ORCID Profile
0000-0001-9723-7343
Current Organisation
University of Sydney
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Publisher: Public Library of Science (PLoS)
Date: 11-06-2019
Publisher: Society for Neuroscience
Date: 24-04-2013
DOI: 10.1523/JNEUROSCI.0174-13.2013
Abstract: Human brain imaging has revealed that acute pain results from activation of a network of brain regions, including the somatosensory, insular, prefrontal, and cingulate cortices. In contrast, many investigations report little or no alteration in brain activity associated with chronic pain, particularly neuropathic pain. It has been hypothesized that neuropathic pain results from misinterpretation of thalamocortical activity, and recent evidence has revealed altered thalamocortical rhythm in in iduals with neuropathic pain. Indeed, it was suggested nearly four decades ago that neuropathic pain may be maintained by a discrete central generator, possibly within the thalamus. In this investigation, we used multiple brain imaging techniques to explore central changes in subjects with neuropathic pain of the trigeminal nerve resulting in most cases (20 of 23) from a surgical event. In iduals with chronic neuropathic pain displayed significant somatosensory thalamus volume loss (voxel-based morphometry) which was associated with decreased thalamic reticular nucleus and primary somatosensory cortex activity (quantitative arterial spin labeling). Furthermore, thalamic inhibitory neurotransmitter content was significantly reduced (magnetic resonance spectroscopy), which was significantly correlated to the degree of functional connectivity between the somatosensory thalamus and cortical regions including the primary and secondary somatosensory cortices, anterior insula, and cerebellar cortex. These data suggest that chronic neuropathic pain is associated with altered thalamic anatomy and activity, which may result in disturbed thalamocortical circuits. This disturbed thalamocortical activity may result in the constant perception of pain.
Publisher: Wiley
Date: 22-09-2015
DOI: 10.1002/EJP.781
Abstract: Pain catastrophizing significantly affects an in idual's experience of pain. High pain catastrophizing is associated with increased fear avoidance behaviours, pain intensity and disability. The aim of this investigation was to determine the effect of pain catastrophizing on ongoing brain activity and movement-evoked brain activity during acute orofacial muscle pain. Thirty-four healthy, pain-free subjects were recruited. In 17 subjects, the effect of catastrophizing on regional brain activity was determined. In 19 subjects, functional magnetic resonance imaging was used to determine the effects of pain catastrophizing on brain activation patterns during jaw movements in the presence of ongoing pain. We found that in the presence of pain, catastrophizing was significantly correlated with activity in multi-sensory integrative brain regions, including the dorsolateral and medial prefrontal cortices. Importantly, this relationship did not exist when subjects were not experiencing pain. In addition, during repetitive open-close jaw movements in the presence of pain, activity in the primary motor cortex, cerebellar cortex and the trigeminal motor nucleus was positively correlated with pain catastrophizing scores. In contrast, in the dorsolateral prefrontal cortex, as pain catastrophizing scores increased, the magnitude of signal intensity change during jaw movements decreased. Again, no such relationships occurred when the in idual was not in pain. These data show that during pain, catastrophic thinking has a significant impact on activity in motor and sensory integrative regions. Reducing negative coping strategies may be an effective means in reducing fear avoidance behaviours and the intensity of ongoing pain.
Publisher: MDPI AG
Date: 05-08-2019
DOI: 10.3390/IJMS20153826
Abstract: Periodontitis is a chronic inflammatory disorder often seen in patients with diabetes mellitus (DM). In iduals with diabetes are at a greater risk of developing cardiovascular complications and this may be related, in part, to lipid abnormalities observed in these in iduals. The objective of this systematic review is to compile the current scientific evidence of the effects of periodontal treatment on lipid profiles in patients with type 2 diabetes mellitus. Through a systematic search using MEDLINE, EMBASE, PubMed, and Web of Science, 313 articles were identified. Of these, seven clinical trials which met all inclusion criteria were chosen for analysis. Between baseline and 3-month follow-up, there was a statistically significant reduction in the levels of total cholesterol (mean differences (MD) −0.47 mmol/L (95% confidence interval (CI), −0.75, −0.18, p = 0.001)), triglycerides (MD −0.20 mmol/L (95% CI −0.24, −0.16, p 0.00001)) favouring the intervention arm, and a statistically significant reduction in levels of high density lipoprotein (HDL) (MD 0.06 mmol/L (95% CI 0.03, 0.08, p 0.00001)) favouring the control arm. No significant differences were observed between baseline and 6-month follow-up levels for any lipid analysed. The heterogeneity between studies was high. This review foreshadows a potential benefit of periodontal therapy for lipid profiles in patients suffering from type 2 DM, however, well designed clinical trials using lipid profiles as primary outcome measures are warranted.
