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Despite progress in primary care, access to oral health remains limited in India. Integrating oral health into primary care can improve oral health outcomes for communities, especially in rural areas. This study aims to develop an implementation model for integrating dental healthcare into primary healthcare systems in Chamarajanagar and Mysuru districts of Karnataka. A mixed-methods implementation research approach will be adopted for this study, comprising three phases: formative, pilot and implementation and evaluation.A mixed-methods study at the district level will be conducted to capture diverse perspectives and characterise inequalities in oral healthcare access and literacy levels across urban, rural and tribal areas. Oral health literacy surveys, facility preparedness checklists and in-depth interviews will be conducted. With a consultative approach involving stakeholders, we ensure their input in the design and pilot the integrated interventions to build a replicable model for integrating dental health services into primary healthcare.Through this structured approach, the study seeks to improve overall oral health outcomes and achieve sustainable improvements in oral health at both community and system levels. This study has been approved by the Institutional Ethics Committee at the Institute of Public Health Bengaluru (IPH/23-24/E/374). Findings will be disseminated through workshops, presentations and publications in peer-reviewed journals.

Combustible cigarette smoking is a well-established risk factor for poor oral health, but the implications of e-cigarette use and dual use remain uncertain. Distinguishing the effects of vaping from the lingering consequences of prior smoking is a persistent challenge in the literature. To assess how distinct nicotine use profiles relate to oral health-related quality of life, self-reported oral health indicators and self-rated dental health among adults in England, while differentiating e-cigarette users by smoking history. We conducted a cross-sectional analysis of 6027 adults (aged ≥ 16 years) from the nationally representative 2021 Adult Oral Health Survey for England. Participants were classified into five current smoking/vaping categories (never users, former smokers, exclusive cigarette smokers, exclusive e-cigarette users, dual users) and, separately, by combined vaping-smoking history. Outcomes included any oral health difficulty and the number of impacts derived from the 14-item Oral Health Impact Profile (OHIP-14), as well as loose teeth, gum disease history, dry mouth and self-rated dental health. Binary outcomes (any oral health difficulty, loose teeth, gum disease history) were analysed using logistic regression, and ordinal outcomes (number of OHIP-14 impacts, dry mouth, self-rated dental health) using ordered logistic regression, with adjustment for sociodemographic, behavioural and oral hygiene covariates. Compared with never users, exclusive cigarette smokers had the highest adjusted odds of reporting any oral health difficulty (OR = 1.85, 95% CI: 1.51-2.27), loose teeth (OR = 3.18, 95% CI: 2.47-4.09), gum disease history (OR = 1.94, 95% CI: 1.52-2.49) and poorer self-rated dental health (OR = 2.88, 95% CI: 2.36-3.52). Dual users showed similarly elevated odds for loose teeth (OR = 3.11, 95% CI: 1.95-4.97), the highest odds for gum disease history (OR = 3.21, 95% CI: 2.06-4.99) and elevated odds for any oral health difficulty (OR = 1.55, 95% CI: 1.04-2.30) and poorer self-rated dental health (OR = 2.45, 95% CI: 1.68-3.58). Exclusive e-cigarette users also showed elevated odds across outcomes, though generally of smaller magnitude. Estimates for the very small subgroup of never-smoking current e-cigarette users did not show significant excess odds across outcomes, but were imprecise and should be regarded as exploratory. In this cross-sectional population-based analysis, combustible cigarette smoking and dual use were associated with poorer self-reported oral health outcomes. Findings related to e-cigarette use require cautious interpretation because of prior smoking history, the sparse never-smoker vaping subgroup and the absence of detailed exposure data (e.g., smoking intensity, pack-years, time since cessation, vaping duration, device type and nicotine concentration). Smoking cessation should remain central to preventive dentistry.

