Background: Conventional methods for assessing exposure to environmental tobacco smoke rely mainly on questionnaires and biomarkers with short half-lives, such as urinary cotinine. In contrast, oral mucosal pigmentation may represent a visible, non-invasive biomarker of chronic exposure. However, its clinical and policy relevance, as well as its validity for screening purposes, remain insufficiently established. Aim: To summarize the evidence on the association between exposure to environmental tobacco smoke and oral mucosal pigmentation and to assess some confounding factors. Materials and Methods: We synthesized findings from observational studies that examined the association between environmental tobacco smoke exposure and oral mucosal pigmentation across all age groups. International electronic databases, including PubMed, Embase, Web of Science, and Scopus, were searched. Data were extracted on exposure–response relationships, measurement instruments, anatomical distribution of pigmentation, confounding by physiological pigmentation, and biochemical validation. The quality of included studies was assessed using the Mixed Methods Appraisal Tool (MMAT). A narrative synthesis was conducted, focusing on the biological plausibility of the biomarker, standardization of measurement, and its potential implications for screening and tobacco control policy. Results: Thirteen observational studies from seven countries, involving a total of 3,284 participants, met the inclusion criteria. Four studies reported a statistically significant association between duration of exposure and severity of pigmentation, while one cohort study showed that urinary cotinine levels increased with age among children. The Gingival Pigmentation Index and the Dummett Oral Pigmentation Index were the most commonly used assessment tools; however, methodological heterogeneity limited direct comparability across studies. The anterior gingiva was the most frequently affected anatomical site. Only a limited number of studies adequately controlled for physiological pigmentation, and skin color was identified as an important confounding factor. The pooled odds ratio was 2.35; however, the certainty of evidence was low due to the observational nature of the included studies. Conclusion Oral mucosal pigmentation may serve as a potential biomarker of long-term exposure to environmental tobacco smoke. Nevertheless, standardized assessment protocols, adequate control for physiological pigmentation, and validation against “gold-standard” biomarkers are required. If validated, this marker could be used for rapid identification of high-risk groups and incorporated into tobacco control policies.

Background: Passive smoking among children remains a serious public health concern, particularly because children’s ability to avoid household environmental tobacco smoke exposure is limited when parents smoke. In recent years, increasing scholarly attention has been given to oral mucosal pigmentation as a potential clinical sign of long-term passive smoking in children. However, no previous study has synthesized the available evidence on this topic. Aim: This systematic review and meta-analysis aimed to evaluate the association between passive smoking and oral pigmentation in children. Materials and Methods: A systematic search was conducted in international electronic databases, including PubMed, Scopus, Web of Science, and the Cochrane Library, in accordance with PRISMA guidelines. Observational studies assessing the association between passive smoking and oral pigmentation among children aged ≤18 years were included. Methodological quality was assessed using the Mixed Methods Appraisal Tool (MMAT). A random-effects meta-analysis was performed, and pooled odds ratios (ORs) with 95% confidence intervals (CIs) were calculated. Between-study heterogeneity was assessed using the I² statistic, and the certainty of evidence was evaluated using the GRADE approach. Results: Seven studies involving a total of 1,582 participants met the inclusion criteria. The meta-analysis demonstrated that passive smoking was significantly associated with an increased risk of oral pigmentation in children, with a pooled OR of 2.58 (95% CI, 1.35-4.95; p=0.004). Compared with children without exposure to passive smoking, those exposed to environmental tobacco smoke had an absolute risk increase of 17% (95% CI, 6.3%-23.9%). Subgroup analysis by assessment method showed a consistent effect among studies using the Gingival Pigmentation Index (GPI) (OR, 2.12; 95% CI, 1.58-2.84), whereas studies using the Dummett Oral Pigmentation Index (DOPI) showed a wider confidence interval (OR, 3.26; 95% CI, 0.68-15.54). According to the MMAT assessment, the included studies demonstrated adequate participant selection in 100% of cases, appropriate outcome measurement in 76.9%, and adequate control of confounding factors in 46.2%. Owing to the observational nature of the included studies, moderate heterogeneity, and the potential risk of confounding by physiological pigmentation, the certainty of evidence was rated as low according to GRADE. Conclusion Children exposed to environmental tobacco smoke had a significantly higher likelihood of oral mucosal pigmentation than unexposed children. These findings suggest that screening for oral mucosal pigmentation during pediatric oral examinations may serve as a non-invasive marker of passive smoking exposure and may provide visible clinical evidence to support counseling parents on smoking cessation and smoke-free household environments.

