Dental Plaque Bacteria Research Articles

Functional Haplotypes in Interleukin 4 Gene Associated with Periodontitis.

Chronic periodontitis (CP) is an infectious inflammatory disease that affects tooth-supporting structures and in which dental plaque bacteria, immune mechanisms and genetic predisposition play important roles. Interleukin 4 (IL-4) is a key anti-inflammatory cytokine with relevant action in imbalances in inflamed periodontal tissue. Individuals carrying the TCI/CCI genotype (S-haplotype) of the IL-4 gene are 5 times more susceptible to CP, whereas the CTI/TTD genotype (P-haplotype) confers protection against CP. Compared with the S-haplotype, subjects with the P-haplotype produce higher levels of the IL-4 protein after non-surgical periodontal therapy. The present in vitro study aimed to investigate the functionality of IL-4 haplotypes in immune cells to obtain insight into the influence of these genetic variations in regulating immune responses to CP-associated bacteria. Peripheral blood was collected from 6 subjects carrying each haplotype, and their immune cells were challenged with periodontopathogens to compare responses of the different haplotypes with regard to gene expression, protein secretion and the immunophenotype of T helper responses. We found higher IL-4 mRNA and protein levels in the P-haplotype, which also presented higher levels of anti-inflammatory cytokines. In contrast, cells from S-haplotype subjects responded with higher levels of pro-inflammatory cytokines. S-haplotype individuals exhibited significantly greater polarization toward the Th1 phenotype, whereas the P-haplotype was associated with an attenuated response to periodontopathogens, with suggestive skewing toward Th2/M2 phenotypes. In conclusion, IL-4 genetic variations associated with susceptibility to or protection against chronic periodontitis are directly associated with influencing the response of immune cells to periodontopathogens.

Changes in periodontal and microbial parameters after the space maintainers application.

This study aims to evaluate the clinical and microbiological changes accompanying the inflammatory process of periodontal tissues during treatment with space maintainers (SMs). The children were separated into fixed (Group 1, n = 20) and removable (Group 2, n = 20) appliance groups. A full periodontal examination, including probing pocket depth (PPD), bleeding on probing (BOP), and plaque index (PI), was performed. Anaerobic microorganisms in the crevicular fluid were detected with the culture method. Clinical and microbial evaluations were performed before (T0) applications. as well as at three (T1), and 9 months intervals (T2) after the application of the fixed or removable appliances. The PI, PPD, and BOP scores at the testing sites of both groups increased significantly from before treatment (T0) to the 9 months' time frame (T2) (P < 0.05), The presence of anaerobic bacteria in the subgingival dental plaque increased from T0 (n = 13, 65%) to T1 (n = 16, 80%) in the fixed SM group, but not statistically significant. The same values were obtained in T1 and T2 (n = 16, 80%). Although, the results of this study demonstrate that the application of fixed or removable SM appliances in children induced an increase of clinical periodontal parameters, anaerobic microbiota consisting of Aggregatibacter actinomycetemcomitans, Porphyromonas gingivalis, and Tannerella forshia were not observed in any of the samples in short-term. Further long-term and comprehensive investigations are necessary.

Dental plaque bacteria with reduced susceptibility to chlorhexidine are multidrug resistant.

BackgroundChlorhexidine (CHX) is used in oral care products to help control dental plaque. In this study dental plaque bacteria were grown on media containing 2 μg/ml chlorhexidine gluconate to screen for bacteria with reduced CHX susceptibility. The isolates were characterized by 16S rRNA gene sequencing and antibiotic resistance profiles were determined using the disc diffusion method.ResultsThe isolates were variably resistant to multiple drugs including ampicillin, kanamycin, gentamicin and tetracycline. Two species, Chryseobacterium culicis and Chryseobacterium indologenes were able to grow planktonically and form biofilms in the presence of 32 μg/ml CHX. In the CHX and multidrug resistant C. indologenes we demonstrated a 19-fold up-regulation of expression of the HlyD-like periplasmic adaptor protein of a tripartite efflux pump upon exposure to 16 μg/ml CHX suggesting that multidrug resistance may be mediated by this system. Exposure of biofilms of these resistant species to undiluted commercial CHX mouthwash for intervals from 5 to 60 s indicated that the mouthwash was unlikely to eliminate them from dental plaque in vivo.ConclusionsThe study highlights the requirement for increased vigilance of the presence of multidrug resistant bacteria in dental plaque and raises a potential risk of long-term use of oral care products containing antimicrobial agents for the control of dental plaque.

