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A distinct body of literature supports the association between clinical postures of the dental practitioner and work-related musculoskeletal disorders (WRMD). Several aids or devices have been tested to improve clinical posture in the interest of decreasing WRMD. The use of magnification lenses while performing dental procedures may increase the quality of work and decrease the likelihood of musculoskeletal problems. To date, only anecdotal and personal opinions had existed regarding the benefits of using magnification lenses, and no empirical evidence had authenticated the contention that use of magnification lenses exerts a positive change in operator posture. The objective of this study was to assess the effect magnification lenses had on the posture of dental hygiene students. Using a randomized crossover design, researchers videotaped nineteen senior dental hygiene students performing an intra-oral procedure with and without the use of magnification lenses. The tapes were then evaluated by a panel of five dental hygiene educators calibrated in the use of Branson's Posture Assessment Instrument (PAI). Results of a paired t-test indicate that the posture of the students while wearing magnification lenses was more acceptable (p=.019) than when wearing traditional safety glasses. Results of this study indicate a quantifiable change in acceptability of posture for clinicians wearing magnification lenses and suggest that the use of such lenses in dental education may be warranted.

The purpose of this study was to examine by transmission (TEM) and scanning electron microscopy (SEM) the supragingival microbial plaque overlying the ulcerated gingival papillae of necrotizing ulcerative periodontitis (NUP) lesions in HIV-seropositive patients. The microbiota of NUP and HIV-seropositive patients with periodontitis has been reported to be similar to that of conventional periodontitis in non-infected subjects, although several investigators have also reported high recovery rates of microbes not generally associated with the indigenous oral microbial flora. Light and electron microscopic observations and microbial culture studies indicate a similar high prevalence of spirochetes in both necrotizing ulcerative gingivitis (NUG) and NUP. In addition, several studies have reported more frequent isolation of Candida albicans from diseased periodontal sites in HIV-seropositive patients than from non-diseased sites. Ten male and six female patients, each HIV-seropositive and exhibiting NUP, constituted the study population. Two biopsies of involved gingival papillae from between posterior teeth were obtained from each patient and processed for examination by both TEM and SEM. Microscopic examination revealed a surface biofilm comprised of a mixed microbial flora of various morphotypes in 81.3% of biopsy specimens. The subsurface flora featured dense aggregations of spirochetes in 87.5% of specimens. Zones of aggregated polymorphonuclear leukocytes and necrotic cells were also noted. Yeasts were observed in 65.6% of specimens and herpes-like viruses in 56.5% of the specimens. Collectively, except for the presence of yeast and viruses, the results suggest that the microbial flora and possibly the soft tissue lesions of NUP and necrotizing ulcerative gingivitis are very similar.

Due to the large number of basic therapeutic and illicit drugs, systematic toxicological analysis has widely been performed with liquid chromatography coupled to mass spectrometry using positive electrospray ionization. However, there exist a smaller number of drugs, typically acidic drugs, which require the use of negative electrospray ionization either via a separate analysis or polarity switching. Here, targets relating to salicylic acid and ibuprofen in positive electrospray ionization were determined through a metabolomics‐driven retrospective investigation of forensic casework. Samples were previously screened using liquid chromatography coupled with high‐resolution mass spectrometry with quantification of target analytes performed using liquid chromatography with tandem mass spectrometry. Of the 1,717 whole‐blood samples submitted between 2014 and 2019, 48 were positive for salicylic acid (1.1–1,400 mg/kg) and 78 for ibuprofen (1–46 mg/kg). Based on the retrospective analysis, 19 and 90 targets were identified for salicylic acid and ibuprofen, respectively. For targets of salicylic acid, the protonated adduct of salicyluric acid ([M + H]+, m/z 196.0605) was present in 89.6% (n = 32) of the salicylic acid positive cases, while the [M + HCOOH + CH3CN + Ca ‐ H]+ adduct (m/z 264.0179) of salicylic acid was present in all positive samples with concentrations above 66 mg/kg salicylic acid. Similarly, the [M + 2Na ‐ H]+ adduct (m/z 251.1018) of ibuprofen was present in 98.7% (n = 77) of positive cases and was present in all samples with concentrations above 3 mg/kg ibuprofen. [ABSTRACT FROM AUTHOR]

