JDR Clinical & Translational Research最新文献

{"title":"Relationship between 1-, 3-, and 6-Month Gingival Bleeding Outcomes.","authors":"T He, J Grender, S Farrell, A R Biesbrock","doi":"10.1177/23800844231206387","DOIUrl":"10.1177/23800844231206387","url":null,"abstract":"<p><strong>Introduction: </strong>Results from systematic reviews and meta-analyses show generally consistent antigingivitis effects between 3- and 6-mo observation time points with twice-daily use of stannous fluoride (SnF₂) dentifrice. However, the relationship between 1-, 3-, and 6-mo gingivitis responses has not been investigated.</p><p><strong>Methods: </strong>This pooled analysis was conducted to understand the relationship of 1-, 3-, and 6-mo gingival bleeding outcomes. Number of bleeding sites, derived from Löe-Silness Gingival Index (LSGI) or Gingival Bleeding Index, was identified as the primary end point of the analysis for the biological and clinical relevance. Randomized, double-blinded, controlled clinical studies meeting the following predefined selection criteria were identified: 1) published and unpublished gingivitis clinical trials conducted from 1995 to 2022 comparing efficacy of 0.454% SnF₂ dentifrices to negative controls (sodium fluoride or sodium monofluorophosphate dentifrice) and 2) studies with a 3-mo assessment and at least a 1- or 6-mo assessment.</p><p><strong>Results: </strong>The search resulted in ten 6-mo and fourteen 3-mo studies meeting selection criteria. A mixed-effects model was performed on the pooled data to assess gingival bleeding outcomes across time. The bleeding efficacy significantly increased between months 1 and 3 (<u>P</u> < 0.0001) and plateaued between months 3 and 6 (<u>P</u> = 0.007), supporting the fact that bleeding reduction relative to control established by 1 mo will increase and be maintained through 3 and 6 mo (<u>R</u>² = 0.857). In addition, gingival bleeding and gingivitis efficacy, as measured by LSGI, were found to be highly correlated (<u>R</u>² = 0.874).</p><p><strong>Conclusion: </strong>A clear relationship has been demonstrated between 1-, 3-, and 6-mo gingival bleeding outcomes in gingivitis clinical studies comparing SnF₂ dentifrice to negative control dentifrice. These findings have important implications to the dental practice and scientific research as antigingivitis efficacy evaluations can be observed as early as 1 mo and are consistent with those seen at 3 or 6 mo.</p><p><strong>Knowledge transfer statement: </strong>Outcomes from this investigation indicate that the clinical evaluation of antigingivitis efficacy at 1 mo is predictive of that at 3 and 6 mo, supporting studies of 1-mo duration as a viable method of knowledge acquisition. This more efficient, expedited research design has positive implications for patient care, clinical practice guidelines, protocols, and policies.</p>","PeriodicalId":14783,"journal":{"name":"JDR Clinical & Translational Research","volume":" ","pages":"286-293"},"PeriodicalIF":2.2,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71423780","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":"A Scoping Review of Oral Health Outcomes and Oral Health Service Utilization of 2SLGBTQ+ People.","authors":"I Fakhrjahani, T Tiwari, A Jessani","doi":"10.1177/23800844231206359","DOIUrl":"10.1177/23800844231206359","url":null,"abstract":"<p><strong>Background: </strong>Oral health is an integral aspect of overall well-being and quality of life. Population groups such as two-spirit, lesbian, gay, bisexual, transgender, and queer, including other sexual and gender minorities (2SLGBTQ+), have reported poor oral health outcomes. Therefore, the aim of this review was to investigate the extent and scope of the literature describing 2SLGBTQ+ oral health outcomes, including unmet oral health needs and patterns of oral health care service utilization, as well as the risk factors affecting both.</p><p><strong>Methods: </strong>A comprehensive search strategy was developed to review the scope of the literature pertinent to unmet oral health needs and factors affecting access to oral health care among 2SLGBTQ+ members, globally. In total, 6 databases were searched with a combination of keywords relevant to 2SLGBTQ+ oral health status and oral health care utilization.</p><p><strong>Results: </strong>Our review identified 10 studies that met the eligibility criteria. Five out of 10 studies were based in India, 4 in the United States, and 1 in Brazil. Two studies reported poorer oral health outcomes among transgender people as compared with cisgender people, while 2 studies reported similar patterns of dental service utilization between their transgender and cisgender participants. Five studies explored the personal and structural risk factors associated with poor oral health outcomes, including financial affordability and income level and perceived discrimination, including instances of misgendering in health care settings. However, further comprehensive studies must be conducted to validate the trends and findings reported by the studies in the review and to generate data from diverse regional contexts.