Detection of selected periodontal bacteria in preschool children affected by early childhood caries.

The aim of this study was to compare the detection frequency of periodontal bacteria in dental plaque in children with early childhood caries (ECC) with and without gingival inflammation. A convenience sample of 25 preschool children (mean age 3.61years, SD 1.42) was recruited. Dental plaque was taken from periodontal areas with and without visible signs of inflammation and processed using the StomaGene® (Protean s.r.o. Czech Republic) and ParoCheck® 20 (Greiner Bio-one GmbH, Germany) detection kits. The two sample t tests between percents for differences between inflammatory and healthy sites and kappa statistics for the agreement of both systems were used. At the inflammatory sites, Porphyromonas gingivalis and Aggregatibacter actinomycetemcomitans were significantly more frequently detected by StomaGene® while Fusobacterium nucleatum, A. actinomycetemcomitans, Tanarella forsythia and Prevotella intermedia were significantly more frequently identified by ParoCheck® test. The agreement between the two detection systems was substantial for A. actinomycetemcomitans and F. nucleatum in the samples collected from inflamed sites and only for F. nucleatum from clinically healthy sites. Therefore, we recommend that the same system should be used when the same patient is examined repeatedly.

Anti-plaque effect of a synergistic combination of green tea and Salvadora persica L. against primary colonizers of dental plaque

ObjectiveGreen tea (Gt), leafs of Camellia sinensis var. assamica, is widely consumed as healthy beverage since thousands of years in Asian countries. Chewing sticks (miswak) of Salvadora persica L. (Sp) are traditionally used as natural brush to ensure oral health in developing countries. Both Gt and Sp extracts were reported to have anti-bacterial activity against many dental plaque bacteria. However, their combination has never been tested to have anti-bacterial and anti-adherence effect against primary dental plaque colonizers, playing an initial role in the dental plaque development, which was investigated in this study. MethodsTwo-fold serial micro-dilution method was used to measure minimal inhibitory concentration (MIC) of aqueous extracts of Gt, Sp and their combinations. Adsorption to hexadecane was used to determine the cell surface hydrophobicity (CSH) of bacterial cells. Glass beads were used to mimic the hard tissue surfaces, and were coated with saliva to develop experimental pellicles for the adhesion of the primary colonizing bacteria. ResultsGt aqueous extracts exhibited better anti-plaque effect than Sp aqueous extracts. Their combination, equivalent to 1/4 and 1/2 of MIC values of Gt and Sp extracts respectively, showed synergistic anti-plaque properties with fractional inhibitory concentration (FIC) equal to 0.75. This combination was found to significantly reduce CSH (p<0.05) and lower the adherence ability (p<0.003) towards experimental pellicles. ConclusionCombination between Gt and Sp aqueous extracts exhibited synergistic anti-plaque activity, and could be used as a useful active agent to produce oral health care products.

24-hour evaluation of dental plaque bacteria and halitosis after consumption of a single placebo or dental treat by dogs.

