Denture plaque - Past and recent concerns

Presence of mutans streptococci and Candida spp. in dental plaque/dentine of carious teeth and early childhood caries

The diagnosis of periodontal disease is commonly based on objective evaluations of the patient's medical/dental history as well as clinical and radiographic examinations. However, periodontal disease should also be evaluated subjectively through measures that quantify its impact on oral health-related quality of life. The aim of this study was to evaluate the impact of periodontal disease on quality of life among adolescents, adults and older adults. A systematic search of the literature was performed for scientific articles published up to July 2015 using electronic databases and a manual search. Two independent reviewers performed the selection of the studies, extracted the data and assessed the methodological quality. Thirty-four cross-sectional studies involving any age group, except children, and the use of questionnaires for the assessment of the impact of periodontal disease on quality of life were included. Twenty-five studies demonstrated that periodontal disease was associated with a negative impact on quality of life, with severe periodontitis exerting the most significant impact by compromising aspects related to function and esthetics. Unlike periodontitis, gingivitis was associated with pain as well as difficulties performing oral hygiene and wearing dentures. Gingivitis was also negatively correlated with comfort. The results indicate that periodontal disease may exert an impact on quality of life of individuals, with greater severity of the disease related to greater impact. Longitudinal studies with representative samples are needed to ensure validity of the findings.

Impact of periodontal disease on quality of life: a systematic review

Emerging yeast pathogens are favoured by increasing numbers of immunocompromised patients and by certain current medical practices. These yeasts differ in their antifungal drug susceptibilities, and rapid species identification is imperative. A large variety of methods have been developed with the aim of facilitating rapid, accurate yeast identification. Significant recent commercial introductions have included species-specific direct enzymatic colour tests, differential chromogenic isolation plates, direct immunological tests, and enhanced manual and automated biochemical and enzymatic panels. Chromogenic isolation media demonstrate better detection rates of yeasts in mixed cultures than traditional media, and allow the direct identification of Candida albicans by means of colony colour. Comparative evaluation of rapid methods for C. albicans identification, including the germ tube test, shows that chromogenic media may be economically advantageous. Accurate tests for single species include the Bichrolatex Albicans and Krusei Color tests, both immunologically based, as well as the Remel Rapid Trehalose Assimilation Broth for C. glabrata. Among broad-spectrum tests, the RapID Yeast Plus system gives same-day identification of clinical yeasts, but performance depends on inoculum density and geographic isolate source. The API 20 C AUX system is considered a reference method, but newer systems such as Auxacolor and Fungichrom are as accurate and are more convenient. Among automated systems, the ID 32 C strip, the Vitek Yeast Biochemical Card and the Vitek 2 ID-YST system correctly identify >93% of common yeasts, but the ID-YST is the most accurate with uncommon yeasts, including C. dubliniensis. Spectroscopic methods such as Fourier transformed-infrared spectroscopy offer potential advantages for the future. Overall, the advantages of rapid yeast identification methods include relative simplicity and low cost. For all rapid methods, meticulous, standardized multicenter comparisons are needed before tests are fully accepted.

Yeast identification in the clinical microbiology laboratory: phenotypical methods

A number of methods of sampling the oral cavity for the presence of candida have been developed. Such techniques play an important role in the diagnosis and management of oral candidosis. In the past, identification of candida isolated from the oral cavity has usually been limited to the genus Candida or to the species C. albicans. However, with the recognition that Candida species differ in the production of putative virulence factors and sensitivity to antifungal agents, greater emphasis has been placed on identification of isolates to species level. As a result a range of commercially available systems for yeast identification can now be used in conjunction with traditional identification procedures.

Oral microbiology: isolation and identification of candida from the oral cavity

A new differential medium, CHROMagar Candida, for the isolation of clinically important yeasts was investigated to determine its usefulness in facilitating the study of oral yeasts. The recovery of yeasts on the medium was not significantly different from the recovery on Sabouraud dextrose agar. The identities of 450 green colonies on CHROMagar Candida, presumptively identified as Candida albicans on the basis of the manufacturer's instructions, were confirmed by testing for beta-N-acetylgalactosaminidase. Candida tropicalis also formed distinctive colonies, and other yeasts including Candida (Torulopsis) glabrata, Candida Parapsilosis, Candida Magnoliae, Candida lusitaniae, Candida Famata, Candida kefir, and Saccharomyces cerevisiae were readily distinguished from C. albicans and C. tropicalis isolates. CHROMagar Candida is a very useful medium, and its use will facilitate the study of yeasts associated with dental diseases.

/pdf/use-of-chromagar-candida-medium-for-isolation-of-yeasts-from-rc91na0sao.pdf

Use of CHROMagar Candida medium for isolation of yeasts from dental samples.