Objective: Work‐related musculoskeletal disorders (MSDs) are common in the dental hygiene profession. Awkward postures contribute to MSDs and magnification loupes have been suggested to reduce this risk factor and minimize MSDs. Methods: After IRB approval, 24 hygienists were enrolled in the study: twelve hygienists wearing loupes with a standard manufacturer determined declination angle (control) and 12 hygienists wearing loupes with a custom measured declination angle (experimental). To measure changes in neck and trunk flexion, accelerometers were placed on the occipital region of head, cervical vertebrae C5, and thoracic vertebrae T5 and baseline posture was recorded. Typodonts with artificial calculus simulated the oral environment. Participants were randomly assigned to wear their designated loupes during the first or second trial of the experiment and scaled in each quadrant (UR, LR, UL, LL) of the mouth for two minutes. Participants completed the scaling task twice: in the loupes and no loupes condition in a counterbalanced order. Three‐way mixed design ANOVA was used to determine posture differences in neck and trunk posture. Results: Those wearing custom loupes (M = 16.52, SD = 6.40) had significantly less trunk flexion while scaling compared to hygienists wearing standard loupes (M = 22.27, SD = 6.40), F(1, 22) = 7.14, P =.01. Neck flexion was not significantly affected while scaling between loupes vs no loupes or loupes type condition, (P's >.05). Conclusion: Posture was partially impacted by loupes type. Custom loupes resulted in less trunk flexion. Neck flexion was not affected by either loupes type. [ABSTRACT FROM AUTHOR]

With the advent of combined antiretroviral therapies, the face of HIV infection has changed dramatically from a disease with almost certain mortality from serious comorbidities, to a manageable chronic condition with an extended lifespan. In this paper we present the more recent investigations into the epidemiology, microbiology, and pathogenesis of periodontal diseases in patients with HIV, and the effects of combined antiretroviral therapies on the incidence and progression of these diseases both in adults and perinatally infected children. In addition, comparisons and potential interactions between the HIV-associated microbiome, host responses, and pathogenesis in the oral cavity with the gastrointestinal tract and other areas of the body are presented. Also, the effects of HIV and combined antiretroviral therapies on comorbidities such as hyposalivation, dementia, and osteoporosis on periodontal disease progression are discussed. [ABSTRACT FROM AUTHOR]

BACKGROUND: Although access to dental care has improved over time, many children still face difficulty in obtaining services. One strategy to increase access is through mobile dental services, often in collaboration with schools, Head Start programs, and school‐based health centers. This study evaluates a large mobile dental care program based in Minnesota. METHODS: Thematic analysis of interview data collected during a 2‐day site visit and multivariate regression analysis of electronic records of patients (adults and children) that received care from 2000 through 2015, representing 84,279 unique patients. RESULTS: The number of patients increased from 5558 in 2000 to 13,863 in 2015. There was a decline in the share of preventive procedures over this period, from 45.7% to 29.4%, and an increase in the share of patients seen at fixed sites. The interview data revealed that program growth relied on relationships with school leaders, expanded scope of practice for dental assistants and dental therapists, and high Medicaid reimbursement. CONCLUSIONS: Mobile dental care programs can increase both preventive and restorative dental care for individuals who otherwise would not easily access oral health care services; mobile dental programs could be an option in many other communities and schools. [ABSTRACT FROM AUTHOR]

The alternation of light and dark periods on a daily or seasonal time scale is of utmost importance for the synchronization of physiological and behavioral processes in the environment. For the last 2 decades, artificial light at night (ALAN) has strongly increased worldwide, disrupting the photoperiod and its related physiological processes, and impacting the survival and reproduction of wild animals. ALAN is now considered as a major concern for biodiversity and human health. Here, we present why insects are relevant biological models to investigate the impact of ALAN. First the phenotypic responses to ALAN and their underpinning mechanisms are reviewed. The consequences for population dynamics, and the community composition and functioning are described in the second part. Because ALAN provides new and widespread selective pressure, we inventory evolutionary changes in response to this anthropogenic change. Finally, we identify promising future avenues, focusing on the necessity of understanding evolutionary processes that could help stakeholders consider darkness as a resource to preserve biodiversity as well as numerous ecosystem services in which insects are involved. Artificial light at night (ALAN) is now considered a major concern for biodiversity and animal health. We review the consequences of ALAN for insects at multiple levels of biological organization: from individuals (physiological, genetic, life‐history, and behavioral traits) to population dynamics and community structure and functioning, as well as the evolutionary changes in response to ALAN. We also identify promising future avenues and discuss how these could help stakeholders preserve darkness as a resource for biodiversity. [ABSTRACT FROM AUTHOR]