Publisher: Elsevier BV
Date: 10-2008
DOI: 10.1016/J.JDENT.2008.05.009
Abstract: The purpose of this clinical study was to examine the relationships of v-shaped noncarious cervical lesion (NCCL) formation with occlusal factors. A total of 159 male self-defense force officials with a mean age of 36.2 years participated in this study. All present teeth were examined for the presence and type of NCCL using the Tooth Wear Index (TWI). The subjects were then interviewed about bruxing and toothbrushing habit. Finally, occlusal force, occlusal contact area and average pressure were measured using a pressure-detecting sheet. Subject-level logistic regression was carried out to assess the associations of factors with presence of v-shaped NCCL teeth. Subjects without v-shaped NCCL were designated as control subjects. Totally, 4518 teeth were examined. Seventy-eight subjects (49.1%) had one or more teeth with typical v-shaped NCCL (259 teeth). The number of teeth with v-shaped NCCL of grade 2 (defect less than 1mm in depth) was 195 (4.3%), and the number of teeth with v-shaped NCCL of grade 3 (defect 1-2mm in depth) was 54 (1.2%). The prevalence of teeth with v-shaped NCCL was significantly higher in the maxilla than in the mandible. Most of the NCCL teeth were premolars. There was no significant difference between teeth with NCCL on the right side and those on the left side. Subject-level logistic regression analysis revealed that age (OR=1.11), toothbrushing pressure (400g, OR=2.43) and occlusal contact area (>23.0mm(2), OR=4.15) were associated with the presence of NCCL teeth. It is concluded that aging, toothbrushing pressure and occlusal contact area are associated with the presence of NCCLs.
Publisher: Wiley
Date: 18-12-2007
Publisher: Wiley
Date: 11-2016
DOI: 10.1111/JOOR.12449
Abstract: To test the hypotheses that experimental noxious stimulation of the anterior temporalis muscle results in significant decreases in jaw movement litude and velocity, and there are significant correlations between scores of mood or pain-related cognitions and litude and velocity. The jaw movements of 14 asymptomatic participants were recorded during standardised open/close jaw movements and free and standardised chewing tasks. Tonic infusion of hypertonic saline into the right anterior temporalis muscle maintained pain intensity between 40 and 60 mm on a 100-mm visual analogue scale. Tasks were performed in a single session in the following sequence: baseline condition, test 1 condition (during hypertonic or isotonic saline infusion), test 2 condition (during saline infusion) (10-min rest between conditions). Participants completed the Depression, Anxiety and Stress Scale (DASS-21) and the Pain Catastrophizing Scale (PCS). Amplitude and velocity of opening and closing were compared between conditions with a repeated-measures analysis of variance (anova), and Spearman's rank correlation coefficient explored correlations statistical significance: P < 0·05. For any of the three tasks, there were no significant differences in kinematic variables between any condition and no significant correlations between DASS-21 or PCS scores and kinematic variables during hypertonic saline infusion. The absence of a significant reduction in velocity or litude of open/close or chewing jaw movements during experimental temporalis muscle pain is not consistent with the Pain Adaptation Model proposing decreases in kinematic measures in pain. The lack of significant correlations between psychological variables and measures of jaw movement may reflect the low scores reported by our study s le.
Publisher: Springer Science and Business Media LLC
Date: 19-04-2017
Publisher: Wiley
Date: 05-02-2011
DOI: 10.1111/J.1365-2842.2010.02195.X
Abstract: The aims of this study were to examine the incidence of temporomandibular disorders (TMDs) over a 3-year period and to evaluate the risk of self-reported TMDs among university students in Japan. The study population comprised 2374 university students examined at the start of their undergraduate course and 492 students re-examined after 3 years using questionnaires on symptoms of TMD and experiences of jaw injury, stress, orthodontic treatment and parafunctional habits. Cumulative incidence (%) and relative risks were calculated overall. Odds ratios (ORs) and 95% confidence intervals (CIs) were calculated to determine the degree of risks of these variables for symptoms of TMDs using logistic regression. Results of logistic regression analysis showed that male subjects with experience of jaw injury had a 3·54 (CI=1·45-8·68, P<0·01)-fold higher risk of temporomandibular joint (TMJ) pain than that for those who did not. Female subjects who reported experiencing stress and bruxism had 10·56 (CI=1·28-87·54, P<0·05)- and 5·00 (CI=1·21-20·71, P<0·05)-fold higher risks of TMJ sound, respectively, than the risk for female subjects who had not experienced stress or bruxism. The results indicated that experiences of jaw injury, stress and bruxism were significantly associated with increased risks of development of TMJ disorders in a 3-year cohort.
