JDR Clinical & Translational Research最新文献

{"title":"Moderating Effects of Oral Bacteria and Tooth Loss on Cognitive Performance.","authors":"H Luo, A R Kamer, Z Xu, X Qi, R Liu, B Wu","doi":"10.1177/23800844261423487","DOIUrl":"10.1177/23800844261423487","url":null,"abstract":"<p><strong>Introduction: </strong>The oral microbiome may influence brain health and contribute to cognitive decline. However, little evidence exists on the potential modifying role of the oral microbiome in the relationship between tooth loss and cognitive performance. This study aimed to investigate the interaction effects between tooth loss and oral dysbiotic status on cognitive performance.</p><p><strong>Methods: </strong>Data were from the 2011-2012 National Health and Nutrition Examination Survey. The sample included 677 adults aged 60 to 69 y. Cognitive performance was assessed by the Consortium to Establish a Registry for Alzheimer's Disease, the Animal Fluency Test (AFT), and the Digit Symbol Substitution Test. Significant tooth loss was defined as a loss of ≥10 permanent teeth out of 28. A high dysbiotic index was defined as being in the upper tertile of the ratio of periodontal disease-associated bacteria (Treponema, Porphyromonas, and Tannerella) to healthy bacteria (Rothia and Corynebacterium).</p><p><strong>Results: </strong>A multivariable linear regression model showed a significant interaction effect between tooth loss and dysbiotic index on the AFT (b = -1.87, P = 0.03), indicating that participants with a higher dysbiosis index and fewer missing teeth scored lower on the AFT.</p><p><strong>Conclusions: </strong>The effect of tooth loss on verbal fluency depends on oral bacterial imbalances: if there is significant tooth loss, bacterial imbalances may not be important. However, when fewer teeth are lost, high bacterial imbalances may account for lower verbal fluency. These findings suggest that maintaining periodontal health aimed at decreasing oral dysbiosis should be promoted among older adults in the community.Knowledge Transfer Statement:Our findings highlight the importance of preserving the health of the teeth and not just retaining the teeth. Oral health awareness and good oral hygiene practice should be further promoted among older adults in the community.</p>","PeriodicalId":14783,"journal":{"name":"JDR Clinical & Translational Research","volume":" ","pages":"605-616"},"PeriodicalIF":2.0,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13262581/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147344282","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Artificial Intelligence Helps Diagnose Oral Potentially Malignant Disorders: A Systematic Review and Meta-Analysis.","authors":"D Horvath, A Fekete, P Martinekova, S Kiss-Dala, E Abram, K Marton, A Zsembery, P Hegyi, A Brody","doi":"10.1177/23800844251403962","DOIUrl":"10.1177/23800844251403962","url":null,"abstract":"<p><strong>Introduction: </strong>Oral potentially malignant disorders (OPMDs) can lead to oral cancer, which is one of the most common cancers worldwide. Prevention is crucial in the avoidance of malignant transformations of OPMDs. Artificial intelligence (AI) provides a new and noninvasive tool for analyzing medical data, such as patient data, radiologic images, and clinical photographs. These AI-based tools can help in the decision-making process. However, histological examination is still the gold standard for diagnosing OPMDs.</p><p><strong>Objectives: </strong>This systematic review and meta-analysis aimed to investigate the diagnostic accuracy of artificial intelligence on intraoral photographs of patients with OPMDs.</p><p><strong>Methods: </strong>A systematic search was conducted on 5 major databases (MEDLINE, Embase, Cochrane Library, Scopus, and Web of Science) on November 10, 2023. Included studies compared AI methods to histology examination as the reference. A quantitative analysis was carried out to assess sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), diagnostic odds ratio (DOR), positive likelihood ratio (LR⁺), and negative likelihood ratio (LR^-) calculated with 95% confidence intervals (CIs).</p><p><strong>Results: </strong>Six eligible articles were included, with 898 images out of 4,046 tested using AI-based architectures. Five studies investigated at least 2 AI models. The overall sensitivity, specificity, DOR, LR⁺, and LR^- were 0.94 (95% CI, 0.88 to 0.95), 0.95 (95% CI, 0.85 to 0.98), 212.39 (95% CI, 56.39 to 800.00), 16.89 (95% CI, 5.72 to 48.68), and 0.08 (95% CI, 0.05 to 0.13) for the best-performing AI-based architectures in terms of sensitivity, respectively.</p><p><strong>Conclusion: </strong>AI-based diagnostic tools have high negative predictive value that could help identify OPMD lesions using intraoral photographs.Knowledge Transfer Statement:This systematic review on AI-based methods to diagnose oral potentially malignant disorders showed that although their high negative predictive value could reduce unnecessary specialist consultations, clinical judgment remains paramount. Further prospective studies are needed to evaluate the integration of AI diagnostics into routine care and screening and policies to enhance efficiency and support early detection and prevention of oral cancer.