Abstract: Objective: To critically evaluate the existing literature on acute lesions occurring in the periodontium (periodontal abscesses [PA], necrotizing periodontal diseases [NPD], and endo‐periodontal lesions [EPL]) to determine the weight of evidence for the existence of specific clinical conditions that may be grouped together according to common features. The ultimate goal is to support an objective classification system. Importance: Although PA, NPD, and EPL occur with relatively low frequency, these lesions are of clinical relevance, because they require immediate management and might severely compromise the prognosis of the tooth. Findings: In general, the evidence available to define these three conditions was considered limited. PA and EPL are normally associated with deep periodontal pockets, bleeding on probing, suppuration, and almost invariably, with pain. EPL are also associated with endodontic pathology. NPDs have three typical features: pain, bleeding, and ulceration of the gingival interdental papilla. The available data suggested that the prognosis of PA and EPL are worse in periodontitis than in nonperiodontitis patients. Lesions associated with root damage, such as fractures and perforations, had the worst prognosis. NPD progression, extent and severity mainly depended on host‐related factors predisposing to these diseases. Conclusions: PA should be classified according to the etiological factors involved, with the most frequent being those occurring in pre‐existing periodontal pockets. NPD are clearly associated with the host immune response, which should be considered in the classification system for these lesions. EPLs should be classified according to signs and symptoms that have direct impact on their prognosis and treatment, such as presence or absence of fractures and perforations, and presence or absence of periodontitis. [ABSTRACT FROM AUTHOR]

In this study, gravity waves (GWs) in the high-resolution GEOS-5 Nature Run are first evaluated with respect to satellite and other model results. Southern Hemisphere winter sources of non-orographic GWs in the model are then investigated by linking measures of tropospheric non-orographic gravity wave generation tied to precipitation and frontogenesis with absolute gravity wave momentum flux in the lower stratosphere. Finally, non-orographic GW momentum flux is compared to orographic gravity wave momentum flux and compared to previous estimates. The results show that the global patterns in GW amplitude, horizontal wavelength, and propagation direction are realistic compared to observations. However, as in other global models, the amplitudes are weaker and horizontal wavelengths longer than observed. The global patterns in absolute GW momentum flux also agree well with previous model and observational estimates. The evaluation of model non-orographic GW sources in the Southern Hemisphere winter shows that strong intermittent precipitation (greater than 10 mm h−1) is associated with GW momentum flux over the South Pacific, whereas frontogenesis and less intermittent, lower precipitation rates (less than 10 mm h−1) are associated with GW momentum flux near 60°S. In the model, orographic GWs contribute almost exclusively to a peak in zonal mean momentum flux between 70 and 75°S, while non-orographic waves dominate at 60°S, and non-orographic GWs contribute a third to a peak in zonal mean momentum flux between 25 and 30°S. [ABSTRACT FROM AUTHOR]

Periodontal diseases are multifactorial, and many etiological agents are suggested to play a role in their etiopathogenesis. Various risk factors are also suggested to influence the progression of periodontal disease. Until recently, specific bacteria were considered the major pathogens for the disease. However, the occurrence of periodontal disease in some patient groups is still poorly understood, and the role of other initiating agents is being investigated. Evidence strongly suggests the presence of many strains of viruses in the periodontal environment, and possible mechanisms have also been suggested. Periodontal disease as a risk factor for other systemic diseases can also be better explained based on this viral etiology. In this review, we critically analyze the role of viruses in different periodontal diseases, and provide a categorical description of the underlying mechanisms. Clinical implications and future directions are also discussed. Evidence of a causal role of herpes viruses in periodontitis might revolutionize existing strategies to diagnose, prevent, and treat the disease. [ABSTRACT FROM AUTHOR]

This review provides updates on acute conditions affecting the periodontal tissues, including abscesses in the periodontium, necrotizing periodontal diseases and other acute conditions that cause gingival lesions with acute presentation, such as infectious processes not associated with oral bacterial biofilms, mucocutaneous disorders and traumatic and allergic lesions. A periodontal abscess is clinically important because it is a relatively frequent dental emergency, it can compromise the periodontal prognosis of the affected tooth and bacteria within the abscess can spread and cause infections in other body sites. Different types of abscesses have been identified, mainly classified by their etiology, and there are clear differences between those affecting a pre-existing periodontal pocket and those affecting healthy sites. Therapy for this acute condition consists of drainage and tissue debridement, while an evaluation of the need for systemic antimicrobial therapy will be made for each case, based on local and systemic factors. The definitive treatment of the pre-existing condition should be accomplished after the acute phase is controlled. Necrotizing periodontal diseases present three typical clinical features: papilla necrosis, gingival bleeding and pain. Although the prevalence of these diseases is not high, their importance is clear because they represent the most severe conditions associated with the dental biofilm, with very rapid tissue destruction. In addition to bacteria, the etiology of necrotizing periodontal disease includes numerous factors that alter the host response and predispose to these diseases, namely HIV infection, malnutrition, stress or tobacco smoking. The treatment consists of superficial debridement, careful mechanical oral hygiene, rinsing with chlorhexidine and daily re-evaluation. Systemic antimicrobials may be used adjunctively in severe cases or in nonresponding conditions, being the first option metronidazole. Once the acute disease is under control, definitive treatment should be provided, including appropriate therapy for the pre-existing gingivitis or periodontitis. Among other acute conditions affecting the periodontal tissues, but not caused by the microorganisms present in oral biofilms, infectious diseases, mucocutaneous diseases and traumatic or allergic lesions can be listed. In most cases, the gingival involvement is not severe; however, these conditions are common and may prompt an emergency dental visit. These conditions may have the appearance of an erythematous lesion, which is sometimes erosive. Erosive lesions may be the direct result of trauma or a consequence of the breaking of vesicles and bullae. A proper differential diagnosis is important for adequate management of the case. [ABSTRACT FROM AUTHOR]