Publisher: Springer Science and Business Media LLC
Date: 15-01-2019
Publisher: Springer Science and Business Media LLC
Date: 02-08-2019
Publisher: Elsevier BV
Date: 07-2021
Publisher: Elsevier BV
Date: 06-2008
Publisher: Wiley
Date: 2010
DOI: 10.1111/J.1601-0825.2009.01619.X
Abstract: To assess the relationship between dietary intake of folate and gingival bleeding in non-smoking adults in Japan. Data were obtained from residents who participated in the regional nutrition survey and survey of dental diseases conducted by the administrative office of northernmost prefecture of Japan. Dietitians visited households to collect data on dietary intake. Clinical parameters, including Community Periodontal Index (CPI) and bleeding on probing (BOP), were examined in community centers. Information on smoking habit was obtained from the interview. Then the data from 497 non-smoking adults with 20 teeth or more, aged 18 years or older, were analyzed. The relationship between dietary intake of folic acid and gingival bleeding status was estimated using multivariate analysis. Pearson's correlation coefficient showed a significant negative correlation between dietary folate level and bleeding on probing. The negative association between folate level and bleeding on probing remained statistically significant in multiple regression analysis (standardized beta = -0.204, P < 0.001). However, no significant association was found between CPI scores and folate intake level. The results suggest that dietary intake of folic acid, an important indicator of gingival bleeding in adults, may provide an important clinical target for intervention to promote gingival health.
Publisher: Quintessence Publishing
Date: 06-2014
DOI: 10.11607/OFPH.1211
Abstract: To investigate differences between higher and lower pain catastrophizers in the effects of hypertonic saline-evoked jaw muscle pain on pain perception and jaw movement. Repetitive open/close jaw movements were recorded in 28 asymptomatic participants (20 men, 8 women ages 25 to 62 years) during continuous infusion of 5% hypertonic saline or isotonic saline into the right masseter muscle. All participants completed the McGill Pain Questionnaire the Depression, Anxiety and Stress Scales and the Jaw Function Limitation Scale. They were ided into two groups depending on the median Pain Catastrophizing Scale score. Statistical analyses involved multivariate analysis of variance, independent s les or paired t tests, and Pearson correlations (statistical α: P < .05). Pain intensity, unpleasantness, perceived area, and pain rating indices were significantly (P < .05) elevated in higher pain catastrophizers during hypertonic saline-evoked pain in comparison with lower catastrophizers. The higher catastrophizers exhibited significantly (P < .05) slower jaw velocity than the lower catastrophizers during hypertonic saline infusion in comparison with IS infusion. In comparison with lower catastrophizers, there was a significantly greater change in the percentage of coefficient of variation between hypertonic saline and isotonic saline infusions in higher catastrophizers for closing velocity and opening and closing litude. The increased reported pain intensity, pain areas, and pain rating indices are consistent with enhanced central sensitization processes in high-catastrophizing in iduals. The slower velocity and greater variability of repetitive jaw movements in higher pain catastrophizing in iduals in acute experimental pain may reflect changes in motor coordination as an ex le of avoidance behavior for the jaw motor system.