A study was conducted to determine the degree of tooth loss, factors influencing tooth loss, and the extent of prosthodontic rehabilitation in Sudanese adults (≥ 16 years old) attending outpatient clinics in Khartoum State. Pearson and multivariate analyses were used to examine the relationships between tooth loss and specific characteristics determined through interviews and clinical examinations. The mean number of missing teeth was 3.6 (SD, 4.9) and the prevalence of edentulism was 0.1%. The prevalence of tooth loss (missing at least one tooth) was 78%; 66.9% of tooth loss was due to caries, and 11.2% was attributable to other reasons. Prosthetic replacement of missing teeth was evident in 3%, whereas a need for prosthetic replacement was evident in 57%. Having < 20 teeth was associated with age, gender, and socioeconomic status; tooth loss due to caries was associated with age, tribe, frequency of tooth-brushing, and a low rate of dental consultation. Tooth loss due to other reasons was associated with age, tribe, education, periodontal pocketing, tobacco use, tooth wear, and prosthetic status. The results of the present study indicated that the major cause of tooth loss was dental caries, thus emphasizing the importance of a public prevention-based healthcare program. Replacement of missing teeth was uncommon in the study subjects, which may reflect lack of access to this type of oral healthcare.

/pdf/factors-associated-with-tooth-loss-and-prosthodontic-status-29l7nl37os.pdf

Factors associated with tooth loss and prosthodontic status among Sudanese adults

Determination of the occlusal vertical dimension (OVD) is an integral part of complete dentures fabrication Due to the lack of teeth, the clinician faces the challenge of how to accurately establish the OVD of the new denture Therefore, the purpose of this review article was to present, discuss and critique the available methods used in determining the OVD for complete dentures patients This review identified two main streams to determine the OVD: (i) pre-extraction methods and (ii) post-extraction methods For the pre-extraction methods, the OVD of the natural dentition is transferred to the new dentures mainly by intra-oral measurements, profile tracing and cephalometric analysis The post-extraction methods rely on mandibular rest position, facial aesthetic appearance, swallowing pattern, craniofacial landmarks measurements, cephalometric analysis, phonetics and existing dentures In general, all the available techniques have merits and are helpful for routine clinical use However, they are empirical in nature, controversial and lack the scientific support Further, there is no single accurate method for OVD determination To overcome the limitations of the techniques, the clinician will benefit from applying combination of techniques to approximate the OVD

Determination of occlusal vertical dimension for complete dentures patients: an updated review.

We aimed to assess the oral health status and risk factors for dental caries and periodontal disease among Sudanese adults resident in Khartoum State. To date, this information was not available to health policy planners in Sudan. A descriptive population-based survey of Sudanese adults aged ≥ 16 years was conducted. After stratified sampling, 1,888 adult patients from public dental hospitals and dental health centres scattered across Khartoum State, including different ethnic groups present in Sudan, were examined in 2009-10. Data were collected using patient interviews and clinical examinations. Dental status was recorded using the DMFT index, community periodontal index (CPI), and a validated tooth wear index. Caries prevalence was high, with 87.7% of teeth examined having untreated decay. Periodontal disease increased in extent and severity with age. For 25.8% of adults, tooth wear was mild; 8.7% had moderate and 1% severe toothwear. Multivariate analysis revealed that decay was less prevalent in older age groups but more prevalent in southern tribes and frequent problem based attenders; western tribes and people with dry mouths who presented with less than18 sound, untreated natural teeth (SUNT). Older age groups were more likely to present with tooth wear; increasing age and gender were associated with having periodontal pocketing ≥ 4 mm. The prevalence of untreated caries and periodontal disease was high in this population. There appear to be some barriers to restorative dental care, with frequent use of dental extractions to treat caries and limited use of restorative dentistry. Implementation of population-based strategies tailored to the circumstances of Sudanese population is important to improve oral health status in Sudan.

/pdf/a-survey-of-oral-health-in-a-sudanese-population-1kgfsglatb.pdf

A survey of oral health in a Sudanese population

The aims of this study were to develop a Sudanese-Arabic version of the English-language Oral Health Impact Profile-14 (OHIP-14), assess the psychometric properties and performance of this new instrument, and then use it to investigate the impacts of selected oral disorders on oral health-related quality of life (OHRQoL). Sudanese adolescents and adults (age, ≥ 16 years; 781 males and 1107 females) attending outpatient clinics in Khartoum State were enrolled. The OHIP-14 was adapted, and the validity and reliability of the Sudanese-Arabic version of the questionnaire (OHIP-14s-ar) were assessed. The OHIP-14s-ar was then used to measure OHRQoL. Pearson correlation coefficients and multivariate analysis were used to examine relationships between OHRQoL and characteristics ascertained by inter- views and clinical examinations. The OHIP-14s-ar had suitable construct validity, reliability, and internal consistency (i.e., Cronbach α). More than half of the participants reported that oral disorders affected quality of life; psychological discomfort and physical pain were the most frequently reported oral health impacts. Our results suggest that being female, tooth decay, systemic illness, and dry mouth worsen OHRQoL. The oral disorder with the greatest impact was dental caries, and tooth condition seemed to be more important than absence of teeth. The OHIP- 14s-ar yielded convincing psychometric data, and its performance makes it a suitable measure for future cross-sectional and longitudinal studies in Sudan. (J Oral Sci 55, 123-132, 2013)

/pdf/psychometric-properties-and-performance-of-the-oral-health-3q962fx3z3.pdf

Nadia Khalifa

Papers

Use of CHROMagar Candida medium for isolation of yeasts from dental samples.

Factors associated with tooth loss and prosthodontic status among Sudanese adults

Determination of occlusal vertical dimension for complete dentures patients: an updated review.

A survey of oral health in a Sudanese population

Psychometric properties and performance of the Oral Health Impact Profile (OHIP-14s-ar) among Sudanese adults.