Indoor aerosol emissions are predominantly attributed to respiratory activities, whereas non-respiratory sources associated with routine hygiene behaviors remain largely overlooked. Here, we investigated aerosol generation during electric toothbrushing through 1290 controlled chamber tests involving human participants. Results showed that emissions were dominated by respirable fine particles, with over 85% below 2.5 μm, while ultrafine particle levels showed no clear increase relative to the pre-brushing baseline, indicating a distinct emission regime compared to respiratory processes. Emission dynamics exhibited structured temporal patterns with sustained release, rather than short-lived bursts. Across device-, product-, and subject-level factors, aerosol generation was primarily governed by toothbrush mechanics, with sonic toothbrushes producing consistently higher emissions than oscillating-rotating types, highlighting the role of bristle vibration frequency and amplitude, whereas toothpaste formulation showed secondary, mechanism-dependent effects, and inter-individual variability remained negligible. These findings suggest that mechanically induced liquid-film disruption dominates aerosol formation. Measured emission rates were comparable to those from speaking and approached the lower range of singing. Dose-response modeling further indicated that, under assumed pathogen concentrations and aerosol viability conditions, high-emission sonic brushing could produce modeled relative infection-risk estimates comparable to speaking, while Monte Carlo rank analysis placed it among the higher-ranked activity scenarios below singing. Notably, subjective perception did not reflect measured emissions, indicating an unrecognized exposure pathway. Overall, electric toothbrushing is identified as a previously overlooked, mechanically driven indoor aerosol source with non-negligible implications for exposure and infection risk, highlighting the need to incorporate hygiene-related emissions into indoor air quality and infection risk assessments.

This research examined host metabolic processes associated with gingivitis and potential impacts of interventions. First, gingival brush samples from a previously reported clinical study in which participants used an intervention (stannous fluoride (SnF2) toothpaste/cetylpyridinium chloride rinse/oscillating-rotating electric toothbrush) or control (standard fluoride toothpaste/manual toothbrush) were analyzed with Metabolon metabolomic assessment. Next, hypotheses were generated about mechanisms of metabolic observations and tested in two in vitro models. Human primary blood cells were treated with endotoxins and outer membrane vesicles (OMVs) in the presence of SnF2. In clinical brush samples, 46 metabolites decreased with intervention at Week 3, including 9- and 13-hydroxyoctadecadienoic acid, citrulline, adenine, and hypoxanthine. Seven metabolites related to nitrogen metabolism and citrulline production were selected for targeted quantification. They were low in health and increased in gingivitis. Targeted quantification demonstrated reduced citrulline, succinate, ornithine and deoxycarnitine (p ≤ 0.001 for all) between baseline and Week 6 with intervention; reductions were greater for intervention vs. control for citrulline, succinate and deoxycarnitine at Week 6 (p ≤ 0.019). In vitro, endotoxin and OMVs increased citrulline and nitric oxide (NO). SnF2 inhibited elevation of both. Citrulline, deoxycarnitine, succinate, and ornithine were identified as potential novel markers of gingivitis. Elevated NO production is a potential driver of oxidative stress, reduced with intervention.