African American, Hispanic/Latina, and American Indian/Alaska Native persons are markedly underrepresented racial and ethnic groups (UREG) in the dental hygiene profession. The purpose of this study was to survey UREG dental hygiene students to determine their perceptions of the barriers and facilitators that influenced their decision to enter the dental hygiene profession. Participants were eighty-four UREG students attending entry-level dental hygiene programs across the state of California. We conducted face-to-face interviews using a survey guide that consisted of forty-two mostly closed-ended questions. Most (57 percent) participants reported that they had either perceived or experienced barriers: primarily costs associated with the program and the lack of role models in their race/ethnicity. Almost all participants reported that there had been a person, mainly a dental professional, who influenced them to become a dental hygienist; 62 percent of these individuals were reported to be from a similar UREG group as the participant. Funding (57 percent) and emotional support from family and friends (87 percent) were the predominant facilitators employed by the participants to overcome barriers. Based on these results, we recommend three strat-egies to recruit more UREG students into the dental hygiene profession: more extensive outreach programs, enhanced mentoring by UREG dental professionals, and a modified admission process. [ABSTRACT FROM AUTHOR]

The number of people in Australia living with HIV is growing. This reflects a consistent rate of new HIV infections combined with an increased life expectancy of people with HIV. Dentists are ideally positioned to identify, manage and treat HIV-associated oral manifestations and have a responsibility to themselves and to their patients to be up-to-date with the evolving area of HIV and related issues. Those issues include medico-legal implications associated with HIV diagnosis and treatment. This article provides a review of the current clinical and medico-legal aspects of HIV in Australia. The oral manifestations of HIV can be divided into five categories: microbiological infections (fungal, bacterial and viral); oral neoplasms; neurological conditions; other oral conditions that may be associated with HIV infection; and oral conditions associated with HIV treatment. Current treatment options in the scope of general dental practice are outlined. Medico-legal issues related to the management of patients with HIV are explored, including rights of the patient regarding disclosure of HIV status; an algorithm for the management of a patient with signs or symptoms indicating possible HIV infection, including referral pathways; and an algorithm for dealing with patient management and referral issues. [ABSTRACT FROM AUTHOR]

Manuscript Type Empirical Research Question/Issue Due to a greater difficulty to achieve compromise, large decision-making groups tend to adopt less extreme decisions. This implies that larger boards are associated with lower corporate risk taking. We test whether a similar effect applies to the case of Japanese firms. The result is expected to be weaker since Japanese boards form relatively homogeneous groups. We further argue that growth opportunities moderate the relation between board size and risk taking. Research Findings/Results Our results indicate that firms with larger boards exhibit lower performance volatility as well as lower bankruptcy risk. However, the effect is not as significant as in the US. The low cross-sectional variation in risk taking among Japanese firms is found to play a role. In addition, we show that the effect of board size is less significant when firms have plenty of investment opportunities, but much stronger when firms have fewer growth options. Theoretical Implications Considering that risk taking contributes to firm performance, our results offer a rationale as to why larger boards might be associated with lower performance. However, they also suggest that this effect should be less detrimental to firms with significant investment opportunities. Practical Implications Firms should adapt their decision processes to their business environment. In particular, they may need to adjust the size of their boards to the characteristics of their investment opportunity sets. Firms with fewer growth options would gain most by operating with smaller boards. By restricting their ability to take risks, firms could undermine their growth potential and performance. [ABSTRACT FROM AUTHOR]

The article reviews several studies on human viruses in periodontal health and disease. Periodontitis studies report the occurrence of herpes simplex virus, Epstein-Barr virus, and cytomegalovirus. The rate of detecting the occurrence of herpesviruses depends on the type of periodontal lesion studied, viral identification method employed and ethnic/geographical factors. Aggressive periodontitis was found to associate with a high periodontal load of active Epstein-Barr virus or cytomegalovirus.

