasms, predominantly squamous cell carcinoma, accounted for 55% of cases, while pleomorphic adenoma was the most frequent benign tumor. No statistically significant associations were identified between demographic and clinical variables (P > 0.05).Conclusion:This hospital-based study describes the distribution of HNN cases within the Ha'il region. Malignant neoplasms, predominantly squamous cell carcinomas, accounted for a slightly higher proportion than benign lesions, while pleomorphic adenoma was the most common benign neoplasm. No significant associations were identified between demographic or lifestyle variables.
Abstract Objective: Endodontic inflammation, particularly pulpitis and apical periodontitis, arises from complex interactions between microbial infection and host immune responses. While conventional endodontic therapy focuses on microbial elimination, persistent inflammation driven by host immune dysregulation significantly influences treatment outcomes. This review aimed to evaluate the current understanding of immunomodulatory mechanisms involved in endodontic inflammation and to explore emerging therapeutic strategies targeting host immune responses. Methods: A narrative review with a structured search strategy was conducted using PubMed, Scopus, and Google Scholar databases. Studies published in English between January 2000 and March 2025 were screened using predefined inclusion and exclusion criteria. This study selection process included database searching, duplicate removal, title and abstract screening, and full-text assessment of eligible articles. Results: The database search identified 312 articles, of which 72 duplicates were removed. After screening titles and abstracts, 240 articles were evaluated, and 168 were excluded for not meeting the inclusion criteria. Seventy-two full-text articles were assessed, and 22 studies were ultimately included in the qualitative synthesis. The literature demonstrates that immunomodulatory strategies, including pharmacological agents, biologics, biomaterials, natural compounds, and nanotechnology-based delivery systems, can regulate inflammatory pathways, suppress pro-inflammatory cytokines, and promote tissue repair in endodontic lesions. Conclusion: Current evidence suggests that host response modulation represents a promising adjunctive approach in endodontic therapy. Although substantial in vitro and experimental data support its potential benefits, clinical evidence remains limited. Future research should focus on well-designed clinical trials and the development of targeted local delivery systems to translate immunomodulatory strategies into routine endodontic practice.
Autotransplantation (AT) of a tooth with complete root development supplemented with extraoral root-end resection (EORER) is a surgical technique developed in the last few years. This promising technique extends the palette of AT indications and appears to be, among other things, a cheaper alternative to the more established AT procedure involving subsequent endodontic treatment of the transplanted tooth. However, the literature on this topic is still scarce, and more information about this technique is needed. In this case report, we present a case of an adult patient undergoing extraction of tooth #26 due to chronic periodontitis with low predictability of re-endodontic treatment outcome. As orthodontic resolution of the arising gap by major bodily movement of the tooth #27 was not recommended by the treating orthodontist, we opted for AT of a third molar with complete root development using the EORER technique due to the lack of space in the target location and the long roots of the donor tooth. The procedure was successful, with signs of revascularization obvious on follow-ups. So far, after 24 months, no issues with the autotransplanted tooth have been observed. This case report shows that even a third molar can be successfully used for AT, provided that the EORER technique with preoperative evaluation based on cone beam computed tomography is employed.
Objective:Individuals with spinal cord injury (SCI) often experience impaired manual dexterity and reduced fine motor coordination. The aim was to facilitate independent toothbrushing using assistive devices, a practical approach was developed involving modifications to both conventional manual toothbrushes and powered toothbrushes.Methods:A randomized clinical trial was conducted among 30 participants, with 15 individuals allocated to each group (Group A and Group B). Assessments were performed at baseline and after 6 weeks using two different toothbrush types. Oral health status was evaluated using the World Health Organization Oral Health Questionnaire for Adults (2013), along with Plaque Index (PI) and Gingival Index (GI) scores. Data were compiled and analyzed using Statistical Package for the Social Sciences software. Appropriate statistical tests, including the Wilcoxon signed-rank test, Mann-Whitney U test, and Fisher's exact test, were applied to determine statistical significance.Results:At baseline, the PI scores in Group A and Group B were 1.88 +/- 0.32 and 1.79 +/- 0.25, respectively, whereas the GI scores were 1.47 +/- 0.28 and 1.46 +/- 0.27, respectively. After 6 weeks, PI scores decreased to 1.48 +/- 0.19 in Group A and 1.53 +/- 0.16 in Group B, whereas GI scores decreased to 1.19 +/- 0.22 and 1.25 +/- 0.17, respectively, in both groups. However, no statistically significant difference was observed between the two groups.Conclusion:Both interventions were found to be effective in improving oral hygiene among individuals with SCI and can be recommended as viable aids for toothbrushing in this population.
