Denture plaque and adherence of Candida albicans to denture-base materials in vivo and in vitro.
The aim of this paper is to review our understanding of the mechanisms and clinical significance of adhesion of C. albicans to denture-base materials in relation to denture plaque and denture-related stomatitis. Earlier reports in the literature of a 65% prevalence level of denture-related stomatitis seem to be exaggerated. More recent studies indicate that denture-related stomatitis is considerably less common, particularly in normal healthy subjects. The etiology of the condition is discussed in this review, and although much of the literature supports the view that the condition is strongly associated with C. albicans, this is not always so. In some subjects, the cause appears to be related to a non-specific plaque. This review also considers the role of denture plaque in the pathogenesis of denture-related stomatitis, the sequential development of denture plaque, and its colonization by Candida organisms. Designing controlled in vivo studies is difficult, and as a consequence, many investigators have had to resort to in vitro studies. The majority of these studies have attempted to investigate the hydrophobicity of C. albicans, relating the surface free-energy of denture-base materials, particularly acrylic resin, to that of the organism. Surprisingly little work has been directed at surface roughness and how it affects retention of organisms. Further, no attention has been paid to the properties and character of the surface, other than average surface roughness, as it affects adhesion. A comparison of results from in vitro studies on the effect on adhesion of pre-coating the surfaces of denture-base materials with saliva has produced equivocal conclusions. This is largely due to little standardization of experimental protocols between studies, particularly in the collection and handling of the saliva used. In conclusion, the review strongly supports the suggestion that adherence of C. albicans to denture-base materials in vitro is related to the hydrophobicity of the organism. The clinical significance of the observation and the mechanisms for the development and maturation of denture plaque are yet to be understood. There is a clear need for further investigation of other factors that may moderate the adhesion of organisms and subsequent colonization of denture-base materials. (+info)
A clinical and microbiological evaluation of denture cleansers for geriatric patients in long-term care institutions.
BACKGROUND: Many elderly patients in long-term care hospitals cannot adequately brush their dentures because of disease, dementia and poor dexterity. Such inadequate cleaning may allow for the multiplication of Candida spp. and bacteria, which could serve as reservoirs for disseminating infections. OBJECTIVE: To assess the efficacy of 3 denture cleansers in reducing the number of microorganisms on dentures in a hospitalized geriatric population. METHODS: Three brands of cleanser (Denture Brite, Polident and Efferdent) were compared; water was used as the control. Microbiological samples were obtained before and after 3 one-week periods of cleanser use; these samples were taken by a microbiologist blinded to the assigned treatment. In the statistical analysis, the ranks of the differences between the before-treatment and after-treatment scores of each regimen were compared by means of the general linear model. In addition, the efficacy of each cleanser in reducing accumulation of plaque, stain and food was assessed. RESULTS: The rank of the differences in the number of colony-forming units (CFUs) of Candida spp. before and after one week of use of Denture Brite (p = 0.04) and Polident (p = 0.01), was significantly greater than that of the control group, but there was no difference between Efferdent use and control (p = 0.10). No significant differences in reduction of Streptococcus mutans were observed between Denture Brite (p = 0.13) or Polident (p = 0.12) and the control group, whereas dentures cleaned with Efferdent exhibited significantly greater reduction in Streptococcus mutans (p = 0.02) than dentures cleaned with water. Over all study periods, there were no significant differences among the cleansers in reduction of Candida spp. or Streptococcus mutans. Dentures cleaned with Denture Brite, Polident or Efferdent appeared to have similar reductions in the level of plaque, stain and food, and all had substantially greater reductions than dentures cleaned with water only. The significant difference in the rank of the reduction in Candida spp. CFUs (p = 0.005) was related to the variance between study periods (p = 0.01) and the variance between subjects (p = 0.008). CLINICAL SIGNIFICANCE: The use of denture cleansers significantly reduced the number of microorganisms on dentures in a hospitalized geriatric population. (+info)
Oral cleanliness of 12-13-year-old and 15-year-old school children of Sunsari District, Nepal.