Publisher: Springer Science and Business Media LLC
Date: 06-02-2013
Publisher: Japan Epidemiological Association
Date: 2006
DOI: 10.2188/JEA.16.214
Publisher: Wiley
Date: 12-2008
Publisher: SAGE Publications
Date: 14-12-2012
Abstract: Some management strategies for chronic orofacial pain are influenced by models ( e.g., Vicious Cycle Theory, Pain Adaptation Model) proposing either excitation or inhibition within a painful muscle. The aim of this study was to determine if experimental painful stimulation of the masseter muscle resulted in only increases or only decreases in masseter activity. Recordings of single-motor-unit (SMU, basic functional unit of muscle) activity were made from the right masseters of 10 asymptomatic participants during biting trials at the same force level and direction under infusion into the masseter of isotonic saline (no-pain condition), and in another block of biting trials on the same day, with 5% hypertonic saline (pain condition). Of the 36 SMUs studied, 2 SMUs exhibited a significant ( p 0.05) increase, 5 a significant decrease, and 14 no significant change in firing rate during pain. Five units were present only during the no-pain block and 10 units during the pain block only. The findings suggest that, rather than only excitation or only inhibition within a painful muscle, a re-organization of activity occurs, with increases and decreases occurring within the painful muscle. This suggests the need to re-assess management strategies based on models that propose uniform effects of pain on motor activity.
Publisher: Frontiers Media SA
Date: 31-01-2020
Publisher: Elsevier BV
Date: 07-2020
Publisher: IEEE
Date: 07-2013
Publisher: Wiley
Date: 06-01-2005
DOI: 10.1111/J.1600-0528.2004.00189.X
Abstract: The aim of this study was to determine associations of lifestyle with dental health behaviors such as tooth brushing frequency, use of extra cleaning devices, and regular dental visits to a dentist. Data were collected from 1182 dentate residents 18 years of age or older who resided in a typical farming district. The data included data on the demographic factors, dental health behavior, and various aspects of lifestyle, i.e. mental condition, alcohol consumption, smoking habit, physical activity, social activity, dietary habits, and presence of systemic diseases. Multiple logistic regression analysis revealed that subjects in a younger group (18-39 years of age) and subjects who had never smoked brushed their teeth more frequently. Experience of social volunteer work and presence of systemic disease were correlated with use of extra cleaning devices. Associations of female gender with frequency of tooth brushing and use of extra cleaning devices were weakly positive. The subjects who considered dietary combination carefully and those who lived alone were predisposed to visit a dentist regularly. The results indicate that dental health behavior is associated with lifestyle as well as demographic factors.
Publisher: Wiley
Date: 09-12-2016
DOI: 10.1111/DMCN.13359
Abstract: To describe the oral health status and investigate factors affecting dental caries experience among children with cerebral palsy (CP) in rural Bangladesh. A cross-sectional study was conducted among children with CP who are part of the Bangladesh Cerebral Palsy Register (BCPR) study. Caries experience was measured by identifying decayed, missing, and filled teeth for deciduous and permanent teeth (dmft/DMFT). Clinical periodontal index, body mass index, oral hygiene behaviour, masticatory ability, and dietary habits were recorded. CP motor types and severity of functional mobility (Gross Motor Function Classification System [GMFCS]) were assessed. Of 90 children with CP (mean age 9y 7mo, range 2-17y, 37.8% female and 62.2% male), 35% of 2 to 6 year olds, and 70% of 7 to 11 year olds (p=0.014) experienced caries (dmft+DMFT>0). The mean values (standard deviation [SD]) of dmft and DMFT were 2.46 (3.75) and 0.72 (1.79) respectively. After adjusting for age and sex, binary logistic regression analysis showed a significant relationship with dental caries for children who had quadriplegia (odds ratio [OR] 5.56, p=0.035), tooth cleaning less than one time/day (OR 0.08, p=0.016), using toothpowder or charcoal for cleaning (OR 7.63, p=0.015), and snacking between meals more than one time/day (OR 6.93, p=0.012). Early oral health preventive care is required for children with CP because dental caries is highly prevalent in these children.
Publisher: Elsevier BV
Date: 2018
Publisher: Elsevier BV
Date: 03-2022
Publisher: Wiley
Date: 18-05-2012
DOI: 10.1111/J.1600-0722.2012.00963.X
Abstract: A major goal of motor coordination is the production of a smooth movement. Jerk-cost, which is an inverse measure of movement smoothness, has been evaluated during gum chewing in previous studies. However, the effect of the gum bolus is still unclear. The aims of this study were to compare the jerk-cost values of normal gum chewing with those of empty chewing. Thirteen subjects undertook, empty chewing, then chewing of gum, and then a second empty chewing. Jerk-cost was calculated from an accelerometer attached to the skin of the mentum. There was a significantly higher smoothness (i.e. lower jerk-cost, P < 0.05) during the opening and second-half closing phases in empty chewing compared with gum chewing. There were no significant differences in jerk-costs (i.e. opening or closing) between the first and the second empty-chewing sequences. These results suggest that the influence of the mechanical effects of tooth contact on jerk-cost is not restricted just to the occlusal phase of chewing, but rather the effect influences the entire opening and closing phases of chewing.