As the highly active antiretroviral therapy (HAART) has transitioned human immunodeficiency virus (HIV) infection into a ‘chronic disease’ management strategy, there is growing evidence that infection with non-HIV pathogens in HIV+ patients may have important public health implications in undermining HAART success and acquired immunodeficiency syndrome progression. Several bacterial and host cell products during infections with non-HIV pathogens have shown the capacity to regulate HIV replication in latently infected cells. A high prevalence of oral infections caused by bacteria, viruses and fungi has been described in HIV+ patients, including periodontal disease. The oral cavity appears to be a site of HIV pathogenesis and potential reservoir for the disease as HIV RNA and DNA forms are present in saliva as well as in gingival crevicular fluid, and oral epithelial cells are susceptible to either cell free or cell-associated HIV infection. The clinical and biological bases of potential associations between chronic oral inflammatory disorders, such as periodontal disease, and exacerbation of HIV viraemia have received little attention. This review attempts to evaluate the current understanding of HIV reactivation as a result of co-infection and/or inflammation induced by non-HIV pathogens in HIV-infected patients, and presents a hypothetic model about the potential role of periodontitis as a global oral infection that potentially contributes to HIV recrudescence. [ABSTRACT FROM AUTHOR]

The article discusses viral infections that can affect the adult human mouth, focusing on the herpesvirus, papillomavirus, picornavirus, and retrovirus families. It discusses other diseases of the mouth as well, providing a table of types of oral ulcers and oral tumors, and discussing the appropriate treatment for these diseases.

The purpose of this study was to compare the educational and career pathways of graduates from associate degree (A.S./A.A.) and baccalaureate degree (B.S./B.A.) entry-level dental hygiene (DH) programs. A thirty-item, closed- ended questionnaire was mailed to a random sample of 1,352 dental hygienists who were educated and licensed in California between 1990 and 2000. The response rate was 76 percent. Approximately half of the respondents had a degree prior to entering the DH program, and the elapsed time between degrees was greater for A.S./A.A. graduates (p=0.05). More B.S./B.A. graduates had earned or were seeking master's and other more advanced degrees: 11.9 percent versus 4.3 percent. Graduates from both types of programs were involved in professional and community organizations and held leadership positions. Most were currently practicing in the traditional clinical setting, with means of 3.6 and 3.3 days/week for the A.S./A.A. and B.S./B.A. graduates, respectively (p<0.05). More B.S./B.A. graduates held DH faculty positions (30.3 percent versus 4.3 percent, p<0.05) and other non-DH teaching positions (14.9 percent versus 8.6 percent, p<0.05) and had greater involvement with research (8.0 percent versus 3.6 percent, p<0.05). The two groups did not differ in regard to other dental and DH-related positions. In conclusion, graduates from B.S./B.A. programs are more likely to have positions in nontraditional settings. [ABSTRACT FROM AUTHOR]

The aim of this paper is to highlight the cultural perceptions of halitosis to dental professionals. Halitosis (oral malodour or bad breath) is caused mainly by tongue coating and periodontal disease. Bacterial metabolism of amino acids leads to metabolites including many compounds, such as indole, skatole and volatile sulphur compounds (VSC), hydrogen sulphide, methyl mercaptan and dimethyl sulphide. They are claimed to be the main aetiological agents for halitosis. Gastrointestinal diseases are also generally believed to cause halitosis. In general, physicians and dentists are poorly informed about the causes and treatments for halitosis. The paper reviews the prevalence and distribution of halitosis, oral malodour, its aetiology, concepts of general and oral health and diseases and their perception among racially diverse population. Eating, smoking and drinking habits and understanding of halitosis as a social norm among different people has been highlighted. The treatment options have also been presented very briefly. A brief discussion about general importance within existing healthcare services has been highlighted. Oral malodour may rank only behind dental caries and periodontal disease as the cause of patient’s visits to the dentist. It is a public social health problem. The perception of halitosis is different in culturally diverse populations. So the dental professionals should be aware of the cultural perceptions of halitosis among racially and culturally diverse populations. There is a need to integrate the cultural awareness and knowledge about halitosis among the dental professional for better understanding of halitosis to treat patients with the social dilemma of halitosis to improve the quality of life and well-being of individuals with the problem. It is concluded that dental professionals (especially dental hygienists) should be prepared to practice in a culturally diverse environment in a sensitive and appropriate manner, to deliver optimal oral health and hygiene care. [ABSTRACT FROM AUTHOR]