To systematically evaluate the economic burden of preventable dental-related emergency department visits (PDEDV) and preventable dental-related hospital admissions (PDHA), identify reasons for these presentations, and synthesise recommendations to reduce avoidable utilisation. This systematic review followed the PRISMA 2020 guidelines. A comprehensive multiple database search was conducted in PubMed, Embase, Cochrane Library, EBSCOHOST, and Web of Science for studies reporting direct and/or indirect costs of PDEDV and PDHA in any age group, published in English from 2000 to March 2026. Three calibrated reviewers screened and critically appraised the identified studies. Data including patient characteristics, estimated charges/costs, reasons for PDEDV and PDHA, and recommendations to minimise the avoidable burden were extracted. Charges/costs were inflation-adjusted and standardised to 2024 US dollars. Of the 2600 total studies identified, 25 met the inclusion criteria. The majority were conducted in the United States and focused on direct medical costs. Uninsured individuals, public health insurance enrolees and residents of low-income areas were more likely to experience PDEDV. Mean charges per any PDEDV ranged from $409.73 to $2740.76. Mean charges per any PDHA ranged from $5234.46 to $62 298.25, while mean hospital costs ranged from $350.42 to $22 375.53. Dental caries was the commonest cause for PDEDV. Odontogenic infections were the costliest to manage, with mean charges of $2740.76 per PDEDV and $62 298.25 per PDHA. PDEDV and PDHA were primarily driven by financial barriers, socio-demographic disparities, limited access to routine dental care, and health workforce constraints. Proposed strategies focused on improving affordability and access to preventive dental care, enhancing oral health literacy, strengthening integration between medical and dental services, and expanding the dental workforce. PDEDV and PDHA, particularly those due to dental caries and odontogenic infections, impose a significant economic burden on healthcare systems, highlighting the need to reduce financial and access barriers to routine dental care for high-risk groups and priority conditions.

Recent studies reveal high rates of dental issues among professional soccer players, worsened by poor hygiene, frequent sport drinks consumption and limited preventive care. Busy schedules, frequent relocations and changing clubs further disrupt dental routines, impacting performance and well-being. Therefore, we decided to assess the oral health status of professional Slovak soccer players and address these critical concerns. We assessed the oral health of 51 male soccer players from two elite Slovak soccer clubs during 2023/2024 season. Data collection included two paper-based questionnaires and a clinical oral examination by dentists. Additionally, clinical laboratory data were collected from saliva to test for presence of periopathogenic bacteria and DNA polymorphisms. Although 92.2% had valid health insurance, 36% did not attend dental check-ups in the past year, indicating underutilization of preventive care. While 86.2% brushed their teeth more than twice daily, only 48% practiced interdental cleaning and 35.3% used mouthwash. A significant 83.7% consumed sports drinks high in sugar and acid, influencing oral health risks. Clinical examinations revealed that 86.3% had a moderate to high DMF index (mean decayed teeth: 3.8) and 54.9% exhibited gingivitis. Bacterial analyses showed 25.5-74.5% carried highly periopathogenic bacteria, indicating a high risk for periodontitis. Additionally, 15.7% of players exhibited presence of DNA polymorphisms associated with risk of periodontitis onset. This study reveals a gap in preventive dental care among professional soccer players, emphasizing the urgent need for integrated oral health strategies within sports programs.

Type 2 Diabetes Mellitus (T2DM) presents a major public health challenge globally, disproportionately affecting Indian migrants who are vulnerable to diabetes-related complications due to cultural, linguistic and systemic barriers that can limit access to timely and effective care. Health literacy is a key determinant of T2DM management, yet its association with medication adherence in this population remains underexplored. This study investigates the association between performance-based (objectively assessed) and self-reported (subjectively assessed) health literacy and medication adherence among Indian migrants with T2DM, while accounting for a range of demographic, socioeconomic and health-specific factors. A cross-sectional study design was employed. Participants (n&#x202f;=&#x202f;309) were recruited through multicultural health services, and hospital diabetes clinics across Greater Western Sydney, a socioeconomically and culturally diverse area of Sydney, NSW, Australia. Eligible participants self-identified as Indian, were aged 18 years or older, had been diagnosed with T2DM for at least one year, and were currently prescribed diabetes medication. Data were collected via a structured survey and analysed using multivariate logistic regression. Low health literacy was prevalent among Indian migrants, with over 67.6% demonstrating low performance-based health literacy and 62.5% reporting low self-reported health literacy. Approximately 68.9% of participants had low medication adherence. Lower medication adherence was significantly and positively associated with lower health literacy, both performance-based (adjOR=9.14, 95%CI: 4.24-19.72; p&#x202f;=&#x202f;<0.001) and self-reported (adjOR=12.45, 95%CI: 4.55-34.10; p&#x202f;=&#x202f;<0.001). Key predictors of medication adherence included health literacy, private health insurance, BMI, glucose level, comorbidities and social support. Models differed slightly depending on the type of health literacy assessed. Health literacy plays an important role in diabetes self-management for Indian migrants. These findings highlight the need for culturally tailored interventions that address both health literacy support - such as improving understanding of medical information and navigating healthcare systems - and social or family support systems that influence health behaviours and decision-making.

