Mouthwash Research Articles

In vitro comparison of zinc-based, chlorhexidine, and essential oil mouth rinses.

Chlorhexidine (CHX)-based mouth rinses are frequently prescribed following periodontal surgeries. A more recently available brand of zinc-based mouth rinses advertises one of its mouth rinses as a substitute for chlorhexidine. The purpose of this study was to evaluate, in vitro, the effects of this brand of zinc-based mouth rinses on cell survival, cell motility, and gene expression of human gingival fibroblasts (HGFs). HGFs were exposed to essential oil (EO), CHX, and three types of one brand of zinc-based mouth rinses designed to treat breath malodor (ZnA), dry mouth (ZnB), and gingivitis (ZnC). Each mouth rinse was tested over a range of concentrations for its effects on HGF survival and motility. Gene expression of cytokines, interleukins, and growth factors were evaluated via reverse transcriptase-polymerase chain reaction (RT-PCR), as a means to assess potential influences on inflammation and wound healing. Cell survival was significantly decreased for CHX and ZnC at 10% dilutions (p<0.05). For all time points, cells exposed to ZnC displayed the greatest reduction in cell motility (p<0.05). The various mouth rinses examined differentially altered the expression of growth factor transcripts. ZnC particularly enhanced the expression of BMP-2 and FGF-2. ZnC was more cytotoxic and inhibited cell motility to a greater extent than any of the other mouth rinses. Therefore, using ZnC as an alternative to CHX could potentially have negative effects on wound healing after periodontal surgery. However, further investigation is required to confirm the clinical relevance of these in vitro findings. One type of zinc-based mouth rinse designed to replace chlorhexidine (often prescribed after oral surgeries) demonstrated the greatest oral cell death and reduction in cell movement when compared to other zinc-based mouth rinses. These zinc-based mouth rinses also reduced the amounts of proteins involved in regulating inflammation, potentially reducing the destruction of bone holding the teeth in place. They also changed the amounts of several molecules involved in tissue healing. It is unknown if this will speed or slow the healing of the soft tissues of the mouth.

Friction versus frictionless mechanics during maxillary en-masse retraction in adult patients with Class I bimaxillary dentoalveolar protrusion: a randomized clinical trial.

Extraction space closure is a challenging phase during orthodontic treatment that affects not only the total treatment duration but also the whole treatment outcome. To compare the efficiency of friction and frictionless mechanics during en-masse retraction of maxillary anterior teeth in adult patients with bimaxillary dentoalveolar protrusion. Two-arm parallel group, single-center randomized clinical trial. Thirty-two adult patients with bimaxillary protrusion were recruited and randomly allocated to two different retraction mechanics. A friction group, using NiTi coil springs and a frictionless group using closing T-loops for en-masse retraction. Randomization in a 1:1 ratio was generated by Microsoft Excel. The randomization numbers were secured in opaque sealed envelopes for allocation concealment. Retraction started in all patients following first premolars extraction using miniscrews as a source of indirect anchorage. Activation was done on a monthly basis until complete retraction of anterior segment. The rate of retraction, amount of anchorage loss, the dental, and soft tissue changes were analyzed on digital models and lateral cephalograms taken before retraction and after space closure. The outcome assessor was blinded through data concealment during assessment. Two patients were lost to follow up, so 30 patients completed the trial. The rate of anterior segment retraction was 0.88 ± 0.66mm/month in the frictionless group compared to 0.72 ± 0.36mm/month in the friction group which was statistically significant. Anchorage loss of 1.18 ± 0.72mm in the friction group compared to 1.29 ± 0.55 mm in the frictionless group with no significant difference. Comparable dental and soft tissue changes following en-masse retraction were reported in both groups, with no statistically significant difference. one patient complained of soft tissue swelling following miniscrew insertion, but the swelling disappeared after one week of using mouth wash. The study focused only on the maxillary arch. Both mechanics have successfully achieved the required treatment objectives in patients with bimaxillary dentoalveolar protrusion. Frictionless group showed a faster rate of retraction than the friction group, which was statistically but not clinically significant. Clinicaltrials.gov with the identifier NCT03261024.

