Salivary Bacterial Counts Research Articles

Salivary Bacterial Count and its Implications on the Prevalence of Oral Conditions

To determine the relationship between salivary bacterial count and some oral lesions. This research was designed as a cross- sectional study assessing the mean bacterial count in the saliva of Nigerians in Ile-Ife who has no history of medical illness. Subjects were randomly selected from consenting staffs and students of Obafemi Awolowo University, Ile-Ife, Nigeria. Oral examinations were done and their saliva collected using spitting method. The bacterial count was determined in the laboratory by culture the bacteria after which the counting was done using colony counter. Data analysis was done using STATA 13 software. A total of sixty participants were recruited for the study, 41 males and 19 females, their mean age was 23.12+3.8 years. The mean salivary bacteria count among the participants was 8.41 × 108 + 1.06 × 109 per mL. The salivary bacterial count is highest among those with poor oral hygiene (1.89 × 109) and also increases with age. Males have a higher bacterial load compared to female. Subjects with periodontitis have the highest bacterial load and are significantly higher in patients with periodontitis in comparison with those who do not have periodontitis p = 0.03 Conclusion: Periodontitis is associated with the significantly higher salivary bacterial load. Male sex and increasing age were also associated with increased bacterial load in saliva. This study showed another potential role of saliva as a reliable diagnostic tool to monitor the severity of oral infections. It also showed the association between salivary bacterial count and some oral lesions further substantiating the possibility of using saliva to monitor disease progression and treatment responses.

Effect of xylitol and sugar-free chewing gums on salivary bacterial count of streptococcus mutans and lactobacilli in a group of Egyptian school children of different ages: A randomized clinical trial

AimThe purpose of this randomized clinical trial was to compare the effect of xylitol containing and sugar free brands of chewing gum on the salivary Colony Forming Unit (CFU) count of streptococcus mutans (SM) and lactobacilli (LB) cariogenic organisms in a group of Egyptian school children of different ages. Study designThis pragmatic randomized controlled trial (parallel group design) was approved by the Research Ethics Committee of the Faculty of Dentistry, Ain Shams University. Materials and methods42 high caries risk children (DMFT/dmft/deft of 3 or more) were randomly allocated to either the xylitol or polyol group. Each main group was divided into three equal subgroups. Each subgroup comprised a block of seven children of the same age group as follows: Nursery group aging 3–6 years, junior primary school group aging 6–9 years and senior primary school group aging 9–12 years. Salivary analysis was carried out at baseline and after three weeks of daily gum chewing to all participating children by recording his/her stimulated salivary flow and salivary CFU counts of SM and LB bacteria. ResultsCompared to polyol gum, xylitol gum showed lower SM CFU counts. LB CFU counts were not affected by either gum types. However, there was no statistically significant difference between the two chewing gum groups in the different ages and regardless of age. ConclusionXylitol gum is more effective in decreasing SM count in saliva compared to polyol gum wheras both sugarless chewing gums show similar effect on LB species.

Impact of different concentrations of an octenidine dihydrochloride mouthwash on salivary bacterial counts: a randomized, placebo-controlled cross-over trial

This bi-centric, placebo-controlled, randomized, evaluator-blinded, incomplete cross-over clinical phase II trial was initialized to identify the most appropriate concentration of octenidine dihydrochloride (OCT) in mouth rinses. Rinses of 0.10, 0.15, and 0.20% OCT were compared to a saline placebo rinse regarding the reduction of salivary bacterial counts (SBCs) in 90 gingivitis patients over 4days. Changes in plaque (PI) and gingival index (GI), taste perception, and safety issues were evaluated. At baseline, the first OCT (0.10, 0.15, 0.20%) rinse resulted in a decrease of SBC (reduction by 3.63-5.44 log10 colony forming units [CFU]) compared to placebo (p < 0.001). Differences between OCT concentrations were not verified. After 4days, the last OCT rinse again resulted in a significant SBC decrease (3.69-4.22 log10 CFU) compared to placebo (p < 0.001). Overall, SBC reduction between baseline and day 4 was significantly higher in OCT 0.15 and 0.20% groups compared to OCT 0.10% and placebo. Mean GI/PIs were significantly lower in OCT groups than in the placebo group (p < 0.001). Differences in GI/PI between OCT groups were not verified. Adverse effects increased with increasing OCT concentrations. Considering antibacterial efficacy, frequency of adverse events, and user acceptance, 0.10% OCT was identified as the preferred concentration to be used in future clinical trials. Due to its low toxicity and pronounced antibacterial properties, octenidine dihydrochloride (OCT) is a promising candidate for the use in antiseptic mouth rinses. OCT concentrations of 0.10% are recommended for future clinical trials evaluating the plaque-reducing properties of OCT mouth rinses. ( www.clinicaltrials.gov , NCT022138552).