Publisher: Wiley
Date: 27-11-2015
DOI: 10.1111/ADJ.12386
Publisher: Wiley
Date: 07-07-2009
DOI: 10.1111/J.1365-2842.2009.01971.X
Abstract: The purpose of this study was to examine the relationship of dietary preference to bite force and occlusal contact area in Japanese elementary school children. A total of 348 children, aged 7-12 years, from two public elementary schools located in Okayama Prefecture, Japan, participated in the study. Clinical examination included decayed, missing and filled teeth (dmft and DMFT), and total numbers of deciduous and permanent teeth. Bite force and occlusal contact area were measured using a pressure-detecting sheet. Dietary preference was assessed using a questionnaire in which the answers were given in like/dislike form. Mann-Whitney U-test and multiple logistic regression analysis were applied to analyse the data. In multiple logistic regression analysis after adjustment for age, gender and total number of teeth present, children who liked cabbage and celery showed significantly higher bite force (P = 0.05 and P < 0.01, respectively) than those who disliked these. Children who liked cabbage and celery also showed higher occlusal contact area (P < 0.05 and P < 0.01, respectively) than those who disliked these. The Japanese elementary school children who liked hard foods such as cabbage and celery showed higher bite force and higher occlusal contact area than those who disliked these foods. A positive attitude towards harder food items might contribute to healthy development of the masticatory apparatus.
Publisher: Wiley
Date: 16-07-2004
Publisher: Wiley
Date: 11-2017
DOI: 10.1111/EJE.12299
Abstract: Most Australian universities have abbreviated the anatomy curriculum and modified its mode of delivery. This study examines dental student perceptions of different methods of head and neck anatomy teaching with respect to the adequacy of allocated time and the relative meaningfulness of the teaching methods. All second-year students in the School of Dentistry and Health Sciences at Charles Sturt University (CSU) were invited to complete a matrix-grid questionnaire. Participants were asked to score four methods of teaching (lectures, study of prosected materials, tutorials and quizzes) using a 5-point Likert scale. The questionnaire included questions about the time adequacy for anatomy lectures, tutorials and laboratory study, and the potential value of learning anatomy through the study of prosected materials. SPSS (Version 21.0) was used to analyse the data, and statistical significance was set at 0.05. Seventy-two students (79.5%) responded to the survey. Overall, learning anatomy through the study of prosected materials was the single highest scored method, followed by lectures, tutorials and quizzes. Graduate entrants felt that not enough time was devoted to learning anatomy through the study of prosected materials, compared with school leavers (89.4% and 10.6%, respectively), having one extra session of learning in the anatomy laboratory (71.4% and 28.6%, respectively) and adding dissection (75.0% and 25.0%, respectively) would be helpful. This study demonstrates that dental students perceive the study of prosected materials in the wet laboratory as the most valuable method of learning anatomy, but an extended anatomy curriculum would be even more effective and appreciated.
Publisher: Elsevier BV
Date: 02-2021
Publisher: Elsevier BV
Date: 10-2008
DOI: 10.1016/J.CANLET.2008.04.052
Abstract: Genetic alteration of p53 is a significant determining factor in the carcinogenesis. The loss of function, mutant p53 can possess a dominant negative effect on wild-type p53 and may also exert gain-of-function activity. It is, however, not clear how p53 functional status due to various types of mutation results in outcome of patients with oral cancer. A total of 60 oral SCC s les were subjected to yeast functional assay that screens human p53 function in yeast, and sequencing for determination of p53 mutations. The detected mutants were further investigated for their dominant negative activity using a yeast-based transdominance assay that tests dominant negative activity of a mutant p53 over wild-type p53 by coexpressing the mutant and wild-type p53 in a yeast transcriptional reporter system. p53 mutation was found in 42 out of 60 of which 10 (24%) exhibited dominant negative activity and 32 (76%) without dominant activity (recessive mutation). The remaining 18 (30%) were considered to have wild-type p53. The patients with dominant negative mutation had significantly shorter disease-free survival than patients with no mutation (log-rank test, p<0.001) and those with a recessive mutation (p<0.016). There were slight significant differences in disease-free survival were found between the patients with tumours harbouring a recessive p53 mutation and those with tumours harbouring a wild-type p53 (p<0.038). The presence and absence of a dominant negative p53 mutation may thus provide a predictor of early recurrence in oral SCC patients.
