Poor oral hygiene and excessive consumption of soda are among the main drivers of systemic health issues in adolescents in the United States. This non-randomized pilot clinical trial focused on the effects of a health text message system and smartphone-based intervention on adolescent tooth-brushing behavior and dietary choices, with a convenience sample of 94 participants aged 12 to 14 years old. A group of 75 participants agreed to use a tooth-brushing app and received a health text message; the other group of 15 agreed to use the tooth-brushing app, but did not receive a health text message. Saliva specimens were collected directly before and at the end of each experiment; changes in the salivary presence of cariogenic bacteria over the duration of the study were evaluated and compared with the demographics and behavioral variables. Within the text message group, 5% of participants increased the frequency of daily tooth brushing. Within the non-intervention group, 29% of participants increased the frequency of their daily tooth brushing. There were reductions in the total salivary bacteria and total streptococci in both groups (p < 0.001), but no change in the presence of cariogenic Mutans streptococci. Raising adolescents’ consciousness of oral health behavior resulted in marginal to moderate improvements to oral hygiene and dietary choices, as well as reductions in total salivary bacteria.

This study examines the relationship between selected socio-demographics and digital health literacy on diabetes knowledge among older adults in the United States. Cross-sectional study. The eHealth Literacy Scale and the Short Diabetes Knowledge Instrument were used. Descriptive statistics, Pearson's r, point-biserial correlation coefficient, Kendall's tau, ANOVA, and Poisson regression were used for data analysis. The mean age was 71. The mean sum score for digital health literacy was 28.32 (SD = 7.95; range, 8-40), and the mean score for diabetes knowledge was 8.8 (SD = 2.3; range, 2-13). The education level, annual income, number of digital devices, and digital health literacy have a significant relationship with diabetes knowledge. Ethnicity, marital status, living arrangement, and health insurance status significantly correlated with diabetes knowledge. The findings can be used as preliminary evidence in developing diabetes education and age-friendly interventions for marginalized older adults, allowing better access to digitally formatted health knowledge. Nurses should be knowledgeable about the impact of digital health literacy on diabetes knowledge for older adults. Nurses and healthcare providers should assess patients' digital literacy levels as part of routine diabetes care and guide the older adults to gain the ability to utilize digital health information resources. Given that diabetes is a chronic illness, older adults should be able to manage it independently, and nurses play a pivotal role in supporting their effective self-care and providing age-tailored health education and interventions.

While most states allow minors 12 years and older to consent to services for contraception, prenatal care, or sexually transmitted infections, the same adolescents are required to have parental consent for even preventive oral health care. Many adolescents are denied access to preventive oral health care because of the challenge of securing parental consent for care when parents are unwilling, unable, or unavailable to consent. Our purpose is to examine the barriers to preventive oral health care for U.S. adolescents related to parental consent laws, explore the issues surrounding these laws, and recommend policy changes. We explain the current range and status of consent laws across the country and arguments for parental consent law as it now stands. We discuss the difficulty of applying general medical consent law to preventive oral health care, neuroscience research on cognitive capacity among adolescents, and the distinction between parental consent and adolescent assent. We recommend replacing required “opt-in” consent with simpler “opt-out” consent; developing a tool for assessing adolescent decision-making capacity; advocating for consent laws that apply specifically to preventive oral health care; and empowering school nurses to lead local, state, and nationwide policy and legislation efforts.

By age 17, almost 80% of US children have dental caries resulting from cariogenic bacteria that could be reduced with tooth brushing. This cross-sectional, correlational pilot study aims to understand the association between tooth brushing and oral microbiota in children. Oral specimens and survey data were collected from a convenience sample of 16 children, aged 7–12, and attending a community dental clinic. Descriptive statistics were used to analyze sample characteristics and tooth brushing behavior. Biospecimens were analyzed using Polymerase Chain Reaction (PCR) amplification and 16S ribosomal RNA (rRNA) gene sequencing. Beta diversity measures were compared across tooth brushing groups using Permutational Analysis of Variance (PERMANOVA) and Analysis of Similarities (ANOSIM) tests in R. The frequency of tooth brushing in this sample was once a day (brush1; 43.8%), twice a day (brush2; 43.8%), or more than twice a day (12.6%). Major phyla found in the subjects’ upper and lower teeth were the following: Proteobacteria, Fusobacteria, Firmicutes, Bacteroidetes, and Actinobacteria. The relative abundance of Actinobacteria was significantly lower in brush2 as compared to brush1 (p = 0.001), whereas the relative abundance of Proteobacteria was significantly higher (p = 0.025). The association between tooth brushing frequency and microbiome beta diversity was significant (p = 0.005 by PERMANOVA and p = 0.002 by ANOSIM). This study demonstrates that tooth brushing frequency could affect the proportional composition of the oral microflora. Additional research on the implication of these changes is warranted.