HSC 440 California National University for Advanced Studies Allied Health

RESULTS

Introduction

This section describes all methods and procedures for collecting and analyzing the data and then presents the following sub-sections: Data Collection Procedures Describe the methods and procedures for collecting the data including, if necessary, informed consent protocols for human participants and field tests preliminary to conducting the study. Data Analysis and Results For qualitative studies (which will have no hypotheses), discuss: (1) the type(s) of data obtained; (2) how the data will be prepared for analysis; (3) how the data will be coded; and (4) how the data will be initially analyzed (e.g., methodological approach [case study, grounded theory, etc.]). For quantitative studies (which contain hypotheses): (1) Decide on the type of data involved in each statistic and correlation; (2) Determine the descriptive statistics required or desired, including both descriptive statistics and summaries (diagrams, histograms, etc.); (3) Determine the sequence of methods for the desired analysis; and (4) Describe how each step will be carried out. REFERENCES References should be double-spaced, with a double-space between entries. Use the ruler to create a hanging indent. APPENDIX A. ADD TITLE (ALL CAPS) Attach your appendix item here. If no appendices are needed, then omit this page. If more than one appendix is needed, continue to the following page, place APPENDIX B (in all caps) centered at the top of the page, the title of the appendix (in all caps), then attach the applicable item (e.g., table, figure, graph, illustration, etc.). Continue the same process as necessary for all subsequent appendices. 1 Literature Review Oral Health Most people, when they think about the dentist, they think about pain, cost, and bad tastes. What people don’t think about is their gums and their entire oral-facial system that allows us to smile, speak, and chew (CDC, 2022). Every time you visit the dental office the entire staff is collecting data to determine your overall health. This is accomplished by updating your medical history (to include all medications being taken), taking dental x-rays, taking periodontal measurements, and visual examination of full oral-facial system (head and neck). Oral health refers to maintaining good health of the mouth. The mouth includes gums, teeth, tongue, and throat. An individual’s oral health significantly contributes to their general health. For example, maintaining oral hygiene helps prevent bacteria from entering the body through the mouth and compromising the immune system. There are different ways of keeping good oral health which includes, brushing and flossing your teeth and gums, eating calciumenriched foods, and increasing fluoride intake. Maintaining good oral health ensure one can give a healthy smile, talk well, and avoid pain (Zohoori, 2017). By maintaining good oral health dental professionals are typically able to decipher between periodontal and systemic diseases. The failure to maintain proper hygiene of the mouth causes various diseases and infections. For instance, one might suffer from mouth and throat cancer, gum diseases, dental caries, and cleft lip. These diseases cause pain among individuals and affect the general economy of a state. Individuals are unable to work under pain caused by poor oral health, which results in weak and reduced production in an economy. Similarly, when school-aged children suffer from any of the above illnesses, they cannot attend a school which affects their performance and learning in general. Thus, oral health does not only contribute to an individual’s public health but also the 2 nations. Some of the diseases that might be caused by failure to observe oral health are diabetes mellitus and pulmonary diseases (World Health Organization, 2017). Oral Manifestations Link The link between oral health and overall health is very clear. Through different pieces of research conducted, a link between oral health and the rest of the body has been established. The mouth acts as the major entry point for different things. Bacteria become part of the entries into the body that come from the mouth. In many cases, people can develop a serious systemic disease when they have poor oral health. Dental procedures such as endodontic treatment and tooth extraction can result in poor general health. Through the procedures, people with poor oral health can experience bacteremia (Taguchi et al., 2004). The bacteria in the mouth can get into the bloodstream