OBJECTIVE To determine whether consumption of a single dental treat with specific mechanical properties and active ingredients would provide a 24-hour effect on dental plaque bacteria and halitosis in dogs. ANIMALS 10 dogs of various breeds from a privately owned colony that had received routine dental scaling and polishing 4 weeks before the study began. PROCEDURES Dogs were randomly assigned to receive 1 placebo or dental treat first. A 4-week washout period was provided, and then dogs received the opposite treatment. Oral plaque and breath samples were collected before and 0.5, 3, 12, and 24 hours after treat consumption. Volatile sulfur compounds (VSCs) concentration was measured in breath samples. Total aerobic, total anaerobic, Porphyromonas gulae, Prevotella intermedia-like, Tannerella forsythia, and Fusobacterium nucleatum bacterial counts (measured via bacterial culture) and total live bacterial counts, total live and dead bacterial counts, and bacterial vitality (measured via quantitative real-time PCR assay) were assessed in plaque samples. RESULTS Compared with placebo treat consumption, dental treat consumption resulted in a significant decrease in breath VSCs concentration and all plaque bacterial counts, without an effect on bacterial vitality. Effects of the dental treat versus the placebo treat persisted for 12 hours for several bacterial counts and for 24 hours for breath VSCs concentration. CONCLUSIONS AND CLINICAL RELEVANCE Although clinical benefits should be investigated in larger scale, longer-term studies, results of this study suggested that feeding the evaluated dental treat may help to decrease oral bacterial growth in dogs for 12 hours and oral malodor for 24 hours. A feeding interval of 12 hours is therefore recommended.

Opportunistic Bacteria in Tonsil and Dental Plaque are Indicator for Oral Care

Background of the study: Detection of the opportunistic microorganisms can be the indicator for

In vitro study of the effect of an essential oil and a delmopinol mouth rinse on dental plaque bacteria.

Mouthrinses are used, by many of our patients, as a complement to daily dental hygiene routine. The use of a toothbrush and an interproximal cleaning method may not be enough to control dental plaque. Essential oils and delmopinol mouth rinses are effective for the prevention of dental caries and gingivitis. To study the effect of an essential oil and a delmopinol mouth rinse on dental plaque bacteria, an in vitro study was developed. The objective of this study was to determine the antibacterial activity of an essential oil and a delmopinol mouth rinse on Streptococcus mutans, Lactobacilli, and aerobic and anaerobic dental plaque nonspecific bacteria. Samples of human dental plaque were collected from consenting participants and bacteria isolated. Disk-diffusion tests were performed to obtain the minimum concentration of the mouth rinses necessary to inhibit bacterial growth. The ability of the commercial mouth rinses to inhibit bacterial growth was studied in comparison to a positive control (0.2% chlorhexidine) and a negative laboratorial control (sterilized water). The minimum inhibitory concentration was found to be inferior to the commercial essential oils and delmopinol mouth rinses concentrations. Delmopinol and essential oils have significant antibacterial properties shown in vitro only for aerobic bacteria, and for S. mutans, Lactobacillus, and anaerobic bacteria, the results were not statistically significant. Essential oils and chlorhexidine are statistically similar and better than delmopinol for aerobic bacteria growth inhibition. For the other bacteria, essential oils and delmopinol are not statistically promising. Results show that essential oils only may help patients to maintain good oral health as a complement to daily brushing and interproximal cleaning.

Systematic review of the in vitro effects of statins on oral and perioral microorganisms.

Statins are medications administered orally and are widely used for lowering the blood cholesterol level. The aim of this study was to investigate the effects of orally administered statins on microorganisms infecting oral and perioral tissues. We performed a systematic review of published studies of the in vitro antimicrobial effects of statins on bacteria, viruses, and fungi, and searched PubMed, Web of Science, Cochrane Central, and Google scholar. Studies show that most statins exhibit antimicrobial effects against various oral microorganisms. Simvastatin is most effective against the periodontal pathogens Aggregatibacter actinomycetemcomitans and Porphyromonas gingivalis, and against most dental plaque bacteria, including Streptococcus mutans. Statins also exhibit antiviral properties against human cytomegalovirus, hepatitis B virus, and hepatitis C virus, and have antifungal properties against Candida albicans, Aspergillus fumigatus, and Zygomycetes spp. There were notable differences in the minimum inhibitory concentrations (MICs) between different studies, which may be attributed to differences in study design. Further studies are warranted to ascertain if statins can be solubilized so that patients, who have been prescribed statins for cardiovascular diseases, can use the medication as a swish and swallow, giving patients the added benefit of the antimicrobial action topically in the mouth against infectious oral diseases.