Formulation of mouth rinse from natural plant\'s leaf extract and evaluation of antibacterial activity

Herbal liquid formulations are the preparation for oral health related issues like toothache, swelling, redness, bacterial or fungal infection in mouth, tooth decay, bleeding gums, weakened gums, etc. Such preparation also improves gums strength, removing bad breath and give fresh feel during good start of the day. Dentists generally use such preparations as antimicrobials before or after oral surgery to sanitize the surface of affected gums and teeth to avoid further contamination. Herbs like Tulsi, Clove, Mint, Ginger etc., are generally used either alone or in combination in herbal mouth-wash preparations which also render antibacterial activities. The other herbs like Eucalyptus and Liquorices have been reported to possess antibacterial, anti-oxidant, aromatic, anti- inflammatory and sweetening properties. In the present work, the research continues with formulation and evaluation of a herbal mouth rinse by using a combination of selected herbal extracts of Tulsi, Bael, Eucalyptus leaves and Liquorices rhizome for their antimicrobial activity against S. aureus using agar well diffusion plate technique. It was found that the formulated herbal mouth rinse or preparations gave satisfactory results in controlling the microorganism. Different physicochemical tests of prepared preparations were performed to figure out their pH, phase separation, homogeneity and scent.,

Rationale and design of the Self-TI Study protocol: a cross-sectional human papillomavirus self-testing pilot study among transgender adults in England

IntroductionPersistent infection with high-risk human papillomavirus (HPV) is the causal agent of several cancers including cervical, anal and oropharyngeal cancer. Transgender men and transmasculine non-binary (TMNB) people with a cervix...

Evaluation of Caries Risk Using Cariogram Among Orthodontic Patients Before and During Treatment: A Comparative Study.

Objective The primary objective was to examine the Cariogram parameters among orthodontic patients with fixed appliances and evaluate the impact of preventive measures on mitigating the risk of dental caries during orthodontic therapy. Materials and methods Patients visiting the representative orthodontic clinics across 14 districts of Kerala participated in the comparative cross-sectional study from January 2023 to January 2024. The sampling method employed in this study was convenience quota sampling, where study subjects were allocated from each of the low, moderate, and high caries risk profiles until the sample size reached the minimal requirement within each group. The baseline Cariogram scores were used to divide the consented participants into two distinct groups. The intervention group was provided with preventive initiatives, including toothpaste comprising 1,450 ppm fluoride, 0.2% NaF mouthwash, pre-cut strands of SuperFloss, an orthodontic toothbrush designed for orthodontic braces, and an interdental flexible brush, as well as videos, pamphlets, and brochures that promoted oral health habits. In contrast, the control group received normal oral health education solely through the use of pamphlets and brochures. After six months, the Cariogram elements were re-evaluated for individuals in both groups. The independent sample t-test and paired t-test were applied to evaluate statistically significant differences between and within the two groups, respectively, using IBM SPSS Statistics for Windows, Version 26 (Released 2019; IBM Corp., Armonk, NY, US). The distribution of patients based on their caries risk profiles was compared between groups at the commencement of the study and six months later using the Chi-square test. Results While the intervention group had 20 males and 22 females, the control group consisted of 21 males and 21 females. The average age in the intervention and control groups was 20.7±3.56 years and 21.2±3.12 years, respectively. Between the two groups, age (t=-0.68; p=0.50) and gender differences (λ2=0.05; p=0.83) were statistically insignificant. The percentage mean of the "Chance to avoid caries" associated with the intervention group increased significantly from 46.15±0.96 to 57.88±1.91, (p<0.001). On the other hand, the chance to avoid caries in the control group at the commencement of the treatment and six months later was found to be statistically insignificant. A statistically highly significant differences for all the Cariogram parameters were found when contrasted between the groups after six months of orthodontic treatment. The distribution of caries risk categorization between the control and intervention groups after six months of orthodontic treatment was found to be statistically significant (λ2=20.16;p<0.0001). Further, a statistically significant difference was observed during the pre-treatment phase and six months later in the intervention group (λ2=13.02; p=0.001). Conclusion The study findings reveal that it would be prudent to utilize 0.2% sodium fluoride mouth rinse, SuperFloss, an orthodontic toothbrush designed for orthodontic braces, and an interdental flexible brush, along with toothpaste containing 1450 ppm fluoride daily, to mitigate the risk of dental cavities during orthodontic treatment, in comparison to the control group.

Oral HPV infection clearance and acquisition after nonavalent vaccination in men who have sex with men and transgender women: a prospective analysis.