Background: In the treatment of plaque-induced gingivitis, in addition to mechanical plaque control, the use of chemical plaque control such as mouth rinses for a certain period has shown a positive effect on treatment outcomes and prognosis. Aim: To evaluate the efficacy of a probiotic mouthwash in the treatment of plaque-induced gingivitis. Materials and Methods: A randomized controlled clinical trial was designed for a period of 2 weeks on 45 systemically healthy subjects between 20 and 25 years having plaque-induced gingivitis. The study population was divided into three groups. Group 1-15 subjects were advised experimental (probiotic) mouthwash. Group 2-15 subjects were advised positive control (chlorhexidine) mouthwash and Group 3-15 subjects into a negative control group. Oral prophylaxis was done for all groups at baseline. After the proper oral hygiene instructions, groups 1 and 2 were instructed to rinse their mouth with 15 ml of their respective mouthwashes, for 1 min twice daily, 30 min after brushing. Clinical parameters such as Full mouth plaque score (FMPS), Full mouth bleeding score (FMBS) were assessed at baseline, 2 weeks respectively. Results: At baseline, there was no statistically significant difference between the groups in terms of FMBS and FMPS mean values (p=0.174, p=0.887). At day 14, the FMPS, FMBS mean values were significantly reduced by all treatment modalities ranking probiotic and chlorhexidine is greater than negative control group (p<0.001, p<0.001). Conclusion The probiotic mouthwash was effectively used as an adjunct to mechanical plaque control in the treatment of plaque-induced gingivitis.

Background: Emerging evidence highlights a close relationship between the oral and gut environments from both microbiological and immunological perspectives. Consequently, a plausible bidirectional association between inflammatory bowel disease (IBD) and periodontitis has been increasingly supported by several studies. Recent epidemiological studies suggest that individuals with IBD have a higher risk of periodontitis compared to non-IBD individuals. Aim: This study aimed to investigate the prevalence and severity of periodontitis in patients with Crohn’s disease (CD) and ulcerative colitis (UC), compared to a control group without IBD. Materials and Methods: A case-control study was conducted involving 22 IBD patients (2 with CD and 20 with UC) and 44 ageand sex-matched healthy controls from the Department of Gastroenterology and Endoscopy, Ulaanbaatar Songdo Hospital. Periodontal evaluation included diagnosis of periodontitis and assessment of full-mouth parameters: probing pocket depth (PPD), clinical attachment loss (CAL), full-mouth bleeding score (FMBS), and full-mouth plaque score (FMPS). Results: The prevalence of periodontitis was significantly higher in the IBD group (95.5%) compared to controls (75%) (p = 0.042). A greater proportion of IBD patients presented with stage III/IV periodontitis compared to controls (57.1% vs. 30.3%, p = 0.044). Binary logistic regression analysis revealed that IBD patients had approximately a fourfold increased likelihood of having stage III/IV periodontitis (p = 0.012). Variables significantly associated with periodontitis in the total sample included older age, presence of IBD, and higher FMPS and FMBS. Conclusions 1. This study found a significant association between IBD and periodontitis. 2. Patients with IBD were 4–6 times more likely to present with advanced stages of periodontitis compared to healthy individuals, supporting the importance of periodontal monitoring in this population.

ABSTRACT. Recurrent aphthous stomatitis, or RAS, is common oral disorder of uncertain etiopathogenesis for which only symptomatic therapy is available. This article reviews the current clinical features of RAS among study patients and the result of therapeutic effects of the herbal preparation Akhizunber. Over the past four years we have treated 61 RAS patients with different clinical forms by herbal preparation Akhizunber or Alumekatin. The distribution of clinical forms RAS RAS among study patients were minor aphthae -75.4%, major aphthae -16.4% and herpetiform ulcers -8.2% respectively. The healing time of treated Akhizunber was in minor aphthae -9.28±4.82 days, major aphthae -14 days and herpetiform ulcers -12 days. Of the total study participants, the patients treated by Akhizunber reported a rapid and complete recovery from RAS during treatment compared with treated patients by Alumekatin. Treatment with herbal preparation Akhizunber can be effective for patients suffering from RAS in any clinic form, regardless of their ulcer number and size.