This case-based review examines oral health challenges among LGBTQ+ populations and how discrimination and stigma contribute to negative outcomes. Two clinical scenarios illustrate the impact of minority stress and prior negative healthcare experiences on dental anxiety, care avoidance, and treatment outcomes. In one case, a nonbinary patient delayed care due to misgendering, resulting in untreated caries. In another, a transgender man's bruxism was associated with stress related to repeated use of his deadname. Both cases demonstrate how affirming care, including correct pronoun use, respect for chosen names, and supportive communication, can reduce anxiety and improve clinical relationships.A literature review complements these cases by identifying barriers to care and risk factors contributing to oral health disparities. LGBTQ+ individuals report higher rates of substance use, delayed dental visits, and limited access to culturally competent care. Certain subgroups, including bisexual adults, experience poorer oral health and greater barriers to care. These findings highlight the need for inclusive clinical practices, improved provider training, and structural changes such as nondiscrimination policies. Integrating affirming approaches into dental care may improve trust, treatment adherence, and oral health outcomes while promoting more equitable healthcare delivery.

To examine whether a history of incarceration is associated with self-reported dental care utilization and oral health difficulties among low-income U.S. military veterans. Data were from Wave 5 of the National Veteran Homeless and Other Poverty Experiences study (N&#x2009;=&#x2009;1384). Weighted logistic and multinomial logistic regression models were estimated to examine the association between a history of incarceration and (a) dental care utilization, and (b) oral health difficulties, adjusting for demographic, socioeconomic, military, and health insurance characteristics. In covariate-adjusted models, veterans with a history of incarceration had significantly higher odds of not having a dental visit in the past year compared to those without prior incarceration (adjusted odds ratio [aOR]&#x2009;=&#x2009;2.393, 95% confidence interval [CI]&#x2009;=&#x2009;1.357, 4.219, p&#x2009;=&#x2009;0.003), and reporting a higher relative risk of occasional oral health difficulties in the past 3&#x2009;months (RRR&#x2009;=&#x2009;1.856, 95% CI&#x2009;=&#x2009;1.027, 3.353, p&#x2009;=&#x2009;0.034) compared to never/hardly ever experiencing difficulties. A history of incarceration may represent an important social driver of dental care utilization and oral health difficulties among veterans. Potential programmatic responses through the U.S. Department of Veterans Affairs and the criminal justice system are discussed.