Molecular Analysis of Oral Bacteria in Heart Valve of Patients With Cardiovascular Disease by Real-Time Polymerase Chain Reaction.

Structural deficiencies and functional abnormalities of heart valves represent an important cause of cardiovascular morbidity and mortality, and a number of diseases, such as aortic stenosis, have been recently associated with infectious agents. This study aimed to analyze oral bacteria in dental plaque, saliva, and cardiac valves of patients with cardiovascular disease. Samples of supragingival plaque, subgingival plaque, saliva, and cardiac valve tissue were collected from 42 patients with heart valve disease. Molecular analysis of Streptococcus mutans, Prevotella intermedia, Porphyromonas gingivalis, and Treponema denticola was performed through real-time PCR. The micro-organism most frequently detected in heart valve samples was the S. mutans (89.3%), followed by P. intermedia (19.1%), P. gingivalis (4.2%), and T. denticola (2.1%). The mean decayed, missing, filled teeth (DMFT) was 26.4 ± 6.9 (mean ± SD), and according to the highest score of periodontal disease observed for each patient, periodontal pockets > 4 mm and dental calculus were detected in 43.4% and 34.7% of patients, respectively. In conclusion, oral bacteria, especially S. mutans, were found in the cardiac valve samples of patients with a high rate of caries and gingivitis/periodontitis.

Molecular Analysis of Oral Bacteria in Dental Plaque, Saliva, and Cardiac Valves of Patients With Cardiovascular Disease

To identify oral bacteria in dental plaque, saliva, and heart valves.

Modern Methods of Diagnosis of Periodontal Diseases in Teenagers

In the article the possibilities of new methods of diagnosis of periodontal diseases in teenagers are characterized. A hygienic condition of the oral cavity was evaluated by the use of the intraoral camera Durr Dental’s Vista Proof (Germany). The polymerase chain reaction (PCR) was performed to detect DNA of pathogenic periodontal bacteria in dental plaque. It was found that the increase in the severity of the disease was accompanied by increased pathogenic periodontal micro flora in dental plaque.

The effect of blue light on periodontal biofilm growth in vitro.

We have previously shown that blue light eliminates the black-pigmented oral bacteria Porphyromonas gingivalis, Prevotella intermedia, Prevotella nigrescens, and Prevotella melaninogenica. In the present study, the in vitro photosensitivity of the above black-pigmented microorganisms and four Fusobacteria species (Fusobacterium nucleatum ss. nucleatum, F. nucleatum ss. vincentii, F. nucleatum ss. polymorphum, Fusobacterium periodonticum) was investigated in pure cultures and human dental plaque suspensions. We also tested the hypothesis that phototargeting the above eight key periodontopathogens in plaque-derived biofilms in vitro would control growth within the dental biofilm environment. Cultures of the eight bacteria were exposed to blue light at 455 nm with power density of 80 mW/cm2 and energy fluence of 4.8 J/cm2. High-performance liquid chromatography (HPLC) analysis of bacteria was performed to demonstrate the presence and amounts of porphyrin molecules within microorganisms. Suspensions of human dental plaque bacteria were also exposed once to blue light at 455 nm with power density of 50 mW/cm2 and energy fluence of 12 J/cm2. Microbial biofilms developed from the same plaque were exposed to 455 nm blue light at 50 mW/cm2 once daily for 4 min (12 J/cm2) over a period of 3 days (4 exposures) in order to investigate the cumulative action of phototherapy on the eight photosensitive pathogens as well as on biofilm growth. Bacterial growth was evaluated using the colony-forming unit (CFU) assay. The selective phototargeting of pathogens was studied using whole genomic probes in the checkerboard DNA-DNA format. In cultures, all eight species showed significant growth reduction (p < 0.05). HPLC demonstrated various porphyrin patterns and amounts of porphyrins in bacteria. Following phototherapy, the mean survival fractions were reduced by 28.5 and 48.2% in plaque suspensions and biofilms, respectively, (p < 0.05). DNA probe analysis showed significant reduction in relative abundances of the eight bacteria as a group in plaque suspensions and biofilms. The cumulative blue light treatment suppressed biofilm growth in vitro. This may introduce a new avenue of prophylactic treatment for periodontal diseases.