</p><p><strong>Conclusions: </strong>Our review identified that the extent of the literature in this research area is sparse and scarce. The evidence indicates poorer oral health status among 2SLGBTQ+ communities. Wider studies with diverse, representative samples are required to gain a comprehensive understanding of 2SLGBTQ+ oral health outcomes.</p><p><strong>Knowledge transfer statement: </strong>The results of this review will undoubtedly be important for many years to come as 2SLGBTQ+ oral health equity is prioritized by experts in public health dentistry. This review will allow other researchers to understand and fill literature gaps regarding 2SLGBTQ+ oral health outcomes, furthering this area of research.</p>","PeriodicalId":14783,"journal":{"name":"JDR Clinical & Translational Research","volume":" ","pages":"199-211"},"PeriodicalIF":2.2,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11184910/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"134649013","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":"AI's Role in Improving Social Connection and Oral Health for Older Adults: A Synergistic Approach.","authors":"X Qi, B Wu","doi":"10.1177/23800844231223097","DOIUrl":"10.1177/23800844231223097","url":null,"abstract":"<p><strong>Knowledge transfer statement: </strong>This study explored how artificial intelligence (AI) can revolutionize geriatric care by improving oral health and alleviating social disconnection among isolated older adults. The findings can guide clinicians in integrating AI tools into practices, assist policymakers in developing AI-inclusive health policies, and inform patients about the potential benefits of AI in enhancing their health outcomes and social connection.</p>","PeriodicalId":14783,"journal":{"name":"JDR Clinical & Translational Research","volume":" ","pages":"196-198"},"PeriodicalIF":2.2,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11318379/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139569735","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":"Cost-Effectiveness Analysis of Regenerative Endodontics versus MTA Apexification.","authors":"N Naved, F Umer, A R Khowaja","doi":"10.1177/23800844231191515","DOIUrl":"10.1177/23800844231191515","url":null,"abstract":"<p><strong>Introduction: </strong>With the introduction of stem cell engineering in dentistry, regenerative endodontics has emerged as a potential alternative to mineral trioxide aggregate (MTA) apexification in the management of necrotic immature permanent teeth. However, the utility of this modality in terms of cost-effectiveness has not yet been established. Therefore, we performed cost-effectiveness analysis to determine the dominant treatment modality that would influence decision making from the private payer perspective.</p><p><strong>Methods: </strong>A Markov model was constructed with a necrotic immature permanent tooth in a 7-y-old patient, followed over the lifetime using TreeAge Pro Healthcare 2022. Transition probabilities were estimated based on the existing literature. Costs were estimated based on United States health care, and cost-effectiveness was determined using Monte Carlo microsimulations. The model was validated internally by sensitivity analyses, and face validation was performed by an experienced endodontist and health economist.</p><p><strong>Results: </strong>In the base-case scenario, regenerative endodontics did not turn out to be a dominant treatment option as it was associated with an additional cost of USD$1,012 and fewer retained tooth-years (15.48 y). Likewise, in the probabilistic sensitivity analysis, regenerative endodontics was again dominated by apexification against different willingness-to-pay values.</p><p><strong>Conclusion: </strong>Based on current evidence, regenerative endodontic treatment was not cost-effective compared with apexification in the management of necrotic immature permanent teeth over an individual's lifetime.</p><p><strong>Knowledge transfer statement: </strong>The study provides valuable insight regarding the cost valuation and cost-efficacy of regenerative endodontic treatment versus apexification in the management of necrotic immature permanent teeth, as this would aid in effective clinical decision making, allowing for the functional allocation of resources.</p>","PeriodicalId":14783,"journal":{"name":"JDR Clinical & Translational Research","volume":" ","pages":"231-238"},"PeriodicalIF":2.2,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9957452","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":"A Qualitative Study on Dentists' Communication Approaches in Managing Fluoride-Hesitant Caregivers.","authors":"S Cruz, A Ko, D L Chi","doi":"10.1177/23800844231203673","DOIUrl":"10.1177/23800844231203673","url":null,"abstract":"<p><strong>Objectives: </strong>Guidelines on effective provider-led communication are available but may be underused in dentistry, even if such guidelines could help dentists manage complex clinical scenarios like topical fluoride hesitancy. The purpose of this study was to investigate current chairside communication approaches used by dentists with fluoride-hesitant caregivers.