Abstract Objective: Resin-based composites are extensively used for posterior restorations; however, several formulations contain bisphenol-derived monomers that may result in trace bisphenol release during clinical use. The aim of this review was to systematically appraise in vitro and randomized clinical evidence on bisphenol exposure associated with posterior resin restorations and its relationship with mechanical, biological, and clinical outcomes. Methods: Electronic searches were performed in PubMed, Scopus, and Web of Science in accordance with Preferred Reporting Items for Systematic Reviews and Meta‑Analyses 2020 guidelines. In vitro studies and randomized clinical trials assessing bisphenol-containing or bisphenol-free posterior resin materials were included. Risk of bias (RoB) was evaluated using a modified checklist for in vitro studies and the Cochrane RoB 2 tool for clinical trials. Results: Fourteen studies (11 in vitro and 3 randomized clinical trials) were included. Most in vitro investigations demonstrated moderate RoB, mainly due to limited reporting of blinding and sample size justification. Clinical trials showed low RoB or some concerns. Bisphenol-free materials exhibited mechanical and clinical performance comparable to conventional bisphenol-containing composites. Conclusion: Current evidence suggests that bisphenol-free posterior resin materials demonstrate outcomes comparable to traditional composites. Nonetheless, long-term randomized clinical trials directly quantifying patient bisphenol exposure are warranted.
Objective: The study aimed to evaluate the association between daily screen time, perceived psychological stress, salivary cortisol levels, and gingival health status among Information Technology (IT) professionals. Methods: A cross-sectional clinical study was conducted among 180 IT professionals aged 20-45 years, who were recruited using a convenience sampling method from multiple technology parks. Daily screen time was assessed using a structured questionnaire. Psychological stress was evaluated using the Perceived Stress Scale-10. Unstimulated morning salivary samples were collected for cortisol estimation using an enzyme-linked immunosorbent assay. Clinical periodontal examination included the gingival index, clinical attachment level (CAL), and probing depth (PD). Data were analyzed using IBM Statistical Package for the Social Sciences Statistics version 23.0. Normality was assessed using the Shapiro-Wilk test. Pearson correlation analysis and multiple linear regression analysis were performed. Results: Daily screen time showed significant associations with the gingival index, CAL, PD, perceived stress scores, and salivary cortisol levels (P < 0.001). Multiple linear regression analysis demonstrated that screen time remained statistically significant in the model (beta = 0.503, P = 0.001), explaining 30.5% of the variance in gingival index scores; however, due to its strong association with perceived stress, the independent effects of these variables should be interpreted with caution. Conclusion: Prolonged daily screen time is significantly associated with increased gingival inflammation among IT professionals, suggesting the possible association of occupational lifestyle factors in periodontal health.
Objective: To assess the time since the last dental visit among Peruvian children under 12 years of age between 2019 and 2021 and to identify the associated sociodemographic and health-related factors. Methods: A cross-sectional analytical study was conducted using secondary data from the Peruvian Demographic and Family Health Survey (ENDES) for 2019, 2020, and 2021. ENDES employs a nationally representative, stratified, two-stage sampling design. The analytical sample included 49,763 children with complete information. The outcome variable was time since the last dental visit (years), based on the ENDES methodology. Independent variables included survey year, place of dental care, geographic characteristics, wealth index, health insurance, age, and sex. Analyses accounted for the complex survey design. Descriptive, bivariate, and hierarchical multiple linear regression analyses were performed (P < 0.05). Results: The mean time since the last dental visit was 5.25 years in 2019, 6.65 years in 2020, and 5.51 years in 2021 (P = 0.021). In the adjusted model, survey year, place of dental care, natural region, area of residence, altitude, health insurance, and age were significantly associated with the outcome.Conclusion: Time since the last dental visit increased in 2020 and decreased in 2021, consistent with pandemic-related disruption in dental visit patterns and partial recovery. Sociodemographic, geographic, and health- related factors were significantly associated with time since the last dental visit.