</p>","PeriodicalId":14783,"journal":{"name":"JDR Clinical & Translational Research","volume":" ","pages":"532-544"},"PeriodicalIF":2.0,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13546436/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146010708","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prior Incarceration and Dental Insurance Trajectories throughout Older Adulthood.","authors":"A Testa, L Mijares, D B Jackson, V Maroufy, R Samper-Ternent, A C Neumann, R Mungia, K T Ganson, J M Nagata, T Oates","doi":"10.1177/23800844251387559","DOIUrl":"10.1177/23800844251387559","url":null,"abstract":"<p><strong>Objectives: </strong>This study examines the relationship between prior incarceration and dental insurance trajectories throughout older adulthood.</p><p><strong>Methods: </strong>A nationally representative sample of adults aged 55 y and older who participated in the 2012-2020 Health and Retirement Survey was analyzed (<i>n</i> = 6,383). Group-based trajectory modeling was used to identify distinct patterns of dental insurance coverage across the 8 survey waves. Multinomial logistic regression was used to assess the association between prior incarceration and dental insurance trajectory group membership.</p><p><strong>Results: </strong>Four dental insurance trajectories were identified: persistent dental insurance (30.0%), intermittent high insurance (16.4%), intermittent low insurance (20.4%), and no insurance (33.3%). Bivariate analyses revealed that formerly incarcerated older adults were significantly more likely to be in the intermittent low dental insurance (relative risk ratio [RRR] = 2.31, 95% confidence interval [CI] = 1.67-3.20) and no dental insurance (RRR = 1.51, 95% CI = 1.09-2.11) groups relative to the persistent dental insurance group. Covariate-adjusted models that accounted for sociodemographic, health, and economic covariates found a significant association between prior incarceration and membership in the intermittent low dental insurance group (RRR = 1.48, 95% CI = 1.03-2.11).</p><p><strong>Conclusions: </strong>Formerly incarcerated older adults were less likely to have consistent dental insurance coverage over time. Additional research is needed to understand why formerly incarcerated individuals are less likely to have consistent dental insurance over time and what policy and programmatic responses may increase access to dental care coverage for this population.Knowledge Transfer Statement:This study shows that formerly incarcerated older adults are more likely to experience periods without dental insurance over time. These findings can inform efforts by dental care providers, policymakers, and community health programs to improve dental care access by expanding insurance coverage and tailoring oral health services to meet the needs of individuals with incarceration histories.</p>","PeriodicalId":14783,"journal":{"name":"JDR Clinical & Translational Research","volume":" ","pages":"658-665"},"PeriodicalIF":2.0,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12719926/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145633674","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Intergenerational Oral Conditions' Relationships: The Role of Sugar Intake.","authors":"S Kiuchi, H S Schuch, Y Matsuyama, K Osaka, J Aida, L G Do, D H Ha","doi":"10.1177/23800844251390461","DOIUrl":"10.1177/23800844251390461","url":null,"abstract":"<p><strong>Background: </strong>Maternal oral health is associated with the oral health of children. However, the role of free sugar intake as a potential effect modifier in this relationship remains unclear. We examined the association between maternal and child caries and assessed whether free sugar intake modifies this relationship.</p><p><strong>Methods: </strong>Data were obtained from the Study of Mothers' and Infants' Life Events Affecting Oral Health (SMILE), an Australian population-based birth cohort study. Maternal caries experience, measured by the number of decayed, missing, and filled surfaces (DMFS; 0 to 9, 10 to 19, 20 to 29, or ≥30 surfaces) when children were at age 2 y was the exposure. Outcomes were children's caries experience (dmfs/DMFS) and prevalence (dmfs/DMFS>0) at age 5 y. We investigated the association between maternal caries experience and children's caries status using negative binomial and Poisson regression models, adjusting for potential confounders. We also assessed the interaction to investigate whether free sugar intake (<12 g: <5% estimated energy requirement [EER], 12 to 24.9 g, ≥25g: ≥10% EER) modified this relationship.</p><p><strong>Results: </strong>A total of 879 mother-child dyads were analyzed (54.0% male). The average number of caries surfaces was 11.8 for mothers and 1.4 for children. Among children, 24.9%, 31.7%, and 43.3% consumed <12 g, 12 to 24.9 g, and ≥25 g of free sugar daily, respectively. At age 5 y, children whose mothers had ≥30 surfaces with caries experienced a 2.84 times greater number of surfaces with caries experience (95% confidence interval [CI], 1.52 to 5.30) and had a 1.68 times higher risk of having caries (95% CI, 1.19 to 2.36). Interactions between maternal caries experience (≥30 surfaces) and both 12 to 24.9 g or ≥25 g free sugar intake were observed (mean ratios [95% CI] for interaction terms: 11.16 [1.55 to 80.34] for 12 to 24.9 g and 17.91 [2.76 to 116.44] for ≥25 g).</p><p><strong>Conclusions: </strong>Having a mother with higher caries experience increases the risk of caries among children; however, limiting free sugar intake mitigates the risk.Knowledge Transfer Statement:This study demonstrates that having a mother with higher caries experience increases a child's risk of developing caries; limiting free sugar intake mitigates the risk. Policymakers and clinicians could promote lower caries prevalence and prevent caries severity of children by encouraging upstream policies of reducing sugar intake.</p>","PeriodicalId":14783,"journal":{"name":"JDR Clinical & Translational Research","volume":" ","pages":"626-637"},"PeriodicalIF":2.0,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145767952","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Oral Health Care in Humanitarian Crises: Developing Research and Guidelines-IADR GOHIRN Workshop at 2025 IADR/PER General Session & Exhibition.","authors":"K Wanyonyi-Kay, K Zaheer, H Lee, E Cuny, M Lee, D Weisfuse, L Cohen","doi":"10.1177/23800844261432999","DOIUrl":"10.1177/23800844261432999","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Introduction: &lt;/strong&gt;More than 123 million people are currently forcibly displaced due to conflict, climate change, and political and economic instability. Despite the considerable burden of oral diseases among displaced communities, oral health remains one of the most underresearched and underaddressed areas in humanitarian response.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objectives: &lt;/strong&gt;To summarise key insights from the 2025 IADR/PER General Session & Exhibition symposium organised by the Global Oral Health Inequalities Research Network (GOHIRN), which focused on advancing oral health research and guidelines in humanitarian crises.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;The 90-min symposium and associated workshop brought together 20 to 30 participants, including researchers, clinicians, and global health stakeholders. Following presentations, participants worked in 3 breakout groups to discuss oral health research needs and guideline development, aligned with the World Health Organization's (WHO's) Global Research Agenda on Health, Migration and Displacement. Proposed research principles were mapped to the WHO's 3 core research themes: 1) generating knowledge to support inclusive universal health coverage and primary health care; 2) strengthening the inclusion of migrants, refugees, and displaced populations in health emergency preparedness and response; and 3) promoting multisectoral research on the social and structural determinants of health among displaced groups.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Discussions across the WHO's agenda themes highlighted the need for improved oral health research for understudied displaced populations and for stronger collaborations to translate evidence into policy and practice. Key priorities included embedding oral health research within primary health care and routine surveillance systems; developing evidence-based safety guidelines for clinicians and patients; delivering care in resource-constrained settings; ensuring that research is ethical, culturally responsive, and centred on community benefit; and promoting intersectoral research that accounts for local contexts, dietary practices, and culturally informed understandings of oral health.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;These insights highlight the pressing need to elevate oral health within humanitarian agendas and establish research frameworks capable of advancing health equity for displaced populations.Knowledge transfer statement:This communication presents insights from a global meeting on research priorities and guidelines for oral health in humanitarian settings. By aligning oral health needs with the World Health Organization's Global Research Agenda on Health, Migration and Displacement, it provides practical guidance for integrating oral health research into primary care, emergency preparedness, and multisectoral public health strategies. It also highlights evidence-based approaches to safety and infection control in crisis contexts, supporting ethical,","PeriodicalId":14783,"journal":{"name":"JDR Clinical & Translational Research","volume":" ","pages":"703-705"},"PeriodicalIF":2.0,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13546421/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147529084","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Indigenous Australians' Oral Health Care Experiences: Recommendations for Culturally Safe Dental Care.","authors":"R Aiyar, S Nath, J Hedges, G L Guzzo, K Kapellas, E Flanagan, T-M Mastrosavas, E Wallace, L Jamieson","doi":"10.1177/23800844251390485","DOIUrl":"10.1177/23800844251390485","url":null,"abstract":"<p><strong>Introduction: </strong>An established body of literature highlights a higher prevalence of oral health concerns among Indigenous Australians including untreated dental caries and periodontal disease. In South Australia, access to and provision of culturally safe oral health care for these communities remains a challenge in dental services, and less is known around what culturally safe dental care means for Indigenous communities.</p><p><strong>Objectives: </strong>This study explored (1) the barriers to accessing culturally safe oral health care for Indigenous Australians and (2) the enablers to promote and support culturally safe oral health care.</p><p><strong>Methods: </strong>This qualitative study involved semi-structured interviews with 136 Indigenous South Australian adults who participated in a dental care intervention involving oral epidemiological examinations at baseline and 12-mo follow-up (after receiving formal dental care) and health assessments. Reflexive thematic analysis was used to analyze qualitative data on participants' oral health care experiences more broadly, the dental care received as part of the study, and their perspectives on improving dental care for Indigenous communities, including culturally safe care.</p><p><strong>Results: </strong>Participants reported a range of experiences in formal dental care settings including discrimination, fear, and limited access to dental care due to cost or location. Various enablers to improve culturally safe dental care were highlighted, including continuity of care, Indigenous-led dental services, mobile services and at-home care, trauma-informed clinics, early intervention, oral health promotion, and improving accessibility through free or low-cost dental care.</p><p><strong>Conclusion: </strong>Overall, this study emphasized the need for further action to ensure cultural safety in Australian dental services.Knowledge Transfer Statement:This study found that Indigenous Australians' access to culturally safe oral health care is limited. Culturally safe care was affected by discrimination and distressing experiences in dental care settings. Dental care remains costly and regional areas remain underserviced, affecting access. Mobile services, continuity of care, early intervention, and Indigenous-led care can improve access. Findings from this study may shape health services planning regarding models of care that are family-centered, affordable, accessible, and prioritize cultural safety.</p>","PeriodicalId":14783,"journal":{"name":"JDR Clinical & Translational Research","volume":" ","pages":"678-690"},"PeriodicalIF":2.0,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13546438/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145648555","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Salivary Lysozymes, Anti-inflammatory Cardiac Medications, and Cardiovascular Mortality.","authors":"S-J Janket, F Tamimi, A E Baird, M Surakka, C Di Paolo, C Lee, T E Van Dyke, J H Meurman","doi":"10.1177/23800844261479727","DOIUrl":"https://doi.org/10.1177/23800844261479727","url":null,"abstract":"<p><strong>Introduction: </strong>Infections and subsequent innate immune activation may contribute to atherogenesis. Salivary lysozyme (SLZ) is a bactericidal enzyme expressed by neutrophils and macrophages in the innate immune system. SLZ hydrolyzes peptidoglycan (PGN) in the bacterial cell wall and generates muramyl dipeptide (MDP), a ligand for nucleotide-binding oligomerization domain-containing receptors that can trigger innate immune activation, which is an established pathway to atherogenesis.</p><p><strong>Objectives: </strong>We examined the association between baseline SLZ levels and cardiovascular disease (CVD) mortality in a prospective follow-up study with a median follow-up of 18.8 y.</p><p><strong>Methods: </strong>Using Cox regression analyses among 471 subjects, we evaluated the association between CVD mortality and SLZ using restricted cubic spline analyses. We compared CVD mortality in group Q1 (SLZ between 25%ile and 75%ile) and Q2 (SLZ ≥ 75%ile) to the reference group Q0 (25%ile) adjusting for age, sex, smoking status, hypertension, diabetes, dyslipidemia, and education. Next, we tested if innate immunity assessed by SLZ is independent of metabolic inflammation measured by the median C-reactive protein level (CRP). Lastly, we assessed whether anti-inflammatory cardiac medications alter the association between SLZ and CVD mortality, given that angiotensin-converting enzyme inhibitors (ACE-i) and statins are known to decrease systemic inflammation.</p><p><strong>Results: </strong>The multivariable-adjusted hazard ratio for CVD mortality for Q1 was 2.53 (95% confidence limit [CL]: 1.38 to 4.64) and for Q2 was 2.86 (CL: 1.45 to 5.66). The association between SLZ and CVD mortality was independent of CRP level or cardiac anti-inflammatory medications. However, adjusting for some cardiac medications such as ACE-i or statins slightly increased the association between SLZ and CVD mortality.</p><p><strong>Conclusions: </strong>Oral innate immune activation assessed by SLZ was associated with an increased risk of CVD mortality. This association was independent of metabolic inflammation or anti-inflammatory actions of cardiac medications.Knowledge Transfer Statement:The current article reports that salivary lysozymes are markers for oral innate immune activation, which is triggered by many oral infections such as aphthous ulcers, dental caries, gingivitis, and other soft-tissue infections. Our results can be used by clinicians, researchers, and policymakers. Future randomized trials are warranted to corroborate or refute the results presented in this article.