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Antibiotics have long been the main reason for the increase in man's longevity. Since their discovery, man has tried to reduce the level of infection by treating with antibiotics. At the same time, prophylactic use has been suggested, although this is controversial. Their routine use is not recommended, and empirical treatments at non-therapeutic doses, and indiscriminately, should be avoided, because they may become dangerous and harmful, causing among other things, the prevalence of resistant microorganisms and the eventual potentiation of an increase in morbid states. Infectious endocarditis is a systemic pathology that can start with a bacteremia, which comes either from dental procedures or/and chronic processes that already existed. Its etiopathