Introduction: The aim of this study was to evaluate the levels of C-reactive protein (CRP) and interleukin-6 (IL-6) in the gingival crevicular fluid (GCF) among stroke survivors in relation to the oral hygiene status and stroke characteristics. Methods: A multi-centre cross-sectional study was conducted among hospitalised stroke survivors. Socio-demographic data were collected. Oral clinical assessment (dental plaque scores) and functional dependency levels scores were carried out. Gingival Crevicular Fluids were collected, using absorbent papers and analysed using ELISA kit. Descriptive statistic and correlation analyses were performed using proportion and Spearmen correlation coefficient test. Results: A total of 53 patients were recruited from five public hospitals. There was a significant correlation between CRP and IL-6 levels of GCF (P=0.021, r=0.21). A significant correlation was also observed between CRP levels in GCF with dental plaque scores and functional dependency levels. There was no statistically significant correlation found between IL-6 levels in GCF with dental plaque scores and functional dependency levels. Dental plaque scores were associated with high levels of CRP in GCF (P=0.014), and swallowing problem was associated with high levels of IL-6 in GCF (P=0.002). Conclusions: IL-6 levels in GCF were correlated with the levels of CRP in GCF. High CRP and IL-6 levels in GCF were significantly associated with dental plaque scores and swallowing condition (presence of dysphagia), respectively. Thus, this pilot study suggests that CRP level in the oral cavity respond to the oral health conditions and may not be a predictor factor of stroke outcomes. Further studies are warranted to compare the level of inflammatory biomarkers from the oral cavity and serum in relation to the stroke conditions and outcomes.

Computer-aided learning (CAL) offers enormous potential in disseminating oral health care information to patients and caregivers. The effectiveness of CAL, however, remains unclear. Objectives: The purpose of this study was to systematically review published evidence on the effectiveness of CAL in disseminating oral health care information to patients and caregivers. Materials and Methods: A structured comprehensive search was undertaken among 7 electronic databases (PUBMED, CINAHL Plus, EMBASE, SCOPUS, WEB of SCIENCE, the Cochrane Library, and PsycINFO) to identify relevant studies. Randomized controlled trials (RCTs) and observational studies were included in this review. Papers were screened by 2 independent reviewers, and studies that met the inclusion criteria were selected for further assessment. Results: A total of 2915 papers were screened, and full texts of 53 potentially relevant papers (j1/40.885) were retrieved. A total of 5 studies that met the inclusion criteria (1 RCT, 1 quasi-experimental study, and 3 postintervention studies) were identified. Outcome measures included knowledge, attitude, behavior, and oral health. Significant improvements in clinical oral health parameters (P<.05) and knowledge/attitudes (P<.001) were reported in 2 of the studies. The 3 remaining studies reported improved oral health behaviors and confidence. Conclusion: There is a limited number of studies which have examined the effectiveness of CAL interventions for oral health care among patients and caregivers. Synthesis of the data suggests that CAL has positive impacts on knowledge, attitude, behavior, and oral health. Further high-quality studies on the effectiveness of CAL in promoting oral health are warranted. � The Author 2016.

Computer-aided learning (CAL) offers enormous potential in disseminating oral health care information to patients and caregivers. The effectiveness of CAL, however, remains unclear. Objectives: The purpose of this study was to systematically review published evidence on the effectiveness of CAL in disseminating oral health care information to patients and caregivers. Materials and Methods: A structured comprehensive search was undertaken among 7 electronic databases (PUBMED, CINAHL Plus, EMBASE, SCOPUS, WEB of SCIENCE, the Cochrane Library, and PsycINFO) to identify relevant studies. Randomized controlled trials (RCTs) and observational studies were included in this review. Papers were screened by 2 independent reviewers, and studies that met the inclusion criteria were selected for further assessment. Results: A total of 2915 papers were screened, and full texts of 53 potentially relevant papers (kappa = 0.885) were retrieved. A total of 5 studies that met the inclusion criteria (1 RCT, 1 quasi-experimental study, and 3 postintervention studies) were identified. Outcome measures included knowledge, attitude, behavior, and oral health. Significant improvements in clinical oral health parameters (P<. 05) and knowledge/attitudes (P<. 001) were reported in 2 of the studies. The 3 remaining studies reported improved oral health behaviors and confidence. Conclusion: There is a limited number of studies which have examined the effectiveness of CAL interventions for oral health care among patients and caregivers. Synthesis of the data suggests that CAL has positive impacts on knowledge, attitude, behavior, and oral health. Further high-quality studies on the effectiveness of CAL in promoting oral health are warranted.

Objectives: This study aimed to examine "intention to" and "performance of" oral hygiene care to stroke patients using the Theory of Planned Behavior. Materials and methods: A large scale survey of 13 centers in Malaysia was conducted involving 806 nurses in relation to oral hygiene care intentions and practices. In addition, information on personal and environmental factors was collected. Results: The response rate was 95.6% (778/806). The domains of the Theory of Planned Behavior were significantly associated with general intention to perform oral hygiene care: attitudes (beta = 0.21, p < 0.001), subjective norms (b = 0.38, p < 0.001), perceived behavior control (b = 0.04, p < 0.001); after controlling for personal and environmental factors. Approximately two-thirds (63.4%, 493) reported the performance of some form of oral hygiene care for patients. This behavior was associated with general intention scores (OR = 1.13, 95% CI = 1.05-1.22, p < 0.01), controlling for other factors. Knowledge scores, training, access to oral hygiene guidelines and kits, as well as working ward type were identified as key factors associated with intention and practice of oral hygiene care. Conclusion: The Theory of Planned Behavior provides understanding of "intention to" and "performance of" oral hygiene care to stroke patients. Several provider and environmental factors were also associated with intentions and practices. This has implications for understanding and improving the implementation of oral hygiene care in stroke rehabilitation.

This systematic review aimed to provide a synthesis of the evidence relating to how the provision of vitamin D supplements influences oral health status. An electronic database search was performed across six databases using a standardised search strategy. The PICO framework (Population, Intervention, Comparison, Outcome) was used to define the review question. The screening and selection followed Preferred Reporting Items for Systematic Reviews and Meta-Analyses process (PRISMA). The quality of reporting was assessed using Consolidated Standards of Reporting Trials (CONSORT) guidelines, and the bias was assessed using the revised Cochrane tool RoB2. A total of 1812 studies were retrieved. 1427 studies were excluded due to unmet inclusion criteria. Full texts of seventy-five potential studies were retrieved and ultimately six studies met the inclusion criteria. There were limitations in the quality of reporting of studies (between 49 % and 73 %). 70 % of the risk of bias items were in the low risks category. Vitamin D interventions varied with respect to dosage and duration. Qualitative syntheses identified significantly better oral health outcomes. Heterogeneity of study design, intervention and outcomes precluded quantitative synthesis. Few clinical trials investigated the effect of vitamin D supplementation on oral health. There is considerable heterogeneity among studies interventions and oral health outcomes. Quality of reporting of studies has limitations and there is evidence of study biases. Nonetheless, qualitative synthesis of the evidence suggests that vitamin D supplements improve oral health outcomes, particularly periodontal health. Calcium may also play a significant role. Further high-quality trials are required of comparable vitamin D supplements with similar oral health outcomes focused to inform quantitative synthesis of the evidence.