Oral HPV infection is the main risk factor for the development of oropharyngeal carcinoma. Men who have sex with men (MSM), especially if living with HIV (PLWH), are at increased risk of infection and consequently of cancer development. Aim of this study is to evaluate the impact of nonavalent vaccine on oral HPV infection in a cohort of MSM and transgender women (TGW). This prospective study included all MSM and TGW who started nonavalent HPV vaccination from May 2019 to September 2021. Oral rinse was collected before each vaccine administration and after six months of follow up. Descriptive statistics were used. Kaplan Meier probability curves and Cox regression models for HPV acquisition and clearance were calculated. The analysis included 211 individuals (202 MSM and 9 TGW). PLWH were 138 (65.4%). Baseline oral rinse was positive in 30 subjects (14.2%). Positivity rate did not change over time (p = 0.742), even when restricting the analysis only to high-risk genotypes (p = 0.575) and to genotypes covered by vaccine (p = 0.894). The risk to acquire HPV infection was 12.8% at one year and 33.4% at two years after vaccination. The probability to clear the infection was 67.6% at one year and 87.9% at two years. HIV infection had no impact on vaccine efficacy. Age above 45 years was the only factor associated to HPV acquisition (aHR 4.06, 95% CI 1.03-15.98, p = 0.045). Prevalence of oral HPV infection was higher in PLWH, but HIV had no impact on viral clearance or acquisition after vaccination.

Effect of Chlorhexidine Gluconate (0.2%), Combination (0.2% Chlorhexidine and 0.05% Sodium Fluoride), and Green Tea Extract (0.5%) Mouth Rinses on Colony Count Changes of Streptococcus mutans and Lactobacillus in Saliva – A Randomized Controlled Trial

Abstract Introduction Streptococcus mutans and Lactobacillus acidophilus are the well-known etiological factors for dental caries. Chlorhexidine (CHX) gluconate is the “gold-standard” antimicrobial agent but having adverse effects such as brown staining of the teeth and altered taste. Thus, there is a need for an alternative herbal product. Objective This study was done to compare the efficacy of CHX gluconate (0.2%) and combination (0.2% CHX and 0.05% sodium fluoride [NaF]) mouth rinses to that of green tea extract (0.5%) mouth rinse in reducing the salivary count of S. mutans and L. acidophilus in dental students. Materials and Methods The sample size of the study was 75 dental students with ≥4 decayed, missing, and filled teeth (DMFT) index. They were divided into three equal groups to test various mouth rinses against S. mutans and Lactobacillus. Unstimulated salivary samples were collected at baseline and postrinse (14 days) and tested for the colony-forming units of S. mutans and Lactobacillus. The Chi-square test was used to ascertain the demographic characteristics of the study population. One-way ANOVA statistics and paired t-test were applied to calculate the inferential statistics between the variables. The statistical constant was fixed at P &lt; 0.05. Results The results of the study indicated that there was a statistically significant reduction in S. mutans and Lactobacilli count in all the three study groups. Conclusion Green tea mouth rinse can be a promising preventive therapy worldwide for the prevention of dental caries but CHX mouthwashes are superior in reduction of S. mutans and Lactobacillus.

Oral specimens as a tool for accurate metagenomic analysis: A pilot study

ObjectivesAcute oral mucosal damage, as well as other inflammatory processes seem to be related to dysbiosis of the oral microbiome. The need to study changes in the oral microbiome led us to hypothesize what type of sample would provide the most representative picture of the entire human oral microbiome. Materials and methodsAn observational, and cross-sectional study was carried out. Six healthy adult participants provided 3 different sample types each, that included saliva, oral rinse and mucosal biopsy tissue. We performed 16S rRNA sequencing of the V3-V4 region of the 18 samples using Illumina MiSeq technology. ResultsParticipants were 27 ± 6,3 years old. Bacterial alpha diversity was higher in oral rinse samples compared to whole unstimulated saliva and oral mucosa tissue (p = 0,005). However, saliva specimens showed a 56 % relative abundance of identified species followed by a 30 % in oral rinse and only 1 % in tissue samples. ConclusionsThis study found differences on oral microbiome composition for each type of sample. Oral rinse should be chosen when higher alpha diversity is needed, whereas whole unstimulated saliva should be more appropriate for larger amount of bacterial DNA. Clinical relevanceThe results obtained demonstrate the importance of a correct choice of the optimal type of oral sample for microbiome studies due to the differences found in its composition.