Effect of Probiotic Lactobacillus reuteri on Salivary Cariogenic Bacterial Counts among Groups of Preschool Children in Jeddah, Saudi Arabia: A Randomized Clinical Trial

To evaluate the effect of probiotic Lactobacilli reuteri lozenges on caries-associated salivary bacterial counts (Mutans streptococci and Lactobacillus), dental plaque accumulation, and salivary buffer capacity in a group of preschool children. The study group consisted of 178 healthy children (aged 3-6 years). Children were randomly grouped: the experimental group (n = 90) received L. reuteri probiotic lozenges and the control group (n = 88) received placebo lozenges, twice daily, for 28 days. Salivary Mutans streptococci and Lactobacillus counts, and buffer capacity were assessed using chair-side caries-risk test (CRT®) kits. The Simplified Oral Hygiene index (OHI-S) was used to assess dental plaque accumulation at baseline and after 28 days. After 28 days, the experimental group had a statistically significant reduction in Mutans streptococci and lactobacilli (p = 0.000 and p = 0.020, respectively) and both groups had less plaque accumulation than at baseline. While the buffer capacity in the experimental group increased more than in the control group, it was not statistically significant (p = 0.577). Compliance was 90%, with no adverse events. Consumption of probiotic lozenges containing L. reuteri reduces caries-associated bacterial counts significantly. Probiotics consumption may have a beneficial caries-preventive effect.

Effects of xylitol-containing chewing gum on the oral microbiota.

In this interventional study, a randomized controlled trial was used to evaluate the short-term effects of xylitol-containing chewing gum on the salivary microbiota. In total, 70 healthy adult men recruited from the Japan Ground Self Defense Force participated in the study during a 2-day training at Yamaguchi camp, Yamaguchi Prefecture, Japan. The men were randomly divided into two groups: one group chewed two pieces of xylitol-containing chewing gum 7 times/day for 2 days (n = 34) and the other did not (n = 36). Baseline and follow-up stimulated saliva samples were collected and the salivary microbial composition was assessed using the 16S rRNA gene next-generation sequencing analysis. The total salivary bacterial count was quantified using a quantitative real-time PCR system. No statistically significant difference was found between the two groups regarding any parameter analyzed in the baseline samples; however, the follow-up samples of the test group showed significantly lower total salivary bacterial count than those of the control group. Conversely, no significant difference was observed in the overall composition of the salivary microbiota between the baseline and follow-up samples of the two groups. These results indicate that xylitol-containing chewing gum inhibits the increase in total salivary bacteria over a short time during which the salivary microbial composition is not affected.

Multicentered epidemiological study of factors associated with total bacterial count in the saliva of older people requiring nursing care.

To clarify whether the number of present teeth, independent of other well-known factors, was associated with the total bacterial count in the saliva of older people requiring care at nursing homes in a multicentered epidemiological survey. The participants were 618 older people (mean age 86.8 ± 6.9 years; 122 men, 496 women) residing in 14 nursing homes across Japan. The dependent variable was the participant's salivary bacterial count, and the independent variables were basic demographic data, oral conditions and activity of daily living (measured by Barthel Index). Statistical analysis was first carried out by Student's t-test, Pearson's correlation coefficient analysis and Spearman's rank correlation coefficient analysis. Independent variables found to have a significant relationship to their salivary bacterial count by the univariate analyses were further examined by stepwise multivariate analysis. The independent variables shown by univariate analysis to have a significant positive relationship with higher salivary bacterial count were presence of food residue (P = 0.001), absence of mouth dryness (P = 0.001), need of oral care assistance (P = 0.001), inability to keep the mouth opened (P = 0.009), inability to gargle (P = 0.002), denture use (P = 0.004), higher number of present teeth (P = 0.006) and lower Barthel Index (P = 0.001). Subsequent multivariate analysis identified presence of food residue (P = 0.031), higher number of present teeth (P = 0.043) and lower Barthel Index (P = 0.001) as independent associated factors for higher salivary bacterial count. The present study found that presence of food residue, higher number of present teeth and decreased activity of daily living were significantly related to higher bacterial count in the saliva of older people requiring care. Geriatr Gerontol Int 2017; 17: 219-225.