Polymerase chain reaction as a prospect for the early diagnosis and prediction of periodontal diseases in adolescents.

This study was to determine the markers representative of pathogenic periodontal microflora [Prevotella intermedia (P.i), Tannerella forsythia (T.f) [Bacteroides forsythus], Treponema denticola (T.d), Actinobacillus actinomycetemcomitans (A.a), Porphyromonas gingivalis (P.g)] in the dental plaque of adolescents with various degrees of severity of periodontium inflammation. Forty-patients aged 15-16 years of age were examined using PMA, CPI and Green-Vermillion indices (Müller 2001). The hygiene status of each patient was also determined using Durr Dental's Vista Proof intraoral camera (Germany). The polymerase chain reaction (PCR) was performed using a Biometra Thermocycler to detect DNA of pathogenic periodontal bacteria in dental plaque. All marker microorganisms (P.i.+T.f.+T.d.+A.a.+P.g.) were identified in patients diagnosed with periodontitis in dental plaque. A direct correlation between the level of oral hygiene and the severity of the pathological process in it was determined. It was found that the increase in the severity of the disease was accompanied by increased pathogenic periodontal microflora in dental plaque. Identification of periodontal pathogens in dental plaque by PCR greatly enhances the early diagnosis of Cronic cattaral gingivitis (CCG) risk factors in adolescents, and allows for detailed analysis of the relation between each factor and severity of the process. This method may be used for the diagnosis of periodontal diseases, prediction of their future course, and reasonable choice of antimicrobial therapy.

The Association Between Proinflammatory Gene Polymorphisms and Level of Gingival Tissue Degradation in Chronic Periodontitis

Copyright © 2014, Zahedan University of Medical Sciences. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Chronic periodontitis (CP) is a common complex infectious disease resulting in inflammation within tissues supporting teeth, which leads to progressive attachment loss, bone loss and eventually tooth loss (1). It is characterized by degradation of extracellular matrix (ECM) components associated with an infiltration of several inflammatory cell populations into the gingival epithelium and connective tissue (2, 3). The first etiologic factor of CP is the accumulation of bacteria in gingival groove. Dental plaque bacteria and calculus have direct and indirect roles in destruction of periodontal tissues. The direct impact is due totoxins, enzymes, and metabolites of bacteria present in dental plaque, which play a key role in the initiation of immune response and induces tissue destruction indirectly by activating host defense cells, which in turns produce and release inflammatory mediators. It stimulates effectors of connective tissue breakdown. Bacteria-derived pathogenic factors such as lipopolysaccharides can activate junctional epithelial cells to release potent cytokines and proteases, leading to inflammation and connective tissue breakdown and bone resorption (4, 5). Fibroblasts, macrophages, osteoblasts, keratinocytes, and endothelial cells are activated in response to stimulus, contributing with the synthesis of cytokines and MMPs (6). Epidemiological studies revealed that differences in periodontitis among individuals could not be explained by differences in oral hygiene alone and that not everybody is equally susceptible (7). The pathogenesis of periodontitis depends on the interactions between host and microorganism and may be complicated by genetic and environmental risk factors (8). There is local infiltration of inflammatory cells and degradation of ECM macromolecules in gingival connective tissue of patients with CP. Among matrix macromolecules, collagen fibers constitute the major compartment of the gingival lamina propria and have an important role in its normal histological architecture. Loss of Collagenous compartment may reflect the severity of periodontitis (8). During the progression of periodontal inflammation, periodontal ligament and gingival fibroblasts secrete high levels of cytokines and chemokines (9). Proinflammatory cytokines play crucial roles in microbe-induced destructive inflammation (8). These molecules contribute to the breakdown of type I collagen and also promote bone resorption by stimulating proliferation, differentiation, and activation of osteoclasts (10, 11). Tissue destruction seems to be regulated by four major pathways of plasminogen-dependent, phagocytic, osteoclastic and matrix metalloproteinase (MMP) ones. It seems that the MMPs pathway is the most relevant in periodontitis. MMPs are a family of metal ions-dependent endopeptidases capable of degrading all matrix macromolecules, including collagen fibers and basement membrane constituents (12). Four major subgroups of MMPs directly related to degradation of periodontal tissues include: collagenases, gelatinases, stromelysins and membrane-type MMPs (MT-MMP). Collagenases due to their helicase activity are capable of degradation of type I collagen. Then degradation of the collagen fibrils is done by gelatinases, or lysosomal proteinases (phagocytic pathway). MMP-2 degrades fibrillar type I collagen (10, 11). Stromelysins (MMP-3) and MT-MMPs play a pivotal role during activation of other MMPs (13). Studies have reported that some cytokines are encoded by polymorphic genes, showing genotypes associated with inflammatory diseases that may confer susceptibility to periodontal disease (9). Therefore, most genetic researches in periodontitis have focused on gene polymorphisms playing role in immune system, tissue destructive processes, or metabolic mechanisms (7, 14). Gene polymorphisms are mechanisms through which individuals may exhibit variations within the range of what is considered biologically normal (7). Polymorphisms represent natural sequence variants (alleles), which may occur with more Ar h ve of S ID