Ensuring equitable access to healthcare services is paramount for the enhancement of societal welfare and the optimisation of public health outcomes. Within the context of West Java Indonesia, accelerated population growth coupled with geographic disparities has resulted in heightened pressure on the existing healthcare infrastructure, thereby rendering numerous communities inadequately served. Although CHCs are already widespread in Indonesia, their distribution remains uneven, especially in growing urban areas. Consequently, there is growing recognition of the need to strategically expand community healthcare centres (CHCs) to improve access across underserved areas. These CHCs are instrumental in providing vital services, encompassing preventive care, maternal and child health, immunisation, dental services, and outpatient care. This study presents an integrated approach combining population forecasting, spatial demand estimation, and optimisation modelling to support long-term planning of CHCs in Kota Bandung. Kota Bandung was selected as the study area due to its high population density, significant spatial disparities in healthcare access, and strategic importance in regional health planning. Using an ARIMA model, the researchers forecasted population growth through 2045. The year aligns with Indonesia's national long-term vision, Visi Indonesia 2045. They then estimated daily CHC demand using spatial grid and population density data, applying a standard utilisation rate. Three mixed-integer linear programming (MILP) models were developed to optimize facility locations by maximizing coverage, minimizing travel time, or balancing both. This method allows planners to explore various scenarios based on local needs and constraints. The forecasting model reveals a consistent escalation in the demand for primary healthcare services within the Bandung region, with distinct growth hotspots identified in presently underserved locales. Optimisation scenarios produced by the MILP models indicate that the strategic positioning of new CHCs can substantially augment service coverage while simultaneously mitigating disparities in healthcare access. Scenario-based simulations were conducted to explore how different planning objectives-such as maximizing coverage or minimizing travel time-impact CHC placement outcomes. The results suggest that the most equitable arrangement of CHCs would enhance accessibility for marginalized populations by more closely aligning resources with geospatial demand. This integrated modelling framework presents a pragmatic paradigm for long-term health infrastructure planning in contexts characterized by resource limitations. By synthesizing demand forecasting with location-optimisation methodologies, regional health authorities are empowered to make data-informed decisions to enhance access and equity in primary healthcare services. These findings bolster broader initiatives aimed at achieving Universal Health Coverage in Indonesia.

Routine dental attendance is associated with better health outcomes, yet those from disadvantaged backgrounds are more likely to seek problem-driven, episodic care. The RETURN intervention, a brief behavioural intervention delivered by dental nurses in urgent care, was designed to support urgent care users to take up planned dental care. This study evaluates the cost-effectiveness of the RETURN intervention. A cost-utility analysis was conducted alongside a randomised controlled trial. Resource use and health outcomes, measured in Quality-Adjusted Life Years (QALYs) derived from the EQ-5D-5L questionnaire, were evaluated at 12 and 18 months. The primary analysis used a cost-effectiveness threshold of &#xa3;20&#x2009;000 per QALY. Multiple imputation was used to account for missing data. Objectives also included providing an estimated incremental cost per improved Oral health impact profile (OHIP-14) point. The intervention was found to be cost-effective with high confidence. At 12&#x2009;months, intervention incremental cost was &#xa3;18.83 with incremental Quality-Adjusted Life Year (QALY) gain of 0.014, and an incremental net health benefit (NHB) of 0.013 QALYs. The probability of cost-effectiveness was 90.5%. At 18&#x2009;months, the incremental cost was &#xa3;15.11 for a QALY gain of 0.009, and incremental NHB of 0.008 (probability of cost-effectiveness 70.9%). The findings were supported by complete case analysis, which showed probabilities of cost-effectiveness of 99.7% at 12&#x2009;months and 98.5% at 18&#x2009;months. Sub-group analysis gave the strongest evidence of cost-effectiveness in the most deprived populations. The RETURN intervention is highly likely to be a cost-effective use of National Health Service resources. Its impact appears particularly strong among those living in the most deprived areas, suggesting the potential to reduce inequalities in access to routine dental care. The RETURN trial was registered at isrctn.com (ISRCTN84666712).