Effectiveness of electric toothbrushing in patients with neuromuscular disability: A randomized observer-blind crossover trial.

To evaluate the effectiveness of an electric toothbrush for oral care in patients with neuromuscular disability. In this randomized observer-blind crossover trial, 30 patients with neuromuscular disease performed either electric or manual toothbrushing each for 4 weeks. Plaque status (plaque control record), periodontal pocket depth, oral status (oral assessment guide), salivary bacterial count, and toothbrushing time were assessed after each period and compared between the two groups by Wilcoxon signed-rank test. Twenty-eight patients completed the study, including 18 communicative patients. Periodontal pockets were significantly shallower and toothbrushing time was significantly shorter with electric toothbrush use than with manual toothbrush use. No significant differences in oral status and salivary bacterial counts were noted between the approaches, but plaque status significantly improved after electric toothbrushing in communicative patients. Electric toothbrushing is beneficial for maintaining oral health in patients with neuromuscular disability and reducing the caregivers' oral care burden.

Antimicrobial efficacy of two commercially available toothpastes on salivary Streptococcus mutans, Lactobacillus, and Candida: A randomized controlled trial

Aim: To assess and compare the antimicrobial efficacy of two commercially available tubes of toothpaste on salivary Streptococcus mutans , Lactobacillus, and Candida . Setting and Design: A total of 30 school children at the age of 4-6 years with decayed, missing, and filled teeth ≤2, subjected to similar dietary restrictions were randomly divided into two Groups A and B. Children in Group A were provided with Pediflor toothpaste and in Group B with Kidodent toothpaste. Saliva was collected for all the children and the baseline salivary count for Streptococcus , Lactobacillus, and Candida were recorded. The brushing technique was demonstrated and the students were asked to brush twice daily. Salivary bacterial counts were again assessed after 30 days and 60 days respectively. Statistical Analysis: The results were statistically analyzed using Friedmans test and Mann-Whitney U-test. Results and Conclusion: The baseline means salivary S. mutans count significantly reduced from 58.4 to 12.67 in Group A and from 58.73 to 13.8 in Group B in 60 days ( P = 0.001). Similarly, Lactobacillus count reduced from 25.07 to 6.0 in Group A and from 26.60 to 6.13 in Group B in 60 days ( P = 0.001). Candida count was too less to be subjected to statistical analysis. Both Pediflor and Kidodent toothpaste showed a marked reduction of S. mutans and Lactobacillus at 30 and 60 days intervals. But there was no statistically significant difference between the two pastes.

Efficacy of adjunctive usage of hydrogen peroxide with chlorhexidine as preprocedural mouthrinse on dental aerosol

Background: The microbial reservoirs of infectious bioaerosols include saliva, calculus, and dental unit water line. Previous studies have observed a reduction in salivary bacterial counts with the usage of chlorhexidine. In this study, calculus has additionally been targeted with the adjunctive usage of hydrogen peroxide followed by chlorhexidine mouthrinse. Aims and Objective: To evaluate the efficacy of preconditioning using 1.5% hydrogen peroxide followed by rinsing with 0.2% chlorhexidine over chlorhexidine alone, with saline as a negative control in reducing the microbial counts in the aerosol produced during ultrasonic scaling. Materials and Methods: Fifteen chronic periodontitis subjects were randomly allocated into three groups. Before scaling, groups 1 and 2 subjects were made to rinse with saline and 0.2% chlorhexidine, respectively. In group 3 patients, calculus was conditioned with a topical application of 1.5% hydrogen peroxide before chlorhexidine mouthrinse. The aerosol produced from the ultrasonic unit was collected at three designated areas on agar plates. The plates were incubated at 37C for 48 h and colony-forming units (CFU) evaluated. Result: The CFUs were the lowest in group 3 at the three designated locations (p = 0.007, 0.006, and 0.003, respectively). Hydrogen peroxide as an adjunct to chlorhexidine showed a statistically significant decrease in the CFUs at the patient and assistant sides, when compared with chlorhexidine alone. Conclusion: This pilot study showed that the adjunctive use of hydrogen peroxide with chlorhexidine is superior to lone usage of chlorhexidine in combating the infected dental aerosols.