The Effect of Pistacia atlantica Var. mutica Mouthwash on Dental Plaque Bacteria and Subgingival Microorganisms: a Randomized and Controlled Triple-blind Study

Dental plaque is a well-documented etiologic factor for periodontal diseases. While chlorhexidine (CHX) is the gold-standard agent for treating dental plaques, undesirable side effects are often found after continuous use of the mouthwash. Therefore, this single-center, randomized, triple-blinded and clinical trial was undertaken to evaluate the efficacy of Pistacia atlantica Var. mutica extract mouthwash on de novo dental plaque bacteria and subgingival microorganisms compared to CHX on a total of 28 patients. The mean aerobic plaque bacterial count of patients at baseline was 2.17 × 10(6). After 4 days of treatment, there were statistically significant decreases in the mean aerobic bacteria in the patients who received P. atlantica and/or CHX (7.25 × 10(4), p = 0.006) and (9.91 × 10(3), p = 0.002), respectively, compared to the patients who received the placebo (6.26 × 10(5)). This study showed that P. atlantica mouthwash is effective against gingival microorganisms. Because of its reduced side effects, P. atlantica mouthwash may be a good alternative choice for patients.

Effect of Bifidobacterium bifidum Containing Yoghurt on Dental Plaque Bacteria in Children

The aim of the present study is to determine the possible effect of Bifidobacterium bifidum DN-173 010 on dental plaque of children. 52 children (25 F and 27 M), between the ages of 8-10, participated in the present study. The study had a double blind, randomized crossover design and the experimental period consisted of four consecutive time periods. During periods 2 and 4 (2 weeks each), children consumed 110 g probiotic fruit yogurt (Bifidobacterium DN-173 010 (1 x 10(10) cfu/g)), or a placebo fruit yogurt per day. Available supragingival plaque (24 h later) was collected from teeth 16, 11, 36 and 31 at baseline and at the end of periods 2 and 4. The counts of dental plaque mutans streptococci (MS) were evaluated using Dentocult SM (Strep Mutans). Changes of pre- and post-treatment levels of dental plaque MS were recorded for four consecutive sampling sites. There were no statistically differences between transition scores of test and placebo groups regarding different dental plaque sampling sites (p > 0.05) (unpaired t-test). Within the limitations of the present study, Bifidobacterium bifidum DN-173 010 has no effect on dental plaque MS levels in children.

Community-level assessment of dental plaque bacteria susceptibility to triclosan over 19 years.