Healthcare access in low- and middle-income countries (LMICs) is constrained by structural and socio-cultural barriers, including language. Oral health, despite its importance to general health, is often overlooked in universal health coverage efforts. The Oral Health Impact Profile (OHIP-5) is a brief patient-reported outcome measure (PROM) for oral health-related quality of life (OHRQoL) but has not been adapted into indigenous Nigerian languages. This study aimed to translate and evaluate the Yoruba version (OHIP-5Yor), assess its psychometric performance using both English and Yoruba administrations, and explore its relevance for improving patient-centred oral healthcare access in LMICs. A cross-sectional survey of 143 adults was conducted at two dental centres in Ibadan, Nigeria. The OHIP-5 was translated using a forward-backward approach with pilot testing. Psychometric evaluation included internal consistency, inter-item correlation, convergent validity, and confirmatory factor analysis. Of the 143 participants, 52 completed the Yoruba version and 91 the English version. The mean OHIP-5 score was 6.6 &#xb1; 4.3. The instrument showed acceptable internal consistency (Cronbach's &#x3b1; = 0.67) and supportive construct validity. Structural validity indices, however, indicated that the factorial structure requires further evaluation in larger and more diverse samples. The findings provide preliminary support for the reliability and validity of the OHIP-5Yor as a culturally adapted tool for assessing OHRQoL among Nigerian adult dental patients. Beyond psychometric evaluation, the instrument may help address an important equity gap by enabling non-English speakers to participate more fully in oral health assessment, thereby supporting patient-clinician communication and highlighting unmet needs. Incorporation of such tools into routine care and public health surveillance represents a potential, scalable approach to strengthening oral healthcare access in low- and middle-income countries (LMICs). The OHIP-5Yor enables brief, culturally appropriate assessment of patient-perceived oral health impacts and may support more equitable oral healthcare delivery in multilingual settings.

The use of virtual reality (VR) in health education is gaining attention; however, evidence regarding its effectiveness in oral health education remains limited. This pilot study involved 13 adolescents (ages 11-14) identified as school-aged English learners and emergent bilingual students enrolled in a nonprofit, community-based after-school academic enrichment program serving racetrack worker families. Participants engaged in two VR animations: one depicting being inside the mouth and fighting bacteria, and another on the anatomy of teeth. Additionally, a presentation that emphasized the importance of oral health on overall health was given, along with a demonstration of proper brushing and flossing techniques using dental models. Pre-survey results show that this group already has very good oral hygiene habits, with 85% of the respondents reporting that they brushed their teeth twice daily, primarily under the guidance of their parents (84%). After the VR activity, participants rated the experience on a 1-6 Likert scale, with 69% reporting being "highly satisfied" and 31% "satisfied". Similarly, students reported they "learned a lot" (31%), "a moderate amount" (38%), and "quite a bit" (15%), and most of the students rated oral health as "very important" for overall health (69%). These encouraging findings suggest that VR could be used as an engaging tool for oral hygiene education.

Introduction The Falkland Islands are a remote archipelago of over 740 islands and host a diverse, multicultural society. Since 2013, consistent efforts to improve and protect children's oral health have been applied and evaluated, and the results after a decade are presented.Methods Child dental health surveys aligning with the World Health Organization methodology have been conducted annually since 2013 (exceptions: 2015 and 2020). Data analysis was undertaken to establish a mean dmft/DMFT (decayed, missing, and filled primary teeth/decayed, missing, and filled permanent teeth) for five-year-olds, 12-year-olds and 15-year-olds within the Falkland Islands.Results Mean dmft/DMFT results have trended down since 2013, with all age groups demonstrating a dmft/DMFT of below 1.0 tooth consistently since 2021. Response rates have been very good to excellent (69% to 97%) which increases confidence in the results.Conclusions Preventative interventions within the Falkland Islands appear to be improving child dental health. There is further scope, and need, for improvement, and additional screening should be investigated to understand the current oral health of the whole population of the Falkland Islands.