Dental caries among a group of boys with β-thalassemia major (10-12 years old) in relation to salivary Mutans streptococci

Background: Beta thalassemia major is an inherited disorder that may affect general and oral health.The purpose of this study was toassess the severity of dental caries in relation to oral cleanliness, mutans streptococciamong a group of boys with beta thalassemia majorin comparison with a control group. Materials and Methods: The study involved 30 boys with BTM aged 10-12 years compared to 30 healthy boys with the same age group. d1-4mfs and D1-4 MFS indices were applied (Muhlemann, 1976), the viable counts of mutans streptococci in stimulated saliva were also determined. Results: The entire thalassemic group was caries-active. For both dentitions, a higher dmfs/DMFS values were recorded for study compared to control group, difference was statistically not significantconcerning dmfs, while it was statistically significant concerning DMFS (P<0.05). Salivary bacterial counts of mutans streptococci were found to be higher in the study compared to control group and the difference was statistically highly significant (P<0.01).All correlations between bacterial counts and dmfs/DMFS indices in study group were statistically not significant. Conclusion: Patients with Beta thalasemic major had more caries severity compared to normal subjects.

구강소독제의 적용 시간 및 기계적 세척 여부에 따른 타액 내 세균 수의 감소 효과

Abstract Salivary Bacterial Counts on Application Time of Oral Antiseptic Agents and Mechanical Irrigation Hyoung-Sup Lim, Jae-Jin Kim 1 , Mija Kim 2 , Hak Kyun Kim 1 Department of Oral and Maxillofacial Surgery, School of Dentist ry, Chosun University, 1 Department of Oral and Maxillofacial Surgery, School of Medicine, Chungnam National University, Rese arch Institute for Medical Sciences, Chungnam National University, 2 Department of Nursing, Pai Chai UniversityPurpose: The purpose of this study is to establish the acceptable intraoral application time of antiseptic agents and evaluate the effect of mechanical irrigation. Methods: A total of 80 subjects were selected for this study. Saliva secreted at the resting state was taken. The subjects were divided into 8 experimental groups, and kept 10% povidone- iodine (PVI) or 0.2% chlorhexidine gluconate (CHX) for 20 or 40 seconds in their oral cavity with/without irrigation o f the oral cavity with sterilized normal saline, respectively. Then, the saliva was taken and diluted with phosphate buffered saline and then plated onto 5% sheep blood agar plates, which were incubated. Colony forming unit (CFU) was measured fo r the salivary bacterial counts.Results: After application of PVI and CHX, all the experimental groups showed statistically significant decrease in CFU (P＜0.01). Group 2 (PVI, 40 s) showed more significant reduction rate in C FU than group 4 (CHX, 40 s; P＜0.01). Group 6 (PVI, 40 s, irrigated) showed more significant reduction rate than gr oup 2 (PVI, 40 s; P＜0.01). Group 2 (PVI, 40 s) showed more significant reduction rate than group 1 (PVI, 20 s; P＜0.01). Conclusion: Application of PVI for 40 seconds and mechanical irrigation wi th sterilized normal saline showed the best result among the 8 groups in terms of the reduction rate of sal ivary bacterial counts.Key words:Povidone-iodine, Chlorhexidine, Irrigation, Bacteria

Evaluation of the effect of Persian shallot (Allium hirtifolium, boiss) aqueous extract on mouth bacterial count compared with chlorhexidine mouth rinse