</p><p><strong>Methods: </strong>A 27-item semistructured interview script was developed and pretested with 3 dentists, revised, and finalized. One-on-one interviews were conducted with a purposive sample of pediatric dentists and general dentists from April to June 2020. Interviews were digitally recorded, transcribed, and analyzed to identify dentists' communication approaches used during clinical interactions with fluoride-hesitant caregivers. Thematic analyses identified themes and subthemes, and exemplary quotes were provided to illustrate each theme.</p><p><strong>Results: </strong>Twenty-seven dentists participated (21 pediatric dentists and 6 general dentists). The mean age of participants was 43.0 ± 8.2 y (range, 30-73). Most participants were women (88.9%), white (51.9%), and non-Hispanic (85.2%). Participants had been practicing dentistry for a mean of 13.2 ± 10.5 y (range, 2-40). There were 4 themes: leaving topical fluoride decisions completely up to the caregiver, educating the caregiver about fluoride, insisting that the caregiver accept fluoride, and engaging the caregiver and child.</p><p><strong>Conclusion: </strong>Most communications approaches used by interviewed dentists to manage fluoride hesitancy in clinical settings are not evidence based. Future dental education efforts should ensure that trainees are exposed to and can demonstrate competency in appropriate, evidence-based patient-provider communication strategies.</p><p><strong>Knowledge transfer statement: </strong>The study highlights the need for dentists to apply evidence-based communication strategies when managing difficult clinical scenarios like fluoride hesitancy, which is important in optimizing dentist-patient trust.</p>","PeriodicalId":14783,"journal":{"name":"JDR Clinical & Translational Research","volume":" ","pages":"212-220"},"PeriodicalIF":2.2,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11318380/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71423779","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":"Longitudinal Microbiome Changes in Supragingival Biofilm Transcriptomes Induced by Orthodontics.","authors":"E Babikow, N Ghaltakhchyan, T Livingston, Y Qu, C Liu, A Hoxie, T Sulkowski, C Bocklage, A Marsh, S T Phillips, K B Mitchell, A De A Ribeiro, T H Jackson, J Roach, D Wu, K Divaris, L A Jacox","doi":"10.1177/23800844231199393","DOIUrl":"10.1177/23800844231199393","url":null,"abstract":"<p><strong>Introduction: </strong>Common oral diseases are known to be associated with dysbiotic shifts in the supragingival microbiome, yet most oral microbiome associations with clinical end points emanate from cross-sectional studies. Orthodontic treatment is an elective procedure that can be exploited to prospectively examine clinically relevant longitudinal changes in the composition and function of the supragingival microbiome.</p><p><strong>Methods: </strong>A longitudinal cohort study was conducted among 24 adolescent orthodontic patients who underwent saliva and plaque sampling and clinical examinations at time points: before fixed appliance bonding and at 1, 6, and 12 wk thereafter. Clinical indices included bleeding on probing (BOP), mean gingival index (GI), probing depths (PDs), and plaque index (PI). To study the biologically (i.e., transcriptionally) active microbial communities, RNA was extracted from plaque and saliva for RNA sequencing and microbiome bioinformatics analysis. Longitudinal changes in microbiome beta diversity were examined using PERMANOVA tests, and the relative abundance of microbial taxa was measured using Kruskal-Wallis tests, Wilcoxon rank-sum tests, and negative binomial and zero-inflated mixed models.</p><p><strong>Results: </strong>Clinical measures of oral health deteriorated over time-the proportion of sites with GI and PI ≥1 increased by over 70% between prebonding and 12 wk postbonding while the proportion of sites with PD ≥4 mm increased 2.5-fold. <u>Streptococcus sanguinis</u>, a health-associated species that antagonizes cariogenic pathogens, showed a lasting decrease in relative abundance during orthodontic treatment. Contrarily, caries- and periodontal disease-associated taxa, including <u>Selenomonas sputigena</u>, <u>Leptotrichia wadei</u>, and <u>Lachnoanaerobaculum saburreum</u>, increased in abundance after bonding. Relative abundances of <u>Stomatobaculum longum</u> and <u>Mogibacterium diversum</u> in prebonding saliva predicted elevated BOP 12 wk postbonding, whereas <u>Neisseria subflava</u> was associated with lower BOP.</p><p><strong>Conclusions: </strong>This study offers insights into longitudinal community and species-specific changes in the supragingival microbiome transcriptome during fixed orthodontic treatment, advancing our understanding of microbial dysbioses and identifying targets of future health-promoting clinical investigations.</p><p><strong>Knowledge transfer statement: </strong>Bonding braces was associated with subsequent changes in the oral microbiome characterized by increases in disease-associated species, decreases in health-associated species, and worsened clinical measures of oral health.