To evaluate the association between Social Determinants of Health (SDOH), Social Capital (SC), and dental caries experience according to severity in 12-year-old children from a rural Peruvian community. A cross-sectional study was conducted with 61 schoolchildren and their families in Pampacolca, Arequipa - Peru. DMFT index (decayed, missing, and filled teeth) was assessed via clinical examination (kappa&#x202f;=&#x202f;0.90). SDOH and SC were evaluated through household interviews with parents, using a survey based on the National Census and the short version of the Adapted Social Capital Assessment Tool (SASCAT), respectively. Data were analyzed using Spearman's correlation and the coefficient of determination (R2). The mean DMFT score was 5.25&#x202f;&#xb1;&#x202f;2.94. SDOH explained 3.99% of the variance in caries experience overall (p >&#x202f;0.05). Significant associations were found when stratified by severity: in children with low severity (DMFT&#x2264;3), maternal education showed a significant correlation (r =&#x202f;-0.632, p =&#x202f;0.007), explaining 39.9% of the variance. In children with high severity (DMFT&#x2265;5), limited access to health services was the most relevant factor (r =&#x202f;-0.605, p =&#x202f;0.001), explaining 36.6% of the variance. Regarding social capital, only Cognitive SC showed a significant correlation (r =&#x202f;0.494, p =&#x202f;0.044), explaining 24.4% of the variance in the low-severity group. The findings suggest that SDOH and specific dimensions of SC are associated with dental caries, with effects varying by disease severity. While limited access to health services was linked to greater caries experience in high-severity cases, higher maternal education and cognitive social capital appeared to be associated with lower caries experience in children with lower severity. These results highlight the importance of context-specific social interventions.

To evaluate the short-term effects of professional scaling and polishing on nine oral health and dental aesthetic outcomes in current smokers and never smokers. A total of 371 participants from the SMILE Study Cohort (305 smokers and 66 never smokers) were assessed at baseline (V0) and 14 days after scaling and polishing (V1). Outcomes included Modified Gingival Index (MGI), quantitative light-induced fluorescence parameters (&#x394;R30, reflecting the percentage of tooth surface covered by mature plaque, and &#x394;R120, reflecting the percentage covered by thicker deposits including calculus), MacPherson-modified Lobene Stain Index (MLSI) for buccal and lingual surfaces, Whitening Index for Dentistry (WID), Simple Oral Hygiene score (SOH), oral health-related quality of life (OHRQoL), and general health perception (EQ-VAS). Linear mixed model analysis was used for between-group comparisons of V0-V1 changes. At baseline, smokers exhibited significantly worse values across all objective indices. Following intervention, significant improvements were observed in MGI, MLSI, &#x394;R30, &#x394;R120, and SOH in both groups (p<0.0001). MGI improved by a median of -0.5 units in smokers (IQR: -0.8/-0.2) and -0.08 units in never smokers (IQR: -0.3/-0.02); the magnitude of improvement was significantly greater in smokers (p<0.0001). Similarly, greater reductions in buccal MLSI (p<0.0001), lingual MLSI (p<0.0001), and &#x394;R120 (p=0.010) were observed in smokers compared to never smokers. WID showed no significant changes in either group. OHRQoL improved slightly without between-group differences; EQ-VAS did not change significantly. Professional scaling and polishing produced consistent short-term improvements in objective oral health indicators in both smokers and never smokers, with greater gains among smokers reflecting their higher baseline burden. Regular professional mechanical plaque removal is clinically beneficial for smokers, producing measurable short-term improvements in gingival and aesthetic parameters even in the presence of ongoing tobacco exposure, although smoking cessation remains essential for long-term oral health.

To explore how Dutch adults with rheumatoid arthritis (RA) perceive their oral health around the diagnostic process and the early disease course. The primary objective was to describe these perceptions in depth, and a secondary objective was to identify areas for future patient-centred research. A phenomenological qualitative study was conducted at Reade, a specialized rheumatology clinic in Amsterdam, The Netherlands. Adults (&#x2265;&#x2009;18&#x2009;years) diagnosed with RA within 5&#x2009;years prior to the start of recruitment, without multimorbidity and irrespective of oral complaints, were eligible. After completing brief sociodemographic/RA and oral-care questionnaires, semi-structured interviews in Dutch (face-to-face or virtual) were conducted with a trained interviewer with lived RA experience. Data were coded inductively in ATLAS.ti using thematic analysis. Eleven adults (7&#x2009;women, 4&#x2009;men; median&#x2009;age&#x2009;68&#x2009;years) were interviewed. Five themes were identified: (1) fluctuating symptoms demanded continual lifestyle adjustments and, for some, financial losses from reduced work hours; (2) the diagnosis carried a wide emotional burden-humour and symptom-downplaying helped, yet most still camped with accepting the disease, its medication and side-effects; (3) relationships with healthcare professionals varied-participants adhered to rheumatologists' recommendations but followed dental advice less consistently, and they viewed dentists and hygienists as having distinct roles; (4) oral hygiene ability varied-hand- or wrist-flare ups briefly hindered routines for some, and awareness of RA-related oral health risks (e.g., temporomandibular-joint involvement) was low; and (5) tailored information linking RA and oral health was scarce, and participants preferred clear guidance from clinicians while firmly rejecting oral hygiene guidance from friends and family. This exploratory study of Dutch adults with RA showed that perceptions of oral health, particularly around the diagnostic process and early disease course, highlighted five patient-centred research areas: determining the optimal timing and provider of RA-oral health information, mapping educational gaps among dental and rheumatology professionals and students, refining ergonomic toothbrush design, addressing socioeconomic barriers to dental care and validating routine TMJ screening tools. These findings may also serve as a foundation for the development of dental guidelines that reflect the patient perspective.