This study attempted to compare Persian shallot aqueous extract with commercially available chlorhexidine mouth rinse with respect to their anti-microbial activity on salivary bacterial counts. Three groups of 10 volunteers with a healthy oral status, were randomly enrolled. Using sterile water as negative control, using 0.2% chlorhexidine as standard control and Persian shallot aqueous extract for test group. A single mouth rinse lasting 15 s of each mouth rinse was employed. Salivary bacterial counts were obtained by collecting unstimulated saliva samples at the beginning before rinsing for measurement of baseline count and 1, 5 and 24 h after rinsing with the assigned solution. Analysis of variance and Bonferroni post hoc tests were used to evaluate significant differences among groups. No significant differences among the allocated groups were detected at baseline. Chlorhexidine produced more significant reduction of salivary bacterial count relative to both shallot and distilled water control at 1 h. In addition, a significant difference at 1 h was also detected between both chlorhexidine and shallot extract with distilled water. Furthermore, at 5 h there was a significant difference in bacterial count between chlorhexidine and shallot extract. After 24 h, the level of bacterial count in shallot extract was still significantly lower than both chlorhexidine and distilled water control groups. The results of this study suggest that Persian shallot extract has more persistent inhibitory action than chlorhexidine mouth rinse lasting up to 24 h. Key words: Antimicrobial mouth rinse, Persian shallot extract, oral bacteria.

Prevenzione orale in alunni del primo anno della scuola primaria

Objectives To evaluate the oral health of children enrolled in the first grade of a primary school in L’Aquila (Italy) during the years 2008-2009 and 2009-2010 and to provide them with free-of-charge dental care. Materials and methods The study included 105 children, aged 6 ± 1 years (64 males and 41 females). Each child had a dental examination that included (as needed) the application of a plaque revealer, plaque and tartar removal, the application of fluoride, saliva testing, and sealing of fissures. Children were also educated about the importance of oral hygiene. Results In 2009, 74 of the 105 pupils enrolled (42 males and 32 females) received treatment, consisting in the application of a plaque revealer (n = 49), tartar and pigment removal (n = 47), application of fluoride gel (n = 42), fissure sealing (n = 36), measurement of salivary pH (n = 66), and salivary bacterial counts (n = 63). In 2010, 36 of the children were retreated. During the first year of the study, the difference between the numbers of enrolled and treated children was linked to the poor cooperation of families; during the second year, the difference was related to logistic and strategic difficulties caused by the earthquake that struck the region on April 6, 2009. The results showed a decrease in the dental plaque index from 58% (2009) to 31% (2010). In addition, the 2009 examination (total no. of children = 74) revealed two filled permanent teeth and 12 permanent teeth that were decayed; in 2010, in 36 children, there were two filled permanent teeth and 9 with caries. In 2010, sealants were reapplied in five cases. Conclusion The Dental Department of the University of L’Aquila plans to extend this study to other schools in the same geographic area to decrease the incidence of the most frequent oral diseases, thereby warranting children's right to good health.

Effects of Flavoured Mouth Rinses on Morning Breath Odour: a Sensory, Analytical and Microbial Evaluation

AbstractTransient oral malodour such as morning bad breath is very common and is caused by accumulation of bacteria and food residues, mainly at the posterior part of the tongue. The use of antimicrobial flavours may help to reduce malodours with limited side effects. The purpose of this work was to compare the effects of five alcohol‐free mouth rinses containing 0.2% w/w antimicrobial flavour oil on 24 human subjects in a randomized, double‐blind clinical study. Two mouth rinses containing triclosan and peppermint oil were used as positive controls. Oral malodours and flavour intensities, as well as analytical and microbial analyses of saliva samples, were performed before rinsing and 1 min and 1 h after rinsing the mouth with a 20 ml mouth rinse for 1 min. Immediately after rinsing, oral malodour scores and salivary bacterial counts were markedly reduced (85 ± 9% and 54 ± 12% decreases, respectively). At 1 h after rinsing, maximum efficacy (61 ± 18% reduction in oral malodours, 40 ± 11% decrease in salivary bacterial count) was observed with the mouth rinses containing the highest levels of menthol, limonene, carvone and eugenol, and these ingredients could still be detected in the saliva of most subjects. The finding that selected antimicrobial flavours have beneficial effects against salivary microorganisms and transient oral malodours may be important for the design of oral care products that promote fresh breath up to 1 h after rinsing without compromising taste.

Extract of Juglandaceae regia inhibits growth, in-vitro adherence, acid production and aggregation of Streptococcus mutans.