BACKGROUND. To identify the prevalence of oral lesions in HIV positive group of patients, and to compare their CD4 cell count and viral load to stages of disease progress. MATERIAL AND METHODS. In the present study, we evaluated 30 HIV+ adult patients, attended to the AIDS/STI Department of National Center for Communicable Diseases, Ministry of Health Mongolia. Each patient was clinically examined for detection of oral mucosal lesions. In addition, CD4 cell count was determined by Flow Cytometry, as well as viral load by RT-PCR (Amplicor HIV- RNA, TM test 1.5, Roche) RESULTS. 46% of all examined HIV/AIDS patients had oral lesions. Oral Candidiasis constituted the most common lesion, representing 35%, Herpes 22%, followed by Oral Leukoplakia 17%, Necrotizing ulcerative periodontitis 9%, Aphthous Recurrent Stomatitis 13%, Kaposi’s sarcoma 4%. The patients, who have a viral load high exhibited oral lesions related to HIV, independent of CD4 cell count, although patients with CD4+ levels of 233 cel/mm3 were more susceptible to develop these lesions. СONCLUSION. The most common oral lesion was Oral Candidiasis, followed by Oral Leukoplakia and Necrotizing ulcerative periodontitis. A high viral load was strongly associated to the oral lesions occurrence independently of CD4+cell count..

BACKGROUND. Periodontal regeneration is the reconstruction of periodontal tissues and restoration of functions, which is achieved through techniques, such as soft tissue grafts, guided tissue regeneration, bone replacement grafts, root bio-modification, and a combination of these techniques. Chitosan is a natural biopolymer with several beneficial properties, including excellent biocompatibility, low toxicity and corresponding degradation rates and hemostatic activities. This systematic review assessed the efficacy of biopolymer membrane (chitosan) for guided tissue regeneration (GTR) in animal and human studies. MATERIAL AND METHODS. The Cochrane Oral Health Group specialist trials, PubMed, MEDLINE, and EMBASE databases were searched for articles published before January 2017. Animal and human studies that used chitosan for GTR, which had a follow-up period of ≥6 weeks and 6 months, respectively, were retrieved. The following outcomes were analyzed: new bone (NB) and new cementum (NC) formation for animal studies and probing pocket depth and clinical attachment level changes for human studies. RESULTS. After a full-text review,six animal studies and three human studies were found to be eligible for this study. All included animal and human studies demonstrated that the use of chitosan for GTR exerts a positive effect on periodontal defects. Subgrouping meta-analysis outcomes of three dog studies revealed that GTR with pure chitosan membranes has a positive effect on NB (14.36%) and NC (10.21%) formation. CONCLUSION. Within the limitations of the present study, there is little evidence to demonstrate the efficacy of chitosan for GTR either in animal or human studies. Chitosan should rather be used as an adjunct component for membrane production.

Aphthae are common oral lesions that affect approximately 10% to 20% of the population. Recurrent Aphthous Ulcers (RAU) are usually classified into three different types: minor, major and herptiform RAU. The etiology of aphthous stomatitis is unknown but according to increasing evidence, its development has an immunogenic process that causes the ulceration of the involved oral mucosa. Similar-appearing lesions may arise in following systemic disorders: 1. Behcet’s disease 2. Sweet’s syndrome 3. Cyclic neutropenia 4. Benign familial neutropenia 5. MAGIC syndrome 6. A periodic syndrome with fever and pharyngitis 7. Various nutritional deficiencies with or without underlying gastrointestinal disorders Several studies from the UK, United States, and Spain have demonstrated that hematinic deficiency (iron, folic acid, or vitamin B12) are twice as common in RAS patients than incontrols. Case report: A 10 year old male patient presented a 3-year history of episodes of multiple minor recurrent Ulcers, this year major aphthae on the anterior ventral surface of the soft palate. Patient had difficulty in eating and in speech. Clinical examination revealed multiple symptomatic ulcers with a perilesional erythematous halo covered with a pseudomembrane. The size of major aphthae was than 20 mm in diameter. The ulcers were not associated with any type of discharge. The ulcers were tender on palpation. The medical history and the family history were non-contributory. A clinical diagnosis of major aphthous ulcers was made on the basis of the history and the clinical examinations. The patient was subjected to a therapeutic regimen consisting of daily topical application of Prednizoloni 0.05%, topical lidoksor and systemic vitamin and Cefatoxime Natrii, Immunomodulators Biferon, Amphotericin B. Recurrent aphthous stomatitis (RAS) or recurrent aphthous ulcers (RAU) remains a common oral mucosal disorder in most communities of the world. Proper systemic evaluation is important before prescribing the medication.