Review of Inherited Coagulation Disorders

Most invasive dental procedures elicit some degree of bleeding which ultimately leads to clotting and eventual hemostasis. However, patients with inherited coagulation disorders may exhibit prolonged or, in some cases, excessive bleeding requiring multiple perioperative interventions. Von Willebrand disease is the most common inherited coagulopathy and often manifests via easy bruising, epistaxis, or prolonged bleeding. Hemophilia A (factor VII) and B (factor IX) are factor deficiencies that are clinically indistinguishable and managed according to severity and the required dental treatment. Other coagulopathies are rare (ie, inheritance is autosomal recessive) and may only become evident in homozygotes or compound heterozygotes. Current lab values and medical consultation with the patient’s hematologist are imperative prior to rendering invasive dental treatment. There are a myriad of sedation and general anesthesia considerations, including risks for epistaxis with nasal instrumentation and bruising with improper patient positioning. Preoperative treatment with desmopressin or factor replacement may be required and generally should facilitate normal hemostasis. Additional therapies should be considered to help ensure adequate postoperative hemostasis, including pressure dressings, resorbable clotting materials, laser therapy, and oral rinses.

Effect of Chlorhexidine and Povidone-iodine Mouth Rinses on Corrosion Resistance and Surface Characteristics of Stainless Steel Orthodontic Brackets – An in vitro and in vivo Study

Abstract Background: Stainless steel (SS) orthodontic brackets may have varying corrosion resistance when used with mouthwashes during orthodontic treatment. Studying their effects on orthodontic brackets will be beneficial. Aim: The study’s objective was to analyze the surface characteristics of SS orthodontic brackets and their resistance to corrosion, exposed to chlorhexidine and povidone-iodine mouth rinses – an in vitro and in vivo study. Materials and Methods: The in vitro test: MBT 0.022” slot SS orthodontic brackets were immersed in three groups – Group A – Modified Meyer-Fusayama artificial saliva (AS), Group B – Chlorhexidine, and Group C – Povidone-iodine mouthwash. The in vivo test: Brackets were conventionally bonded on the patient’s teeth and divided into Group I – control group, Group II – patients used chlorhexidine, and Group III used povidone-iodine mouth rinse. The corrosion resistance and surface characteristics of SS brackets were determined using scanning electron microscope (SEM), electrochemical impedance spectroscopy, and X-ray photoelectron spectroscopy. Results: Higher corrosion resistance was obtained for brackets immersed in chlorhexidine mouth rinse. The polarization resistance value of the orthodontic SS bracket was 109 MΩ, 1383 MΩ, and 769 MΩ immersed in AS, chlorhexidine, and povidone-iodine mouth rinse, respectively. After surface chemical analysis, XPS data showed the largest intensity peak of metallic chromium (CrO) fresh sample and in the sample immersed in chlorhexidine mouthwash. According to SEM, brackets immersed in chlorhexidine showed a relatively smooth surface. Conclusion: In this study, chlorhexidine was found to be less corrosive followed by povidone-iodine.

Effect of hydrogen peroxide and hyaluronic acid in mouth rinse after third molar extraction: a triple-blind parallel randomized controlled clinical trial.

The study aimed to investigate the potential beneficial role of hydrogen peroxide (H2O2) and hyaluronic acid (HA) combination formulation in socket healing after third molar surgery. Biomaterials, including mouthwash formulations, were hypothesized to contribute to improved socket healing and reduced post-operative complications. A triple-blinded parallel randomized controlled clinical trial was conducted at a single-center dental hospital in Milan, Italy. The trial included 114 patients who underwent extraction of impacted, partially erupted, and completely erupted third molars. Patients were randomly assigned to three parallel groups: Group 1 (H2O2 and HA), Group 2 (placebo), and Group 3 (0.2% chlorhexidine). The trial was registered at ClinicalTrial.gov (registration number NCT04438434). The main outcome measures included various parameters related to socket healing, such as pain, inflammation, swelling, plaque index, bleeding index, granulation tissue, suppuration, re-epithelialization, bleeding upon palpation, odor, and taste alteration. Patients were followed up for 7 days. All 114 enrolled patients completed the study, with no dropouts or loss to follow-up. The mean age of patients in the three groups differed (H2O2 and HA: 30.9±14.9; placebo: 27.6±13.1; 0.2% chlorhexidine: 23.05±10.16). Significant reductions (p<0.001) in visual analog scale (VAS) pain levels and other outcome measures were observed in the H2O2 and HA group compared to the placebo group. These findings suggest a positive effect of the H2O2 and HA combination on socket healing after the third molar surgery. The study concludes that the combination of hydrogen peroxide and hyaluronic acid can be considered a potential mouthwash with beneficial effects on socket healing following third molar surgery. However, additional clinical trials are recommended to validate its effectiveness further and provide additional evidence supporting its use in clinical settings. gov: NCT04438434.