</p>","PeriodicalId":14783,"journal":{"name":"JDR Clinical & Translational Research","volume":" ","pages":"23800844261479727"},"PeriodicalIF":2.0,"publicationDate":"2026-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148944952","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Polypharmacy and Self-Reported Tooth Clenching: An Electronic Health Record Analysis.","authors":"P Nguyen, L Marchini, A Greenwood, G Vu, E Zeng","doi":"10.1177/23800844261478627","DOIUrl":"https://doi.org/10.1177/23800844261478627","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Introduction: &lt;/strong&gt;Central nervous system (CNS) medications, particularly antidepressants (selective serotonin reuptake inhibitors [SSRIs], serotonin-norepinephrine reuptake inhibitors [SNRIs]), stimulants for attention-deficit/hyperactivity disorder (ADHD), and antipsychotics, are commonly implicated in drug-induced bruxism, yet evidence derives predominantly from case reports. No large-scale studies have examined associations between CNS medication classes and bruxism while controlling for confounders, and potential effects of drug combinations remain unexplored.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objectives: &lt;/strong&gt;This study aimed to investigate the associations between CNS medication use and self-reported tooth clenching, examining individual drugs, drug classes, and drug combinations.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;This cross-sectional study analyzed electronic health records from 14,643 dental clinic patients at a university dental college. Medications were standardized using RxNorm and classified into 14 pharmacological classes. Multivariable logistic regression estimated adjusted odds ratios (aORs) for self-reported tooth clenching, controlling for age, sex, polypharmacy, respiratory conditions, and neurologic conditions. Missing data were handled using multiple imputation, and the Benjamini-Hochberg (BH) procedure controlled the false discovery rate for exploratory analyses. A total of 66 pairwise drug class combinations were evaluated.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Overall self-reported clenching prevalence was 54.0%. Among 14 drug classes, SNRIs showed significantly elevated odds of clenching (aOR, 1.24; 95% CI, 1.08-1.43; BH-adjusted P = 0.036), whereas SSRIs showed no association. A graded association was observed with CNS polypharmacy: 2 drug classes (aOR, 1.26; 95% CI, 1.13-1.42) and 3 or more classes (aOR, 1.38; 95% CI, 1.20-1.59) showed progressively higher odds (P &lt; 0.001). One of 66 drug combinations (SSRI plus SNRI) retained a significant association (aOR, 2.40; 95% CI, 1.51-3.83; BH-adjusted P = 0.015).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;In this exploratory analysis, SNRIs rather than SSRIs were associated with self-reported clenching, in contrast to the predominance of SSRIs in case-report literature. Greater CNS polypharmacy was associated with higher odds of self-reported clenching, and SSRI-SNRI coexposure emerged as a hypothesis-generating signal requiring confirmatory analysis.Knowledge Transfer Statement:Evidence linking specific central nervous system (CNS) medications to bruxism has relied predominantly on case reports. This cross-sectional study found that serotonin-norepinephrine reuptake inhibitors (SNRIs) and CNS polypharmacy, rather than selective serotonin reuptake inhibitors (SSRIs), were associated with self-reported clenching. These findings may prompt dental professionals to consider CNS medication profiles as one contextual factor when evaluating reported clenching or grinding, pending confirmation in stu","PeriodicalId":14783,"journal":{"name":"JDR Clinical & Translational Research","volume":" ","pages":"23800844261478627"},"PeriodicalIF":2.0,"publicationDate":"2026-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148891031","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"How Do GenAI Chatbots Communicate Fluoride Information? A Readability and Negative Framing Analysis.","authors":"O S Jorge, M Lotto, I F Baptista, B Nogueira, T Cruvinel","doi":"10.1177/23800844261478633","DOIUrl":"https://doi.org/10.1177/23800844261478633","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Introduction: &lt;/strong&gt;As generative artificial intelligence (GenAI) chatbots increasingly mediate online health information seeking, this study aimed to assess the readability of chatbot-generated responses and characterize negatively framed content by estimating its prevalence and identifying its thematic patterns across different communicative scenarios and prompt formats.