</p>","PeriodicalId":14783,"journal":{"name":"JDR Clinical & Translational Research","volume":" ","pages":"265-276"},"PeriodicalIF":2.2,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11184915/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"50157985","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":"In Reply to E. Topkan et al.","authors":"P Saenthaveesuk, S Kiat-Amnuay, M F Walji","doi":"10.1177/23800844231189696","DOIUrl":"10.1177/23800844231189696","url":null,"abstract":"","PeriodicalId":14783,"journal":{"name":"JDR Clinical & Translational Research","volume":" ","pages":"306-307"},"PeriodicalIF":3.0,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10396747","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":"Dentists' Approaches to Treatment Decision-Making for People with Dementia: A Qualitative Study.","authors":"A Geddis-Regan, C Abley, C Exley, R Wassall","doi":"10.1177/23800844231199385","DOIUrl":"10.1177/23800844231199385","url":null,"abstract":"<p><strong>Introduction: </strong>Globally, the number of people living with dementia (PLwD) is projected to increase substantially. Dentists will encounter an increasing number of PLwD retaining natural teeth who need dental care. Dental treatment planning can be complex for PLwD as both oral diseases and dental treatment can be detrimental to patients' oral and social function and comfort. In addition, patients may lack the capacity to make decisions about their treatment, posing further challenges for dentists.</p><p><strong>Objective: </strong>This study aimed to explore dentists' approach to treatment decision-making with or for PLwD.</p><p><strong>Methods: </strong>Semistructured one-to-one interviews were completed with 22 dentists between April 2020 and March 2021. Data generation and analysis followed the principles of constructivist grounded theory with data being collected and analyzed simultaneously using a maximum variation sample. Interviews were recorded, transcribed verbatim, and then analyzed, leading to a theoretical understanding of how dentists approach treatment decisions for PLwD.</p><p><strong>Results: </strong>Four data categories describe dentists' approaches to treatment decision-making for PLwD. Dentists sought to provide individualized care for PLwD. However, they described planning care based on risk-benefit analyses that primarily considered biomedical factors and generic assumptions. There was an underemphasis on the psychological or social implications of dental care or its delivery. Furthermore, while some dentists attempted to involve patients in treatment decisions, they reported fewer attempts to identify the views and preferences of PLwD identified as lacking decisional capacity. In this scenario, dentists reported leading the decision-making process with little regard for patients' known or identified preferences and minimal involvement of PLwD's family.</p><p><strong>Conclusions: </strong>Dentists acknowledge the complexity in treatment decision-making for PLwD yet focused heavily on biomedical considerations, with an underemphasis on individuals' preferences and autonomy. Considering psychosocial aspects of care alongside biomedical factors is essential to support holistic person-centered care for this growing patient cohort.</p><p><strong>Knowledge transfer statement: </strong>This study highlighted that dentists may only be considering biomedical aspects of care when considering what treatment is appropriate for people living with dementia. When making or supporting treatment decisions, dentists should explore patients' preferences and actively consider relevant psychosocial factors. These can be actively identified through considered discussions with patients as well as their family members. Gathering this information should support more person-centered and value-concordant decision-making for people living with dementia.</p>","PeriodicalId":14783,"journal":{"name":"JDR Clinical & Translational Research","volume":" ","pages":"221-230"},"PeriodicalIF":2.2,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11318378/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41121703","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":"Examining the Effect of Income-Based Inequalities and Dental Service Provision on Dental Service Utilization among Older Australians: A Multiple Mediation Analysis.","authors":"A Ghanbarzadegan, W Sohn, J Wallace, D S Brennan, L M Jamieson","doi":"10.1177/23800844231199658","DOIUrl":"10.1177/23800844231199658","url":null,"abstract":"<p><strong>Introduction: </strong>Public service provision is one of the keys to reducing inequalities in the utilization of dental services. Given the increase in the aging population, there should be a focus on older adults' oral health. However, this is often overlooked.</p><p><strong>Objectives: </strong>This study investigates the effectiveness of public services in reducing income-related inequalities in dental service utilization among older South Australians.</p><p><strong>Methods: </strong>A multiple counterfactual mediation analysis using the ratio of mediator probability weighting approach was used to explore the proposed mediation mechanism using a South Australian population of older adults (≥65 y). The exposure variable in the analysis was income, and the mediators were concession cards and the last dental sector (public or private). The outcome variable was the time of last dental visit.