With the global rise in ageing populations, dental education must prepare students to care for older adults with empathy and competence. Ageism, defined as negative bias towards older individuals, can hinder quality care and meaningful dentist-patient relationships. This study aimed to explore whether documenting and narrating oral health-related life experiences of older adults could promote positive intergenerational attitudes and enhance empathy among dental students. A reflective qualitative study was conducted among 3rd-year dental students enrolled in a Social and Behavioural Sciences module. A subgroup of students participated in an enhanced learning session that involved biographical interviews with older adults, focusing on their oral health journeys and related life stories. Students documented these narratives and produced reflective essays. Thematic analysis of the essays was performed to identify key domains of learning and professional development. Engagement with older adults' life stories fostered greater understanding of the psychosocial dimensions of ageing and oral health. Thematic analysis revealed enhanced empathy, improved communication skills and increased cultural sensitivity. Students recognized the importance of preparation, clear communication and digital tools for engagement. They also identified barriers such as financial constraints and access inequalities, demonstrating growing social awareness for older patients. Documenting and reflecting on oral health-related life experiences provided dental students with meaningful intergenerational learning opportunities that strengthened empathy, cultural sensitivity and readiness for geriatric dental care. Narrative-based reflection represents a valuable pedagogical tool to reduce ageist perceptions and promote inclusive care within dental education.

Oral diseases affect more than 3.5 billion people worldwide and remain among the most neglected global health challenges. Access to preventive oral healthcare is constrained by workforce shortages, transportation barriers, and patient apprehension toward dental procedures. Artificial intelligence (AI)-enabled diagnostic systems offer scalable solutions for early detection and triage through non-dental personnel. This study presents the Phase 1 analytical validation of Smilo.ai, an AI-driven platform designed for automated detection of common oral health conditions using standardized digital oral photographs. A cross-sectional validation study was conducted among 45 adult participants in a community-based oral health screening program in India between February 1 and 10, 2025. Each participant contributed one composite oral image containing four standardized views (frontal, left lateral, right lateral, and occlusal), yielding an analytical dataset of 45 images (n&#x2009;=&#x2009;45). Smilo.ai's diagnostic outputs were compared with dentist evaluations of identical photographs across seven diagnostic categories: dental decay, gingivitis, plaque, calculus, tooth wear, discoloration, and crowding. Performance metrics included sensitivity, specificity, precision, accuracy, and Cohen's &#x3ba;, computed using confusion matrix-based analysis in accordance with STARD 2015 and CONSORT-AI guidelines. Inter-rater reliability between the two reference dentists was retrospectively quantified, yielding substantial agreement (&#x3ba;&#x2009;=&#x2009;0.61). Smilo.ai demonstrated an overall sensitivity of 73.6%, precision of 46.0%, accuracy of 47.3%, and a macro-level Cohen's &#x3ba; of 0.010 relative to dentist assessments. High sensitivity was achieved for dental decay, tooth wear, and discoloration (100% each); however, the corresponding near-zero specificity values indicate a pattern of positive prediction bias in the current model configuration. Calculus exhibited the strongest balanced performance (sensitivity 61.0%, specificity 65.0%, precision 73.9%, &#x3ba;&#x2009;=&#x2009;0.24). Gingivitis demonstrated moderate sensitivity (56.0%), while plaque and crowding showed partial detection with variable agreement. This Phase 1 validation establishes a performance baseline for Smilo.ai and identifies optimization priorities, including positive prediction bias correction and threshold recalibration necessary before screening workflow integration. AI-assisted screening models hold significant promise for improving preventive oral healthcare access among underserved populations. The upcoming Phase 2 validation will evaluate clinical generalizability through synchronous clinical examinations to confirm real-world applicability.