through the openings from the procedure resulting in systemic diseases (Sachdev et al., 2013). Poor oral health is very damaging to the overall health and functioning of the body. Failure to maintain proper oral health can affect how someone speaks, chews and swallows. Affecting the essential functions of the mouth can hinder communication and the intake of nutrients into the body. Poor nutrient intake into the body affects an individual’s general health. In the time of the Covid-19 pandemic, maintaining oral health is very critical especially due to the lockdown situations. Since people are mostly at home, it is critical to ensure that there is proper dental hygiene especially among patients with diabetes to prevent the development of periodontal disease and general body wellness. Through the studies selected, we shall deduce the link between oral health and systemic disease to bring out the issues related to oral cavity, oral pathology and bacteremia (Appollonio et al., 2015; Taguchi et al., 2004; Sachdev et al., 2013; Kim et al., 2013). Cardiac Manifestations 3 Individuals can preserve their general and oral wellness by learning about their susceptibility to heart disease and preventative methods. According to Kotronia et al. (2021), oral health issues, such as gum disease, periodontal infection, and parched mouth, build up throughout adulthood and worsen as people age. Increased aggravation, poor nutrition, and illnesses like hyperglycemia, incapacity, and an elevated incidence of cardiovascular disease (CVD) and asthma are all linked to poor oral health (Lazureanu et al., 2022; Kotronia et al., 2021). Additionally, research has shown a link between poor dental hygiene and a heightened mortality incidence, particularly prominent killers like cardiovascular disease (CVD) and pathogens or disorders of the respiratory system. Patients can be informed and educated on a variety of methods to help lower and eliminate CVD. Informing patients about the connection between oral health and overall wellness is a crucial role that dental health providers may play (King et al., 2022). Gianos et al. (2021) suggested data linking poor dental health to atherosclerotic cardiovascular disease (ASCVD). There is growing proof that ASCVD and periodontal disease (PD) are connected via acute and immune-mediated processes. A set of cardiac and circulatory illnesses are referred to as ASCVD together. These conditions are the leading global cause of illness and early mortality (Ellulu et al., 2016). According to Park et al. (2019), oral hygiene concerns such as periodontal health, gum infection, and dental attrition have been linked to CVD. Intermittent bacteremia, increased aggravation, and endothelial impairment are all brought on by PD, and these conditions might be contributing factors to atherogenesis. Thorough tooth hygiene and expert technique are associated with a decreased risk of CVD subsequently in life in healthy individuals. The relationship between oral health and CVD may shift when dental hygiene is improved. It has been shown that regular tooth brushing, good oral hygiene, and prevention of tooth loss reduce periodontal diseases, cavities, and tooth loss. 4 Masi et al. (2019) argued that atherosclerosis is still the biggest etiology of CVD globally and that inflammation is a significant factor in its consequences, as per current scientific practice. Evidence suggests a direct connection between atherosclerosis and improved oral hygiene practices, such as flossing (Lee & Hwang, 2021). A heightened risk of future significant cardiovascular events such as cardiac mortality, transient myocardial attack, heart attack, and bleeding is linked to an increment in dental decay, PD, and tooth loss. Significantly, consistent dental care and washing reduce the incidence of cardiac incidents in individuals with oral illnesses and are related to a decreased CVD risk (Masi et al., 2019). Diabetes Manifestations The oral cavity can show signs of widespread latent illness and is a good gauge of general health. According to Chi et al. (2010), a thorough evaluation of the oral cavities may show signs of a systemic disorder, enabling early detection and treatment. Diagnosis of disorders like diabetes mellitus must begin in the event of severe periodontal irritation or hemorrhage. Diabetes and periodontal conditions, together with gingivitis and periodontitis, have a close relationship. Interestingly, there is a mounting suggestion of a reciprocal association between diabetes and poor periodontal hygiene, making it challenging to manage diabetes. Compared to patients with wellmanaged diabetes or those without diabetes, those with inadequately regulated diabetes lose much more gingival connections. According to Borgnakke and Poudel (2021), periodontitis develops as a combination of polymicrobial dysbiosis in the dental microbiome in the periodontal fissure and the susceptible host, causes persistent, permanent deterioration of the delicate and solid structures surrounding the teeth. Since they both contain identical risk factors and frequently afflict people with weakened immune systems or who display hyperinflammatory reactions, periodontal and diabetes both negatively impact one another. 