Background Fluoride plays a critical role in public dental health, and its judicious use is central to caries prevention strategies worldwide. With the exponential growth of internet usage in the Arab world, dental websites in the Arabic language have become increasingly influential sources of health information. However, the accuracy, completeness, and scientific reliability of fluoride-related content on these platforms remain largely unexplored. This study aimed to assess and evaluate the quality and accuracy of fluoride information disseminated through Arabic-language websites. Methods A cross-sectional web-based study was conducted between January and April 2025. Arabic websites were systematically identified using Google, Bing, and Yahoo search engines with standardized Arabic search terms related to fluoride and dental health. Websites were evaluated using the DISCERN instrument, the Journal of the American Medical Association (JAMA) benchmark criteria, the Health on the Net (HON) code principles, and a custom fluoride-specific accuracy checklist developed from current evidence-based guidelines. A total of 120 websites met the inclusion criteria. Descriptive statistics, chi-square tests, and multivariate logistic regression were employed for data analysis. Results Of 120 eligible websites, 38 (31.7%) were classified as commercial, 29 (24.2%) as health information portals, 27 (22.5%) as governmental or academic, and 26 (21.7%) as social media-based or blog platforms. Overall website quality was rated poor to fair in 68.3% of assessed websites (n = 82). The mean DISCERN score was 38.4 out of 80 (SD = 11.2). Fluoride-specific accuracy scores revealed that only 44.2% of websites correctly described optimal fluoride concentration for drinking water, 52.5% accurately discussed fluoride toothpaste recommendations, and a mere 31.7% provided correct information regarding dental fluorosis. Governmental and academic websites demonstrated significantly higher quality scores compared to commercial and social media platforms (p < 0.001). Conclusion The majority of Arabic websites provide inadequate, inaccurate, or misleading fluoride-related health information. Significant quality disparities exist across different website categories, with governmental and academic websites outperforming commercial and social media platforms. There is an urgent need for standardized guidelines, regulatory oversight, and professional dental society engagement to improve the quality of fluoride information on Arabic dental websites.

Calcific tendinitis commonly affects the rotator cuff; however, involvement of the deep insertion of the gluteus maximus is uncommon and has been described only in limited reports. Deep-seated hip lesions may be difficult to identify on plain radiographs, potentially resulting in delayed diagnosis. We report the case of a 53-year-old woman who presented with atraumatic lateral hip pain and restricted range of motion for 1 month, that was unresponsive to nonsteroidal anti-inflammatory drugs (NSAIDs). Plain radiograph findings were inconclusive. Magnetic resonance imaging (MRI) showed inflammatory edema surrounding the gluteus maximus insertion, and computed tomography (CT) with three-dimensional (3D) reconstruction identified a calcific deposit. Because of persistent pain, functional limitation, and confirmed deep peri-hip calcification, surgical intervention was selected after discussing nonoperative options. Thus, an imaging-guided peri-hip endoscopic debridement was performed under C-arm fluoroscopic guidance following CT and 3D lesion localization. Typical "toothpaste-like" calcific material extruded from the lesion and was completely removed. Histopathological examination confirmed calcific tendinopathy, and postoperative CT verified complete removal of the lesion. At 6 weeks postoperatively, her pain had resolved, and hip function had markedly improved. This case also highlights an effective, imaging-guided diagnostic workflow for deep peri-hip calcific lesions when radiographic findings are inconclusive. Although a CT-planned, C-arm-assisted approach may facilitate rapid recovery, longer-term follow-up is required to evaluate durability, recurrence, tendon healing, and potential delayed complications.

This narrative review traces the evolution of personal oral hygiene from antiquity to the present, examining the shift from rudimentary tools to evidence-based, technologically advanced systems. Historical developments were reviewed alongside current clinical research, including systematic reviews and professional guidelines (e.g., EFP S3-level), to evaluate the efficacy, safety, and behavioral aspects of oral hygiene practices. Oral hygiene has progressed from ancient chewing sticks to modern powered toothbrushes and interdental devices. While manual toothbrushes remain effective, oscillating-rotating and sonic technologies offer more plaque reduction and better gingival outcomes. Interdental cleaning has increasingly favored interdental brushes over dental floss, though rubber picks and oral irrigators provide effective and patient-preferred alternatives. Dentifrices have evolved from simple abrasives to vehicles for fluoride, antimicrobial, and other therapeutic agents. Despite these innovations, oral disease persists, largely due to discrepancies between perceived and actual brushing behaviors, including inadequate duration and technique. Optimal gingival health continues to depend on the quality and consistency of self-performed mechanical plaque removal. Emerging technologies and sustainable, eco-friendly materials may enhance compliance and accessibility, yet they cannot replace professional instruction or habit formation. Future strategies should prioritize personalized, evidence-based oral care that balances clinical efficacy, environmental sustainability, and equitable access.