The potential of social media that offers public health insights in middle-income countries remains underexplored. This study examines patterns of oral health discourse on Indonesian social media and highlighting such insights into promotive and preventive oral health strategies. A discourse and content analysis was conducted on user-generated posts from Quora and Threads over an 18-month period (July 1, 2023-January 31, 2025). Posts were retrieved through automated data extraction and computational text retrieval based on keyword searches and coded into 19 predefined categories. Latent Dirichlet allocation (LDA) was applied to identify underlying thematic structures. Associations between platforms and discussion topics were tested using chi-square and Monte Carlo simulations. Comparative analyses examined platform-specific trends, thematic frequencies and inquiry types, with findings cross-referenced against national survey data. A total of 858 posts (541 from Quora, 317 from Threads) were analysed. The most frequently discussed issues were mouth ulcers and toothache. LDA revealed 10 dominant themes, including oral hygiene practices, children's dental visits, gum swelling and postsurgical recovery. Quora discussions were dominated by symptom-focused inquiries, whereas Threads contained more personal and emotionally expressive narratives. Statistical testing confirmed a significant association between platform type and topics discussed (P < .001). This study demonstrated the utility of automated data extraction and LDA-based thematic modelling in uncovering community-level oral health patterns. Social media provides an immediate context-relevant perspective for monitoring oral health needs, supporting targeted communication strategies and responsive public health interventions. This study introduces a complementary approach to conventional epidemiological monitoring. The findings can guide policymakers and practitioners in developing targeted preventive initiatives and public engagement strategies for improved oral health outcomes.

Periodontitis is a prevalent inflammatory disease characterized by progressive loss of periodontal attachment and alveolar bone. Conventional diagnostic approaches, including periodontal probing and radiographic interpretation, are influenced by examiner variability, limiting consistency in large-scale and community-based assessments. Machine learning-driven models may support standardized screening for periodontal health and periodontitis. To develop and validate a machine learning algorithm to classify periodontal health and periodontitis using clinician-measured and validated radiographic alveolar bone loss obtained from bitewing radiographs, aligned with the 2018 American Academy of Periodontology/European Federation of Periodontology (AAP/EFP) classification of periodontal and peri-implant diseases and conditions. In this retrospective study, 1,537 of 2,162 bitewing radiographs were included. Alveolar bone loss was measured from the cemento-enamel junction to the alveolar crest using MiPACS software and validated by calibrated examiners (&#x3ba;=0.94). Data were preprocessed, balanced, and split into training, validation, and test sets. Multiple classifiers were benchmarked, with Random Forest (RF) selected after hyperparameter tuning. Performance was assessed using accuracy, sensitivity, specificity, F1 score, and area under the receiver operating characteristic curve (AUC). The RF model achieved 96.4% accuracy on the validation dataset and 92% on the independent, previously unseen test dataset. Sensitivity was 100% for periodontitis and 93% for healthy cases in the validation set, with an AUC of 0.99. On the unseen test dataset, sensitivity was 94% for healthy and 92% for periodontitis, with an AUC of 0.97. The machine learning algorithm accurately classified periodontal health and periodontitis from bitewing radiographs, providing an automated assessment aligned with the 2018 AAP/EFP classification. It may improve diagnostic consistency, support early intervention, and enable community-based screening and triage for large-scale periodontal assessment. Automated classification of periodontal status from bitewing radiographs may improve diagnostic consistency and facilitate efficient screening and triage in large-scale and community-based dental care.