Abstract Objective: Dental anxiety is a common challenge in pediatric patients, often leading to reduced cooperation and compromised treatment outcomes. Sensory-adapted interventions and multisensory interventions, such as sensory-adapted dental environments (SADEs), have been proposed to mitigate anxiety and improve child behavior during dental procedures. To systematically evaluate the effectiveness of SADE and multisensory interventions including visual, auditory, tactile, olfactory, and gustatory distraction techniques in reducing anxiety and enhancing cooperation in children undergoing dental treatment. Methods: A systematic search was conducted across electronic databases PubMed, Web of Science, Cochrane, Scopus, LILACS, and Google Scholar, and studies meeting predefined inclusion criteria were selected. Randomized controlled trials and interventional studies assessing SADE and multisensory interventions were included. From initial 842 articles, three were selected. The quality of included studies was assessed using the Cochrane Risk of Bias tool. Data were analyzed qualitatively, and a narrative synthesis of the findings was performed due to heterogeneity among the included studies. Results: Three studies were included. Across the studies, multisensory approaches consistently reduced anxiety, improved behavioral cooperation, and stabilized physiological measures such as heart rate and oxygen saturation. The overall risk of bias across studies ranged from low to moderate, primarily due to limitations in blinding and allocation concealment. Conclusion: SADE and multisensory interventions effectively reduce anxiety and enhance cooperation in pediatric dental patients. Implementing these approaches can improve the overall treatment experience and facilitate better behavioral and physiological outcomes during dental procedures.
Abstract Objective: This narrative review synthesizes evidence on biochemical mechanisms linking lifestyle factors, diet, psychological stress, and obesity to oral health in university students, examining interconnected pathways through which these exposures converge to compromise oral health. Methods: A narrative (nonsystematic) synthesis of literature from PubMed, Scopus, and Google Scholar (2000–2025) was conducted, with emphasis on recent evidence (2020–2025). Articles were selected purposively for a thematic overview of biochemical pathways. Sixty studies met the inclusion criteria (55% published 2020–2025). Results: Unhealthy dietary patterns, sedentary lifestyles, psychological stress, and obesity converge through shared biochemical mechanisms: chronic inflammation, oxidative stress, hypothalamic–pituitary–adrenal (HPA) axis dysregulation, and microbiome dysbiosis, to compromise oral health. Observational studies report twofold to threefold higher periodontal disease risk when multiple factors co-occur, consistent with synergistic interactions reported in individual studies. Salivary biomarkers show promise for early detection in campus health settings. Conclusion: Lifestyle, stress, diet, and obesity are interconnected determinants of oral health in university students through measurable biochemical pathways. Multidisciplinary strategies incorporating dental, nutritional, and mental health services, combined with institutional wellness policies, are recommended.
Objectives: Food insecurity (FI) is increasingly recognized as a critical social determinant of systemic health. However, there is limited population-level evidence linking FI to cumulative functional oral health outcomes, particularly in low- and middle-income countries like India. This study aimed to examine the association between FI and oral health impairment (OHI) in a nationally representative Indian population, evaluating whether the relationship follows a graded pattern across demographic and socioeconomic groups. Methods: Data were analyzed from Wave-1 of the longitudinal aging study in India (2017-18), comprising 72,250 adults aged >= 18 years. A composite OHI index was developed by standardizing and summing measures of tooth loss, chewing difficulty, and self-reported oral problems. FI was quantified using a one-parameter Rasch-based item response model to capture a severity gradient across five items. Multivariable linear regression was employed to estimate the associations, adjusting for age, sex, residence, education, wealth, marital status, caste, religion, and behavioral factors. Results: Overall, 46.5% of participants reported oral impairment, including 58.4% with tooth loss and 6.3% who were completely edentulous. FI was prevalent, with 40.6% lacking their food of choice and 3.0% experiencing an entire day without food. Rasch analysis confirmed a strong severity gradient in the FI index. After full adjustment, each 1-standard deviation increase in FI was significantly associated with a higher OHI score (beta = 0.030, P < 0.001). This functional impairment was most pronounced among older adults (beta = 0.939 for >= 60 years), women, rural residents, widowed individuals, and tobacco users. Conclusion: The findings demonstrate a progressive, graded relationship between worsening FI and the severity of functional oral health problems. These results highlight the necessity of integrating nutritional and oral health policies to address deep-seated health inequities among vulnerable populations.