Aqueous and alcoholic extracts from Juglandaceae regia, used as chewing sticks to maintain oral hygiene, were tested for their ability to inhibit the growth and some physiological functions of Streptococcus mutans. Both the aqueous and the alcoholic extract strongly inhibited the growth, in-vitro adherence, acid production and glucan-induced aggregation of S. mutans. At a concentration of 8% w/v, the aqueous extract produced a 95% inhibition (P < 0.05) of adherence of S. mutans to glass and a 40% inhibition (P < 0.05) of adherence to tooth surface. The alcoholic extract at a concentration of 10% w/v produced a 95% inhibition (P < 0.05) of adherence of S. mutans to glass and a 56% inhibition (P < 0.05) of adherence to tooth surface. At concentrations of 2% w/v the aqueous and alcoholic extracts significantly inhibited (P < 0.05) glucan-induced aggregation of S. mutans and the in-vitro salivary glycolytic reaction for up to 5 h. Bactericidal effects on S. mutans were also evident. At a concentration of 10% w/v, the zone of inhibition observed with the aqueous extract was 12+/-0.01 mm and that observed with the alcoholic extract was 12.6+/-0.02 mm. As the in-vitro studies had shown that both the aqueous and the alcoholic extract of J. regia, at concentrations of 10% w/v, could inhibit the growth as well as the acid-producing ability of S. mutans, they were tested at the same concentration for their activity in-vivo. Three subjects were employed. Parameters monitored were salivary bacterial count and salivary glycolysis. Mouth-rinsing with the aqueous but not the alcoholic extract significantly reduced total streptococcal counts in the salivary samples obtained up to, and including, 3 h after rinsing, compared with the counts obtained pre-rinsing or after placebo rinsing. Mouth-rinsing with the aqueous extract produced a 65%, 27% and 78% reduction (P < 0.05) in the streptococcal count in the salivary samples obtained 10 min, 1 h and 3 h after rinsing, respectively. Both the aqueous and the alcoholic extract also inhibited the glycolytic reaction by the salivary bacteria for up to 90 min post-rinsing. This study provides evidence to justify the use of J. regia sticks as an aid to maintain oral hygiene.

Effect of saline irrigation used in combination with antimicrobial agents on salivary bacterial counts

Introduction: The aim of the present study was to investigate the effect of mechanical irrigation in combination with mouthwash of antimicrob ial agents on salivary bacterial counts. Materials and Methods: This study was performed with a randomized study employing a panel of 40 healthy volunteers (20 males and 20 females) between the age of 26 and 32 years. Volunteers were randomly put in one of four treatment groups. In the first group, 0.2 mL of non-stimulatory saliva was collected from every subjective person. Then, saliva was collected after rinsing with chlorhexidine (CHX) for 1 minute. In the second group, nonstimulatory saliva was collected, and then saliva was collected after rinsing with CHX and irrigation with saline. In the third and fourth groups, the same procedures as the first and second groups were performed with povidone iodine (PVI) instead of CHX. All of these samples w ere cultured for 48 hours aerobically. The reduction rates of colony-forming units (CFU) were calculated for each group. The reduction rate between each group was tested statistically using student t-test. Results: Using CHX in combination with saline irrigation showed a significant decrease of the salivary bacterial CFU when compared with only using CHX.(P 0.01) Conclusion: It was concluded that the CHX or PVI used with saline irrigation made the salivary bacterial counts reduced more than when CHX or PVI was used alone as an oral antiseptic agent.

An update on periodontic-orthodontic interrelationships

Talking about periodontic-orthodontic interrelationships is related primarily to the 1960s, where a generalized increase in salivary bacterial counts, especially Lactobacillus, had been shown after orthodontic band placement. The purpose of this article is to provide the dental practitioner with basic understanding of the interrelationship between periodontics and orthodontics by means of representing classical studies, and, to give an update on this topic by demonstrating the most recent opinions concerning periodontic-orthodontic interrelationships. Specific areas reviewed are the ability of orthodontic treatment to afford some degree of protection against periodontal breakdown, short-term and long-term effects of orthodontic treatment on the periodontium, and some mucogingival considerations. Topics considering orthodontic treatment in periodontally compromised patients were not included in this review. While past studies have shown that orthodontic treatment can positively affect the periodontal health, recent reviews indicate an absence of reliable evidence for the positive effects of orthodontic therapy on patients’ periodontal status. Periodontic-orthodontic interrelationships are still controversial issues. However, a standard language between the periodontist and the orthodontist must always be established to eliminate the existing communications barrier, and to improve the outcomes of the whole treatment.