Relatively little is known about the anxiety-provoking capacity of the various objects and situations characteristic of the dental setting. The aims of the current study were to establish a hierarchy of anxiety-provoking capacities of a large set of dental stimuli and to determine the differences in relation to gender, age, ethnicity, and level of dental trait anxiety. An additional aim was to derive an estimate of the number of stimuli to be presented to anxious patients in order to obtain full coverage of their dental fears. A questionnaire describing 67 potentially anxiety-provoking stimuli was constructed and presented to 960 adults. The results indicated that invasive stimuli (e.g. surgical procedures) were rated as the most anxiety provoking and that non-invasive stimuli (e.g. the dentist as a person) were the least anxiety provoking. The fear-evoking capacity of the dental stimuli varied with gender, age, ethnicity, and level of dental trait anxiety, whereas the rank order of these stimuli appeared to be independent of these factors. Furthermore, it appeared that the top 25 most anxiety-provoking objects and situations found in the current study contained only eight (28%) stimuli, which had been taken into account in previous research. The present findings support the need for assessment procedures using a broad spectrum of potentially anxiety-provoking stimuli. [ABSTRACT FROM AUTHOR]

The chair-side work posture of dental hygienists has long been a concern because of health-related problems potentially caused or exacerbated by poor posture. The purpose of this study was to investigate if using magnification loupes improved dental hygiene students' posture during provision of treatment. The treatment chosen was hand-scaling, and the effect of the timing of introduction of the loupes to students was also examined. Thirty-five novice dental hygiene students took part in the study. Each student was assessed providing dental hygiene care with and without loupes, thus controlling for innate differences in natural posture. Students were randomized into two groups. Group one used loupes in the first session and did not use them for the second session. Group two reversed this sequence. At the end of each session, all students were videotaped while performing scaling procedures. Their posture was assessed using an adapted version of Branson et al.'s Posture Assessment Instrument (PAI). Four raters assessed students at three time periods for nine posture components on the PAI. A paired t-test compared scores with and without loupes for each student. Scores showed a significant improvement in posture when using loupes (p<0.0001), and these improvements were significantly more pronounced for students starting loupes immediately on entering the program compared with students who delayed until the second session (p<0.1). These results suggest a significant postural benefit is realized by requiring students to master the use of magnification loupes as early as possible within the curriculum. [ABSTRACT FROM AUTHOR]

The article offers information on the epidemiology, pathogenesis and medical management of human immunodeficiency virus (HIV) infection in patients with periodontal disease. For immunosuppressed patients with linear gingival erythema, key diagnostic features of the disease include the lack of response to periodontal therapy and its association with a Candida infection. Some measures done in managing periodontal disease include controlling the Candida bacteria and intake of systemic antibiotics.

HIV infection affects residents of all countries of the world, but the greater majority of affected individuals reside in the developing world. In the past decade there have been substantial changes in the management of HIV disease, particularly the introduction of highly active antiretroviral therapy (HAART). Such agents have reduced significantly the morbidity and mortality associated with HIV disease, however, they are not available for most HIV-infected individuals in the developing world. There is now considerable understanding of the molecular epidemiology, transmission and therapy of the common opportunistic oral infections of HIV disease, and as a consequence of improved anti-HIV strategies, the frequency and severity of oral disease associated with HIV infection have reduced considerably, although HAART may predispose to human papilloma virus infection of the mouth and potentially increase the risk of later oral squamous cell carcinoma. Despite advances in clinical care the majority of individuals with HIV disease worldwide will continue to develop oral disease, as they are resident in the developing world and do not have ready access to even simple therapies. [ABSTRACT FROM AUTHOR]

The purpose of this review was to evaluate the evidence supporting the hypothesis that viral infection plays a role in the development of periodontitis. An involvement in periodontal diseases has been suspected specifically for human immunodeficiency virus (HIV) and herpes viruses. An association has been demonstrated between HIV infection and some distinct forms of periodontal infection, i.e. necrotizing lesions. Furthermore, reports of increased prevalence and severity of chronic periodontitis in HIV-positive subjects suggests that HIV infection predispose to chronic periodontitis. Several studies, most of them from the same research group, have demonstrated an association of herpesviruses with periodontal disease. Viral DNA have been detected in gingival tissue, gingival cervicular fluid (GCF) and subgingival plaque from periodontaly diseased sites. In addition markers of herpesviral activation have been demonstrated in the GCF from periodontal lesions. Active human cytomegalovirus (HCMV) replication in periodontal sites may suggest that HCMV re-activation triggers periodontal disease activity. Concerns regarding sampling, methods and interpretation cast doubts on the role of viruses as causes of periodontal disease. [ABSTRACT FROM AUTHOR]

Provides information about the periodontitis, a disease attributable to multiple infectious agents and interconnected cellular and humoral immune responses. Role of various putative pathogens and host responses in the pathogenesis of periodontitis; Detection and quantification of periodontopathic bacterial species.