</p><p><strong>Results: </strong>Half of the older adults with high income (≥$40,000) owned a concession card, and 10% of those who attended public dental services belonged to this group. Interestingly, only 16.3% of the study participants had visited the public dental sector at their last dental appointment. Results showed a negligible indirect effect (odds ratio [OR], 0.99; 95% confidence interval [CI], 0.85-1.05) and a significant direct effect (OR, 3.09; 95% CI, 2.24-4.87). By changing the potential outcome distributions to the counterfactual exposure distributions and taking the mediators' distribution as a counterfactual exposure distribution, the odds of dental visits occurring before the past 12 mo approximately tripled for low-income compared to high-income individuals.</p><p><strong>Conclusion: </strong>Income inequalities were associated with relatively delayed dental visits in older South Australians, and provision of public services could not improve this pattern. This might happen due to inequitable access to concession cards and public services. A review of policies is required, including addressing income inequalities and implementing short-term approaches to improve service utilization patterns in older South Australians.</p><p><strong>Knowledge transfer statement: </strong>The findings of this study can enable policymakers for informed decision-making about the provision of public dental services for older Australians. This study emphasizes the importance of reviewing the current public dental services and subsidies and implementing short-term approaches to reduce income inequalities for older Australians.</p>","PeriodicalId":14783,"journal":{"name":"JDR Clinical & Translational Research","volume":" ","pages":"248-255"},"PeriodicalIF":2.2,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11186176/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49677552","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":"A Cluster Analysis of Oral and Cognitive Health Indicators in the CLSA: An Exploratory Study on Cholinergic Activity as the Link.","authors":"K Rohani, B Nicolau, S Madathil, L Booij, D Jafarpour, P B Haricharan, J Feine, R Alchini, F Tamimi, R de Souza","doi":"10.1177/23800844231190834","DOIUrl":"10.1177/23800844231190834","url":null,"abstract":"<p><strong>Introduction: </strong>Poor oral health has been suggested as a risk factor for cognitive decline. Yet, biologically plausible mechanisms explaining this relationship remain unknown.</p><p><strong>Objectives: </strong>We aimed (1) to identify oral and cognitive health clustering patterns among middle-aged to elderly Canadians and (2) to investigate the extent to which these patterns could be explained by bone mineral density (BMD), a proxy measure of the cholinergic neurons' activity.</p><p><strong>Methods: </strong>This cross-sectional study used baseline data from the Comprehensive cohort of the Canadian Longitudinal Study of Aging (CLSA). Oral health was assessed by a self-report questionnaire, and 7 task-based instruments measured cognitive health. We identified oral and cognitive health clusters, our outcome variables, using latent class analysis. Two sets of multivariate logistic regression and 95% confidence intervals were used to investigate whether BMD explains the odds of membership in a certain oral and cognitive health group. The final models were adjusted for socioeconomic, health, and lifestyle factors.</p><p><strong>Results: </strong>Our study sample (N = 25,444: 13,035 males, 12,409 females) was grouped into 5 and 4 clusters based on the oral health status and performance on the cognitive tasks, respectively. After adjusting for all potential covariates, increase in BMD was not associated with higher odds of membership in classes with better oral health (odds ratio [OR] = 1.58 [95% confidence interval {CI}: 0.85-2.92]) and cognitive health (OR = 1.61 [95% CI: 1-2.6]) compared with the groups with the least favorable oral and cognitive health status, respectively.</p><p><strong>Conclusion: </strong>Middle-aged and elderly Canadians show different oral and cognitive health profiles, based on their denture-wearing status and performance on cognitive tests. No evidence could be found to support BMD in place of cholinergic neurons' activity as the common explanatory factor behind the association between oral health and cognitive health.</p><p><strong>Knowledge transfer statement: </strong>This study is probably the first of its kind to shed light on the cholinergic system as a potential pathway influencing oral and cognitive health. Our findings may support the notion that any potential association between poor oral health and cognitive health might be explained by common contributors, helping clinicians to find the common risk factors for both conditions.</p>","PeriodicalId":14783,"journal":{"name":"JDR Clinical & Translational Research","volume":" ","pages":"294-305"},"PeriodicalIF":3.0,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11184914/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10041962","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}