The aim of the study was to evaluate the oral cleanliness of school children in the District of Sunsari, Nepal. A multi-stage random sampling oral epidemiological survey was conducted in private and government, urban, rural town and rural village schools in 15 illakas of Sunsari District, Eastern Nepal. A total of 600, 12-13-year-old and 600 15-year-old school children were examined by trained examiners using the simplified oral hygiene index (OHI-S). The average age-group, debris and calculus index scores were combined to obtain the simplified oral hygiene index (OHI-S). The mean OHI-S scores were compared and evaluated using the parametric t-test for two independent samples. The mean OHI-S for urban 12-13-year-old school children was 0.98 compared to 1.34 for school children of rural towns and 1.44 for school children of rural villages and these differences in mean OHI-S were statistically significant (P < 0.005). In the 15-year-old age group, urban school children had a mean OHI-S score of 1.00 compared to 1.37 for rural towns and 1.43 for rural villages. The variance in the mean OHI-S scores were statistically significant (P < 0.005). The overall level of cleanliness in the school children surveyed was good. Children of urban schools had the lowest scores followed by school children from rural towns and then rural villages. When the mean OHI-S scores were compared with the DMFT scores, there was an inverse relationship between oral cleanliness and dental caries. Frequency of sugar consumption and the availability and affordability of fluoridated toothpaste may be important factors in the development of dental caries than oral cleanliness. (+info)
Self-assessed and clinically diagnosed periodontal health status among patients visiting the outpatient department of a dental school in Bangalore, India.
BACKGROUND: The purpose of the present cross-sectional study was to assess the extent of agreement between clinical and self-assessed periodontal health status among patients visiting the outpatient department of M.S. Ramaiah Dental College, Bangalore, India. MATERIALS AND METHODS: The study population included 216 patients aged between 20 and 44 years who attended the outpatient department of the M.S. Ramaiah Dental College, Bangalore. The study population was subjected to a self-administered questionnaire (questions regarding bleeding gums, deposits on teeth, receding gums, swelling of gums, loose teeth), which was followed by periodontal examination. The clinical examination included an assessment of the periodontal condition, using the criteria of Loe and Silness Gingival Index, the Community Periodontal Index, and Mobility, respectively. CONCLUSION: The present study showed that the perceived periodontal health status was low and the discrepancy between the subjectively and objectively assessed needs was very distinct. The awareness of the periodontal problems has been reported to increase with increasing severity of the disease due to the destructive changes that set in. (+info)
Periodontitis as a potential risk factor for chronic obstructive pulmonary disease: a retrospective study.
Dental disease prevalence among methamphetamine and heroin users in an urban setting: a pilot study.
BACKGROUND: Researchers have reported rampant caries among methamphetamine users. The authors investigated the prevalence of dental disease and associated risk behaviors in methamphetamine users compared with those in heroin users. METHODS: This pilot project was a cross-sectional study of an ongoing cohort of young adult injection-drug users (IDUs) in San Francisco. Participants completed an oral health questionnaire administered by a research assistant, and dentists performed clinical examinations to record the participants' data in terms of scores on the decayed-missing-filled surfaces (DMFS) index, presence of residual roots, scores on an oral hygiene index and whether any salivary hypofunction was observed. RESULTS: The prevalence of dental disease among 58 young adult IDUs was strikingly high compared with that in the U.S. general population; however, the authors found no difference in the level of dental disease between users of methamphetamine and users of heroin. The mean DMFS score and number of decayed surfaces exceeded 28 in both groups. CONCLUSIONS: Although the authors detected no difference in dental disease between methamphetamine and heroin users, they found a high prevalence of caries and caries-associated behaviors in the sample of young adult IDUs. CLINICAL IMPLICATIONS: Given the high level of dental disease observed in this population of young adult IDUs, one next step may be to explore the feasibility and effectiveness of providing low-intensity preventive measures (such as distribution of chlorhexidine rinses or xylitol gum or application of fluoride varnishes) through outreach workers. (+info)