5 Sleep Apnea Manifestations According to Salamah et al. (2022), learning how the activities of the brain, physique, and good sleep are interconnected is a relatively recent development. Sleep apnea is caused by an elevation in the topmost airway’s compressibility at the pharyngeal level when a person is sleeping, which enhances the energy required to breathe through the restricted airway while also increasing hypercarbia and decreasing hypoxemia. According to Berggren et al. (2021), obstructive sleep apnea (OSA) can affect a person’s dental health and overall wellness and comfort of daily existence. The patient’s recollections, periodontal complaints, and indicators might point to OSA. During average clinical visits, dental experts can identify several gingival indications and characteristics related to OSA. These periodontal manifestations comprise dryness in the mouth, rigidity, and retrusive jawline, as well as inflammation in the sensitive palate and umbilicus region, a thin palate, an expanded tongue, and circular mandibularis. Mood Disorder Manifestations According to McRae et al. (2016), mood disorder is a general phrase used to describe the many bipolar and depressing diseases that influence emotions. Whereas negative emotions are defined by overwhelming and prolonged emotions of uncertainty, concern, and even terror, such temperament abnormalities are distinguished by the weakening or augmentation of a person’s mood. Torales et al. (2017) stated that persons with psychiatric or mood problems are more likely than the public at large to be exposed to a variety of health conditions for oral and periodontal illnesses. The adverse impacts of the drugs they take, an absence of self-care, accessibility to quality healthcare being problematic, a lousy mindset regarding healthcare professionals, and sufferers refusing to cooperate with dental procedures are the leading causes of oral health issues. The fundamental problem with conditions like nervousness and sadness is the lack of motivation 6 in self-care, which leads to poor cleanliness. Periodontal infections and gum disease are the most extraordinarily prevalent oral and dental conditions in people with mood disorders. 7 References Appollonio, I., Carabellese, C., Frattola, A., & Trabucchi, M. (2015). Dental status, quality of life, and mortality in an older community population: A multivariate approach. Journal of the American Geriatrics Society, 45(11), 1315–1323. https://doi.org/10.1111/j.15325415.1997.tb02930.x Berggren, K., Broström, A., Firestone, A., Wright, B., Josefsson, E., & Lindmark, U. (2021). Oral health problems linked to obstructive sleep apnea are not always recognized within dental care—as described by Dental professionals. Clinical and Experimental Dental Research, 8(1), 84–95. https://doi.org/10.1002/cre2.517 Borgnakke, W. S., & Poudel, P. (2021). Diabetes and oral health: Summary of current scientific evidence for why transdisciplinary collaboration is needed. Frontiers in Dental Medicine, 2, 1–13. https://doi.org/10.3389/fdmed.2021.709831 Centers for Disease Control and Prevention. (2022, April 6). Oral Health Conditions. Centers for Disease Control and Prevention. https://www.cdc.gov/oralhealth/conditions/index.html Chi, Neville, B. W., Krayer, J. W., & Gonsalves, W. C. (2010). Oral Manifestations of Systemic Disease. American Family Physician, 82(11), 1381–1388. https://www.aafp.org/pubs/afp/issues/2010/1201/p1381.html Rivera, M., Coleman, D., & Henriquez, P. (n.d.). Cancer and the oral systemic link – dimensions of Dental Hygiene: Magazine. Dimensions of Dental Hygiene | Magazine. https://dimensionsofdentalhygiene.com/article/cancer-and-oral-systemic-link/ Gianos, E., Jackson, E. A., Tejpal, A., Aspry, K., O’Keefe, J., Aggarwal, M., Jain, A., Itchhaporia, D., Williams, K., Batts, T., Allen, K. E., Yarber, C., Ostfeld, R. J., Miller, 8 M., Reddy, K., Freeman, A. M., & Fleisher, K. E. (2021). Oral Health and Atherosclerotic Cardiovascular Disease: A Review. American Journal of Preventive Cardiology, 7, 1–7. https://doi.org/10.1016/j.ajpc.2021.100179 Ellulu, M. S., Patimah, I., Khaza’ai, H., Rahmat, A., Abed, Y., & Ali, F. (2016). Atherosclerotic cardiovascular disease: A review of initiators and protective factors. Inflammopharmacology, 24(1), 1–10. https://doi.org/10.1007/s10787-015-0255-y Kim, J. K., Baker, L. A., Davarian, S., & Crimmins, E. (2013). Oral health problems and mortality. Journal of dental sciences, 8(2), 1-11. 