65 Non-bacterial originated tooth wear is a normal process which occurs throughout lif. If the rate of loss is likely to prejudice the survival of the teeth, or is a source of concern to the patient, then it may be considered ‘pathological’. Robb reported that the prevalence of pathological loss of tooth tissue in patients less than 26 years of age was greater than in many older age groups. Tooth surface loss was classified into 4 groups: attrition, erosion, abfraction and abrasion. To find the prevalence of four different types of tooth wear among patients visited Digital Dental Office, Ulaanbaatar, Mongolia and investigate their dental attrition severity. Methods: From total of patients visited Digital Dental Office clinic between September 2016 and September 2017 adults aged 16-62 who was found with any type of tooth wear were explored by 4 types. Those patients with attrition were chosen and severity was determined by Bardsley’s simplified tooth wear index (TWI). There were total of 5432 patients examined and treated during this period of time. From them total of 1002 patients aged 16-62 presented some degree of tooth hard tissue wear/dental attrition. Most of the patients were with combination of 4 types of tooth wear: attrition, abrasion, abfraction and erosion. Attrition (At) was found in 68 patients which was only 6.7%, Abrasion (Ab) in14 people-1.3%, Abfraction (Abf) in 4-0.3%, Erosion (Er) in 2 -0.1% alone. The combination of these types of tooth hard tissue was dominant. At+ab+abf+er in 59 patients of total 1002 (5.8%). At+ab+er in 58 (5.7%). Ab+abf in 29 (2.8%). At+er in 25 patients (2.4%). Er+ab in 27 (2,6%). At+abf+er in 264 people (26.3%). At+abf in 452 (45.1%), which was the most prevalent combination. Dental attrition severity in these 1002 patients were shown as following: -0-0- No loss of contour. -1-229 people (22.8%) - Loos of enamel surface characteristics. Minimal loss of contour. -2- 505 people (50.3 %) - Loss of enamel exposing dentine for less than one third of surface.Loss of enamel just exposing dentine. Defect less than 1 mm deep. -3- 211 people (21 %) - Loss of enamel exposing dentine for more than one third of surface.Loss of enamel and substantial loss of dentine. Defect less than 1-2 mm deep. -4-57 people (5.6%) - Complete enamel loss - pulp exposure - secondary dentin exposure.Pulp exposure or exposure of secondary dentine. Defect more than 2mm deep - pulp exposure - secondary dentine exposure. In this descriptive study showed patients with some degree of tooth wear were around 19% from total patients visited during 1 year of period. Four types of tooth hard tissue wear shown as a different combination, very low percentage was in these types alone. Most of the attrition patients were with mild to moderate degree of enamel loss. This kind of study should be continued to explore harmful dentofacial change

BACKGROUND In recent years, the new treatment and technology developing quickly however, the disease prevention therapy necessary investigate in preventive dentistry. Oil pulling is a traditional Indian folk remedy and Researchers et al previously first time investigated this method. Asokan S, Emmadi P, Chamundeswari et al have indicated the antibacterial activity of sesame oil against on oral microorganisms and found the bacterial growth decreased 20%. In our country, this has not been investigated thus . AIM The aim of this study to assess the antimicrobial efficacy of sunflower oil for reducing micro bacterial count in the oral cavity. METHODS The present study was a parallel design, double-blind, randomized clinical trial with two groups which collected from 162 dental students at the MNUMS, School of Dentistry. The participants rinsed a mouth by 10 ml oil 5 min twice a day after meal and all participants used the same teeth paste during the study period. Oral health status and plaque index were obtained and assessed at baseline and after 30 days of oil therapy . RESULTS However, the Oral health status index not reduced after 30 days. The baseline bacterial count mean of treatment group: a) 0-15 colons subgroup increased from 40.4% to 55.4%, b) 16-200 colons subgroup reduced from 33.3% to 28.6% and c) >201 colons subgroup reduced from 26,3% to 16.1%. In the control group no differences the bacterial count means on baseline and after therapy. CONCLUSION The oil rinse therapy can be used as valuable preventive agents in maintaining and improving oral health furthermore reduced plaque formation and bacterial colonization 15%.