Kubar A, Saygun I,Özdemir A, Yapar M, Slots J. Real-time polymerase chain reaction quantification of human cytomegalovirus and Epstein–Barr virus in periodontal pockets and the adjacent gingiva of periodontitis lesions. J Periodont Res 2005; doi: 10.1111/j.1600-0765.2005.00770.x© Blackwell Munksgaard 2005Genomic sequences of human cytomegalovirus (HCMV) and Epstein–Barr virus (EBV), two herpesviruses, can frequently be detected in periodontal pockets of progressive periodontitis lesions, but the prevalence and load of the two viruses in gingival tissue are unknown. This study determined levels of HCMV and EBV DNA in the periodontal pocket and in the adjacent gingiva of periodontitis lesions using a real-time polymerase chain reaction (PCR) assay.A total of 20 systemically healthy periodontitis patients participated in the study. Nine patients below 35 years of age were tentatively diagnosed as having aggressive (early onset) periodontitis, and 11 patients 36–56 years of age as having chronic (adult) periodontitis. Clinical parameters were evaluated using established methods. Using periodontal curettes, specimens were harvested from 6–10 mm periodontal pockets and from the adjacent inflamed periodontal pocket wall. A 5′-nuclease (TaqMan®) real-time PCR assay was used to identify and quantify genomic copies of periodontal HCMV and EBV.HCMV DNA was detected in 78% of subgingival and 33% of gingival tissue samples from aggressive periodontitis lesions, but only in 46% of subgingival and 9% of gingival tissue samples from chronic periodontitis lesions. In aggressive periodontitis, HCMV subgingival and gingival tissue counts were positively correlated with periodontal pocket depth and probing attachment loss at sample sites (p ≤ 0.03; Spearman's rank correlation coefficient test). EBV DNA was identified in 89% of subgingival and 78% of gingival tissue samples from aggressive periodontitis lesions, but only in 46% of both subgingival and gingival tissue samples from chronic periodontitis lesions. In aggressive periodontitis, positive correlations were found for EBV subgingival counts and periodontal pocket depth at sample sites (p = 0.04; Spearman's correlation) and for EBV gingival tissue counts and whole mouth mean gingival index (p = 0.04; Spearman's correlation). In chronic periodontitis, statistical significance was only found between EBV subgingival counts and periodontal pocket depth at sample sites (p = 0.04; Spearman's correlation). HCMV–EBV coinfection was revealed in 78% of aggressive periodontitis lesions but only 27% of chronic periodontitis lesions (p = 0.03; chi-squared test). Also, seven of nine aggressive periodontitis patients but only three of 11 chronic periodontitis patients revealed more than 10,000 copies of HCMV or EBV in subgingival or gingival tissue samples (p = 0.03; chi-squared test). Four of six patients having mean periodontal pocket depth at sample teeth (four study sites per tooth)> 6 mm, but none of 14 patients having mean pocket depth at sample teeth≤ 6 mm revealed more than 100,000 copies of HCMV or EBV in subgingival or gingival samples (p = 0.001; chi-squared test). In periodontitis lesions demonstrating herpesviruses in paired subgingival and gingival tissue samples, the tissue samples showed the higher HCMV copy counts in three of four patients and the higher EBV copy counts in six of eight patients.The elevated occurrence of HCMV and EBV DNA copies in periodontal pockets and in the gingival tissue of aggressive periodontitis lesions relative to chronic periodontitis lesions, and the increase in herpesvirus counts with increasing severity of periodontitis lend substantial support to a periodontopathic role of the two viruses. Real-time PCR determination of herpesvirus DNA in periodontal sites may become a promising marker to monitor the course of destructive periodontal disease. Herpesviruses and bacteria, now mostly studied in isolation, may cooperate synergistically in the development of periodontitis, and should probably be considered as a pathogenetic consortium in future investigations of periodontal infections. [ABSTRACT FROM AUTHOR]

Slots J. Update on human cytomegalovirus in destructive periodontal disease. Oral Microbiol Immunol 2004: 19: 217–223.© Blackwell Munksgaard, 2004. Human cytomegalovirus (HCMV), a herpesvirus, is discussed in this review as it relates to destructive periodontal disease in humans. HCMV genomic sequences, detected by polymerase chain reaction identification, occur with elevated frequency in severe adult periodontitis, localized and generalized aggressive (juvenile) periodontitis, Papillon–Lefèvre syndrome periodontitis, acute necrotizing ulcerative gingivitis, and periodontal abscesses. Herpesviruses establish lifelong persistent infections. HCMV infection involves an asymptomatic latent phase interrupted by periods of recrudescence where viral replication and possibly clinical disease become manifest. HCMV reactivation is triggered by a number of immunosuppressive factors, some of which have been shown also to be risk factors/indicators of periodontitis. HCMV periodontal infection may cause release of tissue-destructive cytokines, overgrowth of pathogenic periodontal bacteria, and initiation of cytotoxic or immunopathologic events. A growing body of data supports the concept that HCMV contributes to severe types of periodontal disease. HCMV infection of the periodontium may alter the immune control of resident microorganisms and be important in a multistage pathogenesis of periodontitis involving viral activation, periodontopathic bacteria, and host immune responses. Understanding the significance of HCMV and other herpesviruses in the development of periodontal disease may have important therapeutic implications. Vaccines against HCMV, which are in various stages of development, need to be evaluated for their ability to decrease the incidence of destructive periodontal disease. [ABSTRACT FROM AUTHOR]