10.1016/j.jds.2012.12.011. https://doi.org/10.1016/j.jds.2012.12.011 King, S., Chow, C. K., & Eberhard, J. (2022). Oral Health and cardiometabolic disease: Understanding the relationship. Internal Medicine Journal, 52(2), 198–205. https://doi.org/10.1111/imj.15685 Kotronia, E., Brown, H., Papacosta, A. O., Lennon, L. T., Weyant, R. J., Whincup, P. H., Wannamethee, S. G., & Ramsay, S. E. (2021). Oral health and all-cause, cardiovascular disease, and respiratory mortality in older people in the UK and USA. Scientific reports, 11(1), 1-10. https://doi.org/10.1038/s41598-021-95865-z Lazureanu, P. C., Popescu, F. G., Stef, L., Focsa, M., Vaida, M. A., & Mihaila, R. (2022). The influence of periodontal disease on oral health quality of life in patients with cardiovascular disease: A cross-sectional observational single-center study. Medicina, 58(5), 1–17. https://doi.org/10.3390/medicina58050584 Lee, S. K., & Hwang, S. Y. (2021). Oral Health in adults with coronary artery disease and its risk factors: A comparative study using the Korea National Health and Nutrition Examination 9 Survey Data. BMC Cardiovascular Disorders, 21(1), 1–11. https://doi.org/10.1186/s12872021-01878-x Masi, S., D’Aiuto, F., & Deanfield, J. (2019). Cardiovascular prevention starts from your mouth. European Heart Journal, 40(14), 1146–1148. https://doi.org/10.1093/eurheartj/ehz060 McRae, L., O’Donnell, S., Loukine, L., Rancourt, N., & Pelletier, C. (2016). Report summary Mood and Anxiety Disorders in Canada, 2016. Health promotion and chronic disease prevention in Canada: research, policy and practice, 36(12), 314–315. https://doi.org/10.24095/hpcdp.36.12.05 Mirfarsi, Stoopler, E. T., Sun, H.-H. (Brian), & Elo, J. A. (2016). Common Oral Manifestations of Select Systemic Diseases: Anemia, Diabetes Mellitus and HIV. Journal of the California Dental Association, 44(9), 553–559. Park, Kim, S.-H., Kang, S.-H., Yoon, C.-H., Lee, H.-J., Yun, P.-Y., Youn, T.-J., & Chae, I.-H. (2019). Improved oral hygiene care attenuates the cardiovascular risk of oral health disease: a population-based study from Korea. European Heart Journal, 40(14), 1138– 1145. https://doi.org/10.1093/eurheartj/ehy836 Sachdev, A., Talwar, M., Malik, G., & Sharma, S. (2013). Association of Oral Health and Systemic Diseases in the elderly. International Journal of Experimental Dental Science, 2(1), 9–13. https://doi.org/10.5005/jp-journals-10029-1031 Salamah, F. S., Alfayez, H. M., & Melibary, R. T. (2022). Diagnosis and treatment of obstructive sleep apnea. International Journal of Community Medicine and Public Health, 9(2), 1–8. https://doi.org/10.18203/2394-6040.ijcmph20220016 Taguchi, A., Sanada, M., Suei, Y., Ohtsuka, M., Lee, K., Tanimoto, K., Tsuda, M., Ohama, K., Yoshizumi, M., & Higashi, Y. (2004). Tooth loss is associated with an increased risk of 10 hypertension in postmenopausal women. Hypertension, 43(6), 1297–1300. https://doi.org/10.1161/01.hyp.0000128335.45571.ce Torales, J., Barrios, I., & González, I. (2017). Oral and dental health issues in people with mental disorders. Medwave, 17(08), 1–5. https://doi.org/10.5867/medwave.2017.08.7045 World health organization. (2017). Oral health. https://www.who.int/health-topics/oralhealth/#tab=tab_1 Zohoori. F. (2017). The impact of nutrition and diet on oral health. https://books.google.co.ke/books?id=l07ADwAAQBAJ&printsec=frontcover&dq=oral+ health&hl=en&sa=X&ved=2ahUKEwiuLTtt9nqAhVFC2MBHZbFDt0Q6AEwAHoECAAQAg#v=onepage&q=oral%20health&f =false Good Oral Health Makes for Good Overall Health Please circle the answer that applies to you 1) Do you understand there is a connection between your oral health and your overall health? Yes 87 No 13 2) Do you have any systemic diseases, such as heart disease, diabetes, sleep apnea? Yes 75 No 25 3) Do you suffer from any mood disorders? (Anxiety, depression, etc.) Yes 22 No 78 4) How many times do you visit the dentist in a year? 2 13 3 56 4+ 31 5) Do you think your dental office cares about your overall health too? Yes 100 No