Oral Diseases

Authors: Northridge, Mary E., Chenchen Yu, Bibhas Chakraborty, Ariel Port Greenblatt, Janet Mark, Cynthia Golembeski, Bin Cheng et al.

Objectives. We explored the interrelationships among diabetes, hypertension, and missing teeth among underserved racial/ethnic minority elders.

Methods. Self-reported sociodemographic characteristics and information about health and health care were provided by community-dwelling ElderSmile participants, aged 50 years and older, who took part in community-based oral health education and completed a screening questionnaire at senior centers in Manhattan, New York, from 2010 to 2012.

Results. Multivariable models (both binary and ordinal logistic regression) were consistent, in that both older age and Medicaid coverage were important covariates when self-reported diabetes and self-reported hypertension were included, along with an interaction term between self-reported diabetes and self-reported hypertension.

Conclusions. An oral public health approach conceptualized as the intersection of 3 domains—dentistry, medicine, and public health—might prove useful in place-based assessment and delivery of services to underserved older adults. Further, an ordinal logit model that considers levels of missing teeth might allow for more informative and interpretable results than a binary logit model.

To evaluate the in vivo antimicrobial activity on the salivary flora of a single mouthrinse of chlorhexidine (CHX) digluconate, analysing the influence of its concentration (0.2% versus 0.12%).
The study group was formed of 20 adult volunteers with a good oral health status. Non-stimulated saliva samples were collected under basal conditions and at 30s and 1h after a single mouthrinse with sterile water, 0.2% or 0.12% CHX digluconate. Serial dilutions were then performed and the resulting samples were cultured on conventional culture media for aerobes/facultative anaerobes and obligate anaerobes. The number of colony forming units (CFU/ml) was then determined and the results expressed on a decimal log scale (log(10)CFU/ml).
A significant reduction in the total bacterial population was observed at 30s and 1h after the mouthrinse with both CHX concentrations; this antimicrobial activity was more pronounced on the obligate anaerobes. The antimicrobial activity of 0.2% CHX on the salivary flora at 30s and 1h after the mouthrinse was significantly greater than that of 0.12% CHX. Only 0.2% CHX showed bactericidal activity (differential factor> or =3 log(10)CFU/ml) against salivary obligate anaerobes.
The greater antimicrobial activity of 0.2% CHX confirms the influence of the concentration on its antibacterial activity. In consequence, the CHX concentration seems to be an important factor to guarantee a high antibacterial activity in those clinical situations where it is required.

To investigate the prevalence, duration, and etiology of bacteremia following dental extractions performed after a single administration of chlorhexidine mouthwash.
A randomized, controlled trial performed in a university hospital.
A series of 106 patients with mental and behavioral disabilities who underwent dental extractions under general anesthesia were randomly assigned to a control group or chlorhexidine group. The exclusion criteria applied were use of antibiotics in the previous 3 months, use of oral antiseptics, any type of congenital or acquired immunodeficiency, and disease that predisposes the patient to infections or bleeding. The chlorhexidine group had 0.2% chlorhexidine mouthwash administered for 30 seconds before any dental manipulation. Blood samples were collected at baseline, 30 seconds, 15 minutes, and 1 hour after the dental extractions. Subculture and further identification of the isolated bacteria were performed by conventional microbiological techniques.
The prevalence of bacteremia after dental extraction in the control and chlorhexidine groups were 96% and 79%, respectively, at 30 seconds (P=.008), 64% and 30% at 15 minutes (P<.001), and 20% and 2% at 1 hour (P=.005). The most frequently identified bacteria were Streptococcus species in both the control and chlorhexidine groups (64% and 68%, respectively), particularly viridans group streptococci.
We recommend the routine use of a 0.2% chlorhexidine mouthwash before dental extractions to reduce the risk of postextraction bacteremia.