The positive effects of preoperative chlorhexidine rinse to reduce postoperative pneumonia after kidney transplantation surgery

BackgroundPostoperative pneumonia is one of the most observed hospital-acquired infections and increases the postoperative mortality rate. Further, it drives the healthcare systems under a severe financial burden. Preventing postoperative pneumonia is an incredibly challenging issue for clinicians. Since immunosuppression therapy, the patients who had kidney transplants are more vulnerable to postoperative infections. There is no data in the scientific literature focusing on the effects of preoperative oral care with chlorhexidine antiseptic solutions on postoperative pneumonia in kidney transplantation surgery cases. In the present research, we studied this topic. MethodsA prospective, randomized clinical trial was conducted at our institution between August 2020 and August 2022. Group A: Received 0.12 % chlorhexidine oral rinse preoperatively; Group B: Not received 0.12 % chlorhexidine oral rinse preoperatively. We analyzed the differences between the two trial groups using a chi-square or t-test. The Mann-Whitney U test was used for the categorical data. ResultsNine patients (17.6 %) were diagnosed with postoperative pneumonia in Group A and fourteen (25.9 %) in Group B (p < 0.05). Hospitalization time of Group B was prolonged (p < 0.05). In multivariate analysis, significant risk factors associated with postoperative pneumonia were advanced age, diabetes mellitus, smoking, delayed graft function and not gargling with 0.12 % chlorhexidine (p < 0.05). ConclusionsTo reduce postoperative pneumonia risk in patients undergoing kidney transplantation surgery, an oral health protocol including 0.12 % chlorhexidine mouth rinse seems beneficial.

Herbal Formulation of High Phenols and Flavonoids with the Extract of Phyllanthus emblica, Punica granatum, and Illicium verum and Assessment of Hematotoxicity Assay: An In vitro Study.

A growing number of consumers are embracing the philosophy that natural products are better for their health and the environment. As such, they are seeking products they perceive to be safer, healthier, and without toxic chemical or synthetic ingredients. Natural products are gentle enough for daily use and provide a less abrasive alternative to more potent prescription formulations meant for short-term use. Herbal antimicrobial and antioxidant mouth rinses are considered effective adjuncts to toothbrushing and flossing for patients having gingivitis who have undergone implant treatment, providing a clinically significant benefit in the reduction of dental plaque, and also being antioxidant in nature. Three types of plant species were taken into consideration. Phyllanthus emblica fruit, Punica granatum flower, and Illicium verum fruit and seed were collected from the native trees of Chennai, Tamil Nadu. We conclude that P. emblica fruit, P. granatum flower, and I. verum fruit and seed exhibit large amounts of flavonoids, phenolics, and tannins. This study also shows that these samples can be used in clinical practice as it has less hematotoxixity percentage. P. granatum that is a pomegranate flower shows a high positive percentage in the presence of flavonoids and phenols. These plant extracts can be used in further studies and in clinical use as mouthwash or topical gel by adding preservatives and flavoring agents.

How well do antimicrobial mouth rinses prevent dysbiosis in an in vitro periodontitis biofilm model?

Periodontal diseases are associated with dysbiosis in the oral microbial communities. Managing oral biofilms is therefore key for preventing these diseases. Management protocols often include over-the-counter antimicrobial mouth rinses, which lack data on their effects on the oral microbiome's ecology, bacterial composition, metabolic activity, and dysbiosis resilience. This study examined the efficacy of antimicrobial mouth rinses to halt dysbiosis in in vitro oral biofilms under periodontitis-simulating conditions. Multispecies oral biofilms were grown on hydroxyapatite discs (HADs) and rinsed daily with one of six mouth rinses. Positive and negative controls were included. After three rinses, biofilms were analyzed with viability quantitative polymerase chain reaction and visualized using scanning electron microscopy. Supernatants of rinsed biofilms were used for metabolic activity analysis. In addition, human oral keratinocytes were exposed to rinsed biofilms to assess their inflammatory response. All outputs were analyzed for correlation using Spearman coefficient. Product-related changes were observed in the rinsed biofilms. Three of the six tested mouth rinses could significantly prevent dysbiosis with ≥30% reduction in pathobiont abundance relative to the control. These biofilms had lower metabolic activity, and the exposed human oral keratinocyte produced less interleukin-8. Interleukin-8 production correlated to both pathobiont quantity and the metabolic activity of the biofilms. Some mouth rinses could support biofilm resilience and stop dysbiosis evolution in the biofilm model, with a clear product-related effect. Such mouth rinses can be considered for patients under maintenance/supportive periodontal therapy to prevent/delay disease recurrence. Others are more useful for different periodontal therapy stages.