Chlorhexidine rinse for prevention of urethritis in men linked to oral sex

BackgroundOral sex among teenagers is on the rise. Similarity between the oral flora and organisms recovered from nongonococcal urethritis and prostatitis, points to retrograde entry of bacteria from oral cavity into the urethra following insertive oral intercourse.Presentation of the hypothesisChlorhexidine has a wide spectrum of anti-bactericidal activity encompassing gram positive and negative bacteria. It is also effective against HIV and HBV. It produced large and prolonged reductions in salivary bacterial counts within 7-h of its use. Hence, it would seem logic to postulate that rinsing with chlorhexidine before oral sex will be effective for prevention of retrograde entry of bacteria from oral cavity into the urethra. The recommendation for rinsing will be: 15 ml of a 0.12% or 10 ml of 0.2% chlorhexidine rinse for 30 seconds. Also other drug delivery systems such as chlorhexidine chewing gum or spray can be used.Testing the hypothesisMen suffering from recurrent nongonococcal urethritis or prostatitis are good subjects for testing the hypothesis. They perform genital safe sex via consistent use of condom. Yet they generally received unprotected insertive oral intercourse. Chlorhexidine can be used for prevention of recurrences of the disease.Implications of the hypothesisThe chlorhexidine will be a new, easy, attractive and effective method for reduction of nongonococcal urethritis, prostatitis and epidydimitis following insertive oral intercourse. It is poorly absorbed from skin, mucosa and gastrointestinal tract indicating systemic safety of chlorhexidine. The agent does not cause any bacterial resistance and supra-infection.

A Pilot Study to Assess Bacteraemia Associated with Tooth Brushing Using Conventional, Electric or Ultrasonic Toothbrushes

Aim: This was to compare the incidence of bacteraemia following toothbrushing using ultrasonic, powered or conventional manual children’s toothbrushes. Methods: Healthy subjects (11), aged 18 to 45 years, attending the Leeds Dental Institute were recruited. Subjects attended three separate appointments, during which they had their teeth brushed with a conventional manual toothbrush (CMT), a powered Braun-Oral B toothbrush (PBT) or a Sonicare Optima ultrasonic toothbrush (STB). Venous blood samples were taken immediately before, 30 secs and 2 mins after brushing. Blood and saliva samples collected prior to tooth brushing, all samples were immediately processed for microbiological analysis. Results: An increase in the incidence of bacteria in blood samples followed the use of all types of toothbrush. The highest incidence of bacteraemia (8/11 subjects) was following brushing with powered toothbrushes, which was significantly (p<.025) greater than that following brushing with ultrasonic (5/11) or manual (5/11) toothbrushes. There was no significant difference in salivary total bacterial counts comparing all individuals, so this had little bearing on subsequent development of bacteraemia. Conclusion: Brushing with a powered toothbrush resulted in a transient bacteraemia more frequently than brushing with a manual or ultrasonic toothbrush and may affect children with congenital heart defects at risk of bacterial endocarditis.

Tongue-coating as risk indicator for aspiration pneumonia in edentate elderly

Silent aspiration of oral microorganisms is a major cause of aspiration pneumonia. To establish oral hygiene criteria for the prevention of aspiration pneumonia in edentulous elderly persons, we investigated the relationship between presence of tongue-coating and number of oral bacteria in saliva and episodes of pneumonia. A total of 71 edentulous Japanese people aged 65 years or older living in nursing homes were enrolled in the study. A tongue plaque index (TPI) was used to evaluate quantity of tongue-coating, with TPI0 signifying no tongue-coating and TPI1 signifying presence of tongue-coating. Edentate elderly with TPI1 demonstrated significantly higher salivary bacterial counts than those with TPI0 ( p < 0.05). The number of elderly patients developing aspiration pneumonia was larger ( p < 0.005) in patients with TPI-based poor scores (average TPI > 0.5) than in those with TPI-based good scores. The relative risk of developing pneumonia in the good tongue hygiene group compared with in the poor tongue hygiene group was 0.12, 95% confidence interval (CI): 0.02–0.9. The results demonstrate that tongue-coating is associated with number of viable salivary bacterial cells and development of aspiration pneumonia, suggesting that tongue-coating is a risk indicator of aspiration pneumonia in edentate subjects.