Diagnostic delays in oral cancer have been classified as "patient delay" and "delay by the clinicians". However, the influence of the accessibility (scheduling delay) to the health care system in oral cancer diagnosis has not been studied before. To assess scheduling delay, a descriptive, cross-sectional study was designed. This study was based upon role-play telephone conversations with two standardised patients (lingual ulceration-SP1 and patient seeking fixed prosthodontics-SP2). that followed a structured script. The variables considered in the study were days to go until the arranged appointment, professional degree of the contacted person and referral to other provider of care. The scheduling delay for SP1 reached a median value of 1 day, and for SP2 was 6 days. When the professional degree (receptionist vs GDP) of the person arranging the appointment for the patient with lingual ulceration was considered, the scheduling delay was significantly shorter when the appointment was fixed by the GDP (X approximately i-X approximately j=4.5; 95%CI=-7.48,-1.51). GDPs gave priority to the patients with lingual ulcerations over those demanding fixed bridgework (X approximately i-X approximately j=6.48; 95%CI=-9.46,-3.50). The GDPs showed a high level of awareness of the oral cancer, however, educational interventions seem to be necessary for dental surgery receptionists.

Oral Diseases (2012) 18, 293–298Objectives:  To generate and validate at pretest level a cross-culturally adapted Portuguese version of Xerostomia Inventory (XI), a 11-item questionnaire designed to measure specific xerostomia rating of patients complaints.Methods:  The original English version of the XI was translated into Portuguese following the guidelines for cross-cultural adaptation of health-related quality of life measures. Thirty patients with primary Sjögren syndrome were recruited for this study. The questionnaires were administered by trained and calibrated dental doctors to each patient. XI properties were examined including reliability, internal consistency, and test-retest reliability, using Cronbach’s alpha, total and inter-item correlation, and intra-class correlation coefficients (ICC), respectively. Construct validity supported by objective measurements of xerostomia intra-oral signs and salivary secretion was investigated. Alpha was set at 0.05. Informed consents and local ethical committee clearance were obtained.Results:  Internal consistency and test-retest reliability were excellent (Cronbach’s α = 0.9; ICC range = 0.79–0.94). Scatterplot interpolation and Pearson correlation coefficient suggested the presence of a strong, negative, and significant correlation between salivation and the XI scores indicating construct validity.Conclusion:  The Portuguese version of the XI can be considered a reliable and valid instrument to measure patients’ xerostomia symptoms.

Aims: Study on the evaluation of phytochemical and antimicrobial effects of tomato Solanum lycopersicum (L.) on oral thrush and human cariogenic pathogens was designed to determine the antimicrobial effect of tomato extracts, and to identify the common phytochemical constituents of tomato that may be inhibitory to oral pathogens. Place and Duration of Study: Fresh tomato fruit samples were collected from Samaru market, Zaria in the month of November and December 2015, and analyzed at Microbiology Laboratory, Nigerian Institute of Leather and Science Technology Zaria, Kaduna. Methodology: Cold maceration extraction using methanol and water was adopted. All the extracts were subjected to standard phytochemical qualitative screening for the presence or absence of various primary and secondary metabolites. Antimicrobial susceptibility was carried out by agar-well diffusion technique. The antimicrobial susceptibility test of Solanum lycopersicum (tomato) fruit extracts against selected bacterial (Streptococcus mutans, Bacillus subtilis) and yeast (Candida albicans) pathogens capable of causing oral thrush and dental caries was carried out. Ciprofloxacin and Econazole were used as positive controls. The Minimum Inhibitory Concentrations (MICs) were determined in three concentrations; 100 mg/ml, 50 mg/ml and 25 mg/ml of each extract. Mean zone of inhibition was used to measure the antimicrobial potential of tomato fruit extracts against the test organisms. The microbial isolates were obtained from the and tannins are present in tomato fruit extract, but, anthraquinones and phlabotannins are absent in methanolic extract. While, the only phytochemical that was not detected in the aqueous extract is anthraquinones. Highest antibacterial activity was recorded on Bacillus subtilis at the concentrations of 100 mg/ml and 50 mg/ml for aqueous and methanolic extracts respectively. Candida albicans and Streptococcus mutans showed resistance to the various extracts at various concentrations used. The MIC of 100mg/ml was recorded on Bacillus subtilis, whereas all other test organisms showed relative resistance to various concentrations of the extracts used. Conclusion: Tomato fruit contains phytochemicals that showed promising antimicrobial effect on oral thrush and cariogenic pathogens. The tomato extract recorded antimicrobial effect against Bacillus subtilis with MIC of 100 mg/ml. The methanolic extract was the most active that could compete favourably with the conventional antibiotic (ciprofloxacin) at higher concentrations, which suggests that possible new drug candidates can be harnessed from the tomato fruit against oral thrush and cariogenic pathogens.