Morphological, Phytochemical and Pharmacological Properties of Carum carvi (Caraway) and Bunium persicum (Black Caraway) Seeds: A Review

Carum carvi and Bunium persicum belongs to Apiaceae family. Both the species are medicinally important and has been used as antimicrobial, antioxidant, anticarcinogenic, antidiabetic, to treat heart problems, spice, condiments and breath freshener or lotions industries etc. Due to morphological similarities, the adulterations are being observed, so it is essential to understand the morphological, phytochemical and pharmacological properties of both the seeds. The plants look similar with approximately similar flower colour. Most prominent difference is in root structure. The roots of C. carvi are fleshy, fusiform tap while that of B. persicum is tuberous. C.carvi seeds are larger than that of B. persicum, with comparatively lighter brown colour. The seeds of C. carvi are sickle shaped while the seeds of the B. persicum are cylindrical in shape. Chemical composition of essential oil is approximately similar with variation in the percentage content of various compounds. Both the seeds are used for food preparation with some variation in their utilization due to difference in their aroma.

Sucralose Mouth Rinse Enhances Cephalic Phase Insulin Release

Objective: To assess the combined and independent effects of energy content and sweetness on cephalic phase insulin release (CPIR) and compare responses in adults with normal weight (NW) and obese (OB) body mass indexes (BMI). Methods: In this randomized, double-blind crossover study, 39 adults (NW: n=21; OB: n=18), aged 18-45y (24±5y), rinsed with mouth rinses containing either sucrose, sucralose, maltodextrin, or water for 2min before expectorating the solution. Blood sampling occurred at -5, 1, 3, 5, 7, 10, and 15min following each mouth rinse to assess changes in glucose and CPIR. Results: All rinses elicited increases in insulin (d = -0.5) and glucose (d = -1.1) (p&lt;0.05). There was enhanced CPIR in response to sucralose vs. sucrose (d = 0.4, p=0.004), driven by OB (d = 0.3, p=0.001) vs. NW (p=0.99). For glucose, there was a greater increase following maltodextrin vs. water (d = 0.3, p=0.01), driven by OB (d = 0.2, p=0.02) vs. NW (p=0.99).Conclusion: Sucralose and maltodextrin elicited more robust CPIR and enhanced glucose release, with differences occurring only amongst OB. As postprandial hyperglycemia is a hallmark of obesity, sucralose and maltodextrin rinsing may be important for improving post-meal responses in adults with obesity.

The effect of different sweeteners on the oral microbiome: a randomized clinical exploratory pilot study

ABSTRACT Introduction The aim of the study was to evaluate the modulating effects of five commonly used sweetener (glucose, inulin, isomaltulose, tagatose, trehalose) containing mouth rinses on the oral microbiome. Methods A single-centre, double-blind, parallel randomized clinical trial was performed with healthy, 18–55-year-old volunteers (N = 65), who rinsed thrice-daily for two weeks with a 10% solution of one of the allocated sweeteners. Microbiota composition of supragingival dental plaque and the tongue dorsum coating was analysed by 16S RNA gene amplicon sequencing of the V4 hypervariable region (Illumina MiSeq). As secondary outcomes, dental plaque red fluorescence and salivary pH were measured. Results Dental plaque microbiota changed significantly for two groups: inulin (F = 2.0239, p = 0.0006 PERMANOVA, Aitchison distance) and isomaltulose (F = 0.67, p = 0.0305). For the tongue microbiota, significant changes were observed for isomaltulose (F = 0.8382, p = 0.0452) and trehalose (F = 1.0119, p = 0.0098). In plaque, 13 species changed significantly for the inulin group, while for tongue coating, three species changed for the trehalose group (ALDEx2, p < 0.1). No significant changes were observed for the secondary outcomes. Conclusion The effects on the oral microbiota were sweetener dependant with the most pronounced effect on plaque microbiota. Inulin exhibited the strongest microbial modulating potential of the sweeteners tested. Further full-scale clinical studies are required.