Allied dental program directors have expressed increasing concerns about possible current and future shortages of allied dental educators. As a result, the ADEA Board of Directors created a task force to investigate the current status of allied dental faculty, including the degree of cultural diversity, and to identify whether current and/or potential future shortages of educators exist. A survey was sent to all accredited allied dental program directors. Results indicated that a current faculty shortage exists for dental assisting and dental hygiene programs, with a projected greater future shortage for all allied dental education disciplines, primarily as a result of retirement of current faculty members. The data collected also revealed a lack of diversity in allied dental faculties, especially in dental hygiene and dental assisting programs. Recommendations for action steps included investigating: 1) the use of technology to provide the faculty expertise necessary to allow more affordable quality education in almost any location and to maximize available resources; 2) alternative ways to reward faculty; 3) loan forgiveness as an incentive for exemplary graduates to pursue educational career goals; 4) an ongoing database to monitor the status of allied dental educators; and 5) best practices in higher education to attract a more diverse student body and faculty in terms of gender, ethnicity, and race. [ABSTRACT FROM AUTHOR]

Oxidation is known to affect the structure, activity, and rate of degradation of proteins, and is believed to contribute to a variety of pathological conditions. Metal-catalyzed oxidation (MCO) is a primary oxidizing system in many cell types. In this study, the oxidative effects of a MCO system (the Fenton reaction) on the structure of the tryptophan residues of α-crystallin were determined. Tandem mass spectrometry (MS/MS) was utilized to identify specific tryptophan and methionine oxidation products in the bovine α-crystallin sequence. After oxidative exposure, α-crystallin was digested with trypsin, and the resulting peptides were fractionated by reverse-phase HPLC. Structural analysis by mass spectrometry revealed that tryptophan 9 of αA- and tryptophan 60 of αB-crystallin were each converted into hydroxytryptophans (HTRP), N-formylkynurenine (NFK), and kynurenine (KYN). However, only HTRP and KYN formation were detected at residue 9 of αB-crystallin. Oxidation of methionine 1 of αA- and methionine 1 and 68 of αB-crystallin was also detected. The products NFK and KYN are of particular importance in the lens, as they themselves are photosensitizers that can generate reactive oxygen species (ROS) upon UV light absorption. The unambiguous identification of HTRP, NFK, and KYN in intact α-crystallin represents the first structural proof of the formation of these products in an intact protein, and provides a basis for detailed structural analysis of oxidized proteins generated in numerous pathological conditions. [ABSTRACT FROM AUTHOR]

Since the early 1990's, the death rate from AIDS among adults has declined in most developed countries, largely because of newer antiretroviral therapies and improved access to these therapies. In addition, from 2006 to 2011, the total number of new cases of HIV infection worldwide has declined somewhat and has remained relatively constant. Nevertheless, because of the large numbers of existing and new cases of HIV infection, the dental practitioner and other healthcare practitioners will still be required to treat oral and periodontal conditions unique to HIV/AIDS as well as conventional periodontal diseases in HIV-infected adults and children. The oral and periodontal conditions most closely associated with HIV infection include oral candidiasis, oral hairy leukoplakia, Kaposi's sarcoma, salivary gland diseases, oral warts, other oral viral infections, linear gingival erythema and necrotizing gingival and periodontal diseases. While the incidence and prevalence of these oral lesions and conditions appear to be declining, in part because of antiretroviral therapy, dental and healthcare practitioners will need to continue to diagnose and treat the more conventional periodontal diseases in these HIV-infected populations. Finding low-cost and easily accessible and acceptable diagnostic and treatment approaches for both the microbiological and the inflammatory aspects of periodontal diseases in these populations are of particular importance, as the systemic spread of the local microbiota and inflammatory products of periodontal diseases may have adverse effects on both the progression of HIV infection and the effectiveness of antiretroviral therapy approaches. Developing and assessing low-cost and accessible diagnostic and treatment approaches to periodontal diseases, particularly in developing countries, will require an internationally coordinated effort to design and conduct standardized clinical trials. [ABSTRACT FROM AUTHOR]