BackgroundTriclosan is a broad-spectrum antimicrobial agent used in toothpaste to reduce dental plaque, gingivitis and oral malodor. This community-level assessment evaluated the susceptibility of dental plaque bacteria to triclosan in samples collected over 19 years.MethodsA total of 155 dental plaque samples were collected at eleven different times over 19 years from 58 adults using 0.3% triclosan, 2% copolymer, 0.243% sodium fluoride toothpaste and from 97 adults using toothpaste without triclosan. These included samples from 21 subjects who used triclosan toothpaste for at least five years and samples from 20 control subjects. The samples were cultured on media containing 0, 7.5 or 25 μg/ml triclosan. Descriptive statistics and p values were computed and a linear regression model and the runs test were used to examine susceptibility over time.ResultsGrowth inhibition averaged 99.451% (91.209 - 99.830%) on media containing 7.5 μg/ml triclosan and 99.989% (99.670 - 100%) on media containing 25 μg/ml triclosan. There was no change in microbial susceptibility to triclosan over time discernible by regression analysis or the runs test in plaque samples taken over 19 years including samples from subjects using a triclosan-containing dentifrice for at least five years.ConclusionsThis community-level assessment of microbial susceptibility to triclosan among supragingival plaque bacteria is consistent with the long-term safety of a 0.3% triclosan, 2% copolymer, 0.243% sodium fluoride dentifrice.

Protein biomarkers of periodontitis in saliva.

Periodontitis is a chronic inflammatory condition of the tissues that surround and support the teeth and is initiated by inappropriate and excessive immune responses to bacteria in subgingival dental plaque leading to loss of the integrity of the periodontium, compromised tooth function, and eventually tooth loss. Periodontitis is an economically important disease as it is time-consuming and expensive to treat. Periodontitis has a worldwide prevalence of 5–15% and the prevalence of severe disease in western populations has increased in recent decades. Furthermore, periodontitis is more common in smokers, in obesity, in people with diabetes, and in heart disease patients although the pathogenic processes underpinning these links are, as yet, poorly understood. Diagnosis and monitoring of periodontitis rely on traditional clinical examinations which are inadequate to predict patient susceptibility, disease activity, and response to treatment. Studies of the immunopathogenesis of periodontitis and analysis of mediators in saliva have allowed the identification of many potentially useful biomarkers. Convenient measurement of these biomarkers using chairside analytical devices could form the basis for diagnostic tests which will aid the clinician and the patient in periodontitis management; this review will summarise this field and will identify the experimental, technical, and clinical issues that remain to be addressed before such tests can be implemented.

Dental Hygiene Intervention to Prevent Nosocomial Pneumonias

Nosocomial and ventilator associated pneumonias that plague critically ill, elderly and long-term care residents could be reduced with effective oral hygiene practices facilitated collaboratively between nurses and dental hygienists. BackgroundNosocomial pneumonias, specifically aspiration pneumonias and ventilator-associated pneumonias in the elderly and infirm have become a major health care issue, The provision of oral care in hospital and hospital-like facilities presents challenges that can prevent patients from receiving optimal oral care One sequela can be aspiration pneumonia which ranks first in mortality and second in morbidity among all nosocomial infections. Since aspiration pneumonia is linked to the colonization of oral bacteria in dental plaque and biofilm, it is time to look for creative solutions to integrating the expertise of dental hygienists into health care teams in these institutional settings. MethodsA comprehensive review of the literature was conducted regarding the etiology and prevalence of health care related pneumonias. Evidence describing the challenges and barriers that the nurses, nursing staff, and dental hygienists face in the provision of oral care in hospitals and long-term care facilities is provided. Intercollaborative solutions to providing optimal oral care in hospitals and long-term care facilities are suggested. ConclusionDental hygienists have the expertise and practice experience to provide oral care in hospitals, long-term care and residential facilities. They can contribute to solving oral care challenges through intercollaboration with other health care team members. Yet, there are long-standing systemic barriers that must be addressed in order to provide this optimal care. Dental hygienists becoming better assimilated within the total health care team in hospital and residential facilities can positively impact the suffering, morbidity and mortality associated with aspiration pneumonias.