Supra- and Subgingival Microbiome in Gingivitis and Impact of Biofilm Control: A Comprehensive Review.

This comprehensive review aimed (1) to characterize the sub- and supragingival microbiome in patients with biofilm-induced gingivitis (including experimental gingivitis), (2) to assess its stability and evolution over time, and (3) to assess the impact of biofilm control measures on this stability. An electronic search of the MEDLINE®/PubMed® database until December 2023 was conducted. NCBI Taxonomy, eHOMD 16S rRNA Reference Sequence, and Tree Version 15.23 databases were used to standardize taxonomic nomenclature. Out of 89 papers initially retrieved, 14 studies were finally included: 11 using experimental gingivitis as a model and three randomized clinical trials evaluating the impact of biofilm control measures. Among them, five characterized the subgingival microbiome, nine the supragingival microbiome, and one both the sub- and supragingival microbiome. In addition, five studies evaluated the effect of toothpaste, and four studies evaluated the effect of mouth rinses. The diversity and structure of the microbiome differed significantly between patients with periodontal health and those with biofilm-induced gingivitis (including experimental gingivitis). Those differences were not reversed through conventional oral hygiene measures. Specific antiseptic agents, especially if delivered as mouth rinses, may have an impact on the supra- and subgingival microbiome in gingivitis.

Patient perceptions of advanced practice radiation therapists prescribing medication in radiation therapy

IntroductionThe purpose of this study was to determine patient perceptions of an advanced practice radiation therapist (APRT) prescribing medication for radiation therapy treatment-related side effects. By comprehending patient perceptions, it is important to implement change in order to improve patients’ quality of life. MethodsA literature review was conducted on advanced practice (AP) roles in Canada and world-wide; the roles searched were: APRT, nurse practitioner and pharmacist. The search focused on evidence demonstrating improvements made to patient care due to the implementation of these roles. Based on this review and input from a team of experts a qualitative semi-structured interview survey was designed, and pilot tested. The survey consisted of five open-ended questions, which were designed to determine patient satisfaction of an APRT prescribing medication over the course of their radiation therapy treatments. Patients undergoing head and neck radiation therapy treatments at a large, academic cancer centre were invited to participate. Six patients who had a head and neck APRT involved in their treatment were interviewed. A comprehensive thematic analysis was then conducted using the transcripts created from these interviews, which was followed by two independent blinded analyses to ensure validity of the results. DiscussionThe thematic analysis produced four salient themes which were: side effect management, care provided by the APRT in comparison to other healthcare workers, patients’ access to care, and overall patient satisfaction. Common medications for head and neck radiation therapy treatment related side effects were discussed and these were: Magic Mouthwash, Xylocaine, Nystatin, Benadryl, Advil, Tylenol, Dexamethasone, Tantum, Biotene, Mucaine, Flamazine, Hydrocortisone, Ondansetron, Senokot, and narcotics. ConclusionThis study was valuable to understand patient experiences and provide evidence to change processes in order to improve quality of patient centered care. The study revealed that although patients were happy with the process of prescribing medication, they all agreed that having an advanced practice radiation therapist prescribe would improve care. Patient responses further demonstrated the need for future research in regards to side effect management as a whole by APRTs as well as how role clarification can impact patient perceptions of APRTs.

Is Oral Microflora Related to Development of Malfunction in Patients Using Voice Prosthesis?

Background: this prospective study investigated the correlation between the oral bacterial microflora and the microflora found in voice prostheses (VPs) among 20 patients who had undergone laryngectomy. The aim was to explore the associations between the microflora's presence and the malfunction of VPs, along with the association between the predominant microorganism and the longevity of VPs. Methods: the research process included gathering medical histories, conducting ENT examinations, replacing VPs, and performing check-ups every four months for a period of 15.5 months. Additionally, microbiological examinations, blood tests, and voice change surveys were conducted. Results: a correlation between the microflora isolated from VPs and that from oral rinses was demonstrated in a large percentage of patients who experienced a loss of prosthetic functional efficiency. The correlation analysis between the type of microorganism and the lifespan of VPs showed a non-significant Pearson correlation coefficient (r = 0.043, p = 0.678). Conclusions: there is no significant linear correlation between the predominant microorganism and the average lifespan of VPs.