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;This cross-sectional infodemiological study evaluated fluoride-related responses generated by 5 freely accessible GenAI chatbots. To support this assessment, prompts were developed to simulate 3 communicative scenarios through which users may request or evaluate fluoride-related information: fact-checking, opinion, and explanation. Each prompt was formulated in both organic and structured versions, representing simple user-like questions and formulations expanded using prompt-engineering principles. Responses were segmented into sentences, which were independently classified by 2 trained and calibrated evaluators as positively/neutrally or negatively framed with respect to fluoride use for dental caries prevention. Readability was assessed using distinct indices, and topic modeling was performed to characterize thematic patterns.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;A total of 1,326 sentences were analyzed, of which 1,040 were classified as positively/neutrally framed and 286 as negatively framed. The prevalence of negatively framed sentences did not differ significantly across chatbots or prompt formats. However, it varied according to the communicative scenario, with fact-checking prompts generating a higher prevalence of negatively framed content than opinion and explanation prompts. Topic modeling showed that negatively framed sentences were primarily organized around risk-oriented themes, including dental fluorosis, excessive fluoride exposure in children, toxicity, potential neurodevelopmental concerns, and skeletal fluorosis. Although structured prompts improved readability across most grade-level indices, chatbot-generated responses generally remained within difficult readability levels.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;GenAI chatbots have the potential to support communication about fluoride use; however, the frequent emphasis on fluoride-related risks in fact-checking responses and the generally difficult readability of the generated texts may hinder lay audiences' interpretation of evidence-based recommendations.Knowledge Transfer Statement:Although generative artificial intelligence (GenAI) chatbots can provide adequate fluoride-related information, the presence of unfavorable content and high readability demands limit their practical usefulness. Because patients use these tools for health queries, clinicians must proactively address AI-driven misconceptions during consultations. Additionally, public health policymakers should advocate for digital oversight to ensure AI platforms deliver accurate, unbiased, and broadly acce","PeriodicalId":14783,"journal":{"name":"JDR Clinical & Translational Research","volume":" ","pages":"23800844261478633"},"PeriodicalIF":2.0,"publicationDate":"2026-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148890943","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Trends in Dental Utilization among Children with Special Health Care Needs.","authors":"V Amonoo, S Dhar, R Marwaha, C Geneus, S Challa","doi":"10.1177/23800844261468743","DOIUrl":"https://doi.org/10.1177/23800844261468743","url":null,"abstract":"<p><strong>Objective: </strong>To identify trends in dental utilization and factors associated with using dental services before and during the pandemic among children with special health care needs (CSHCNs) aged 0 to 17 y.</p><p><strong>Methods: </strong>This cross-sectional study analyzed data from the National Survey for Children's Health (NSCH), including a total sample of 78,006 CSHCNs aged 0 to 17 y from 2016 to 2023. Dental utilization trends across the years, including prepandemic and pandemic periods, were analyzed using chi-square tests of independence, while trends stratified by met and unmet dental needs were assessed using the Cochran-Armitage trend test. Pooled multivariable logistic regression analyses were performed to examine the associations between dental utilization and sociodemographic factors.</p><p><strong>Results: </strong>CSHCNs were 30% more likely to forgo dental care during the pandemic than in prepandemic years (odds ratio = 1.33; 95% confidence interval, 1.27-1.39). Unmet dental needs, age, household poverty level, caregiver education, caregiver employment, insurance coverage, and race were associated with dental utilization among CSHCNs in pooled regression models and in prepandemic and pandemic regression models.</p><p><strong>Conclusion: </strong>This study found lower odds of dental care utilization among CSHCNs during the pandemic. It also demonstrated that factors like unmet dental needs, age, caregiver education, and household poverty level were associated with dental utilization among CSHCNs. Future research should explore the effectiveness of strategies to promote dental care utilization among CSHCNs.Knowledge Transfer Statement:This study found that dental service utilization among CSHCNs significantly decreased during the pandemic compared to prepandemic years. In addition, factors such as unmet dental needs, age, sex, race, caregiver education, insurance coverage, family structure, and household poverty level were associated with dental utilization among CSHCNs. These findings can inform efforts by policymakers to address gaps in access to care and ensure continuity of care, especially during times of instability, such as the COVID-19 pandemic.</p>","PeriodicalId":14783,"journal":{"name":"JDR Clinical & Translational Research","volume":" ","pages":"23800844261468743"},"PeriodicalIF":2.0,"publicationDate":"2026-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148793425","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}