Publisher: MDPI AG
Date: 19-01-2021
Abstract: While periodontal disease is associated with many risk factors, socioeconomically disadvantaged communities experience the highest disease burden. The aim of this study was to evaluate the effectiveness of a personalized oral health education program, in combination with routine dental treatment, in participants from a low socioeconomic community. We used a randomized, controlled, examiner-blinded clinical trial. A total of 579 participants (aged 18–60 years) were randomly grouped: the intervention group (n = 292) received a personalized oral health education program in combination with routine dental care and the control group (n = 287) received routine dental care. All participants were assessed for improvement in oral health care behaviors, dental plaque, and periodontal status at baseline, 12 months, and 24 months. We found a significant drop (p 0.001) in the plaque indices, Periodontal Probing Depths (PPD) and Bleeding on Probing (BOP) between baseline and the 12-month follow-up for both groups. For BOP, the number of sites positive was significantly different between baseline and the 24-month follow-up (p = 0.037). No differences were found between the two groups for any evaluated clinical outcome. The personalized oral health education program used in the current study did not appear to add significant improvement to clinical outcomes of periodontal health compared with routine restorative dental care per se.
Publisher: Quintessence Publishing
Date: 2018
DOI: 10.11607/OFPH.1821
Abstract: To determine if the effects of experimental temporalis muscle pain on jaw muscle activity vary with the jaw task performed, jaw displacement magnitude, participant being studied, and with psychological measures. Jaw movement was tracked, and electromyographic (EMG) activity was recorded from the masseter and anterior temporalis and digastric muscles in 14 asymptomatic participants during standardized opening/closing jaw movement, free chewing, and standardized chewing tasks. Tasks were repeated in three blocks: Block 1 (baseline), Block 2 (during 5% hypertonic or 0.9% isotonic saline infusion into the anterior temporalis), and Block 3 (during infusion of the opposite solution). Participants also completed the Depression, Anxiety, and Stress Scales 21 (DASS 21), the Fear of Pain Questionnaire (FPQ III), the Pain Self-Efficacy Questionnaire (PSEQ), and the Pain Catastrophizing Scale (PCS). Analyses involved linear mixed-model analysis and Pearson correlations. P < .05 was considered statistically significant. The presence of a significant difference in jaw muscle EMG activity between hypertonic and isotonic saline infusions varied between tasks and between jaw muscle agonists and antagonists, but not in displacement magnitude. There were qualitative differences between participants in the effects of infusion on EMG activity. During hypertonic saline infusion, significant positive correlations were noted between jaw-closing EMG activity and anxiety, fear of medical pain, and PCS scores. Noxious stimulation of the temporalis muscle results in changes in jaw muscle activity, which can vary with the task, the muscle, the participant, and some psychological variables.
Publisher: MDPI AG
Date: 30-06-2022
Abstract: Cerebral palsy is a developmental motor disorder which has far-reaching impacts on oral health. This scoping review examined the extent of research undertaken regarding the risk factors affecting dental caries experience in children and adolescents with cerebral palsy. Data were obtained from the electronic databases Web of Science and PubMed, using 10 search strings, for studies published between 1983 and 2018. Eligible studies were required to have investigated caries in children under 18 with cerebral palsy, as well as be written in English. 30 papers published were identified for inclusion in the review. These included 23 cross-sectional, 6 case–control, and 1 longitudinal study. Studies were categorized into six domains of risk factors: socioeconomic status (SE) cerebral palsy subtype (CPS) demographics (D) condition of oral cavity (OC) dental habits (DH) nutrition and diet (ND). This review was conducted and reported in accordance with Preferred Reporting Items for Systematic reviews and Meta-Analyses Extension for Scoping Reviews (PRISMA-ScR) guidelines. The most significant risk factors were caregiver-related education levels, oral health literacy, and sugar intake this underlines the important role of special education and dental awareness in reducing dental caries incidence in CP children. Other factors showed ergent findings, highlighting the need for standardization and culturally specific studies in future literature.
Publisher: Wiley
Date: 12-2016
DOI: 10.1111/ADJ.12482
Publisher: Springer Science and Business Media LLC
Date: 15-01-2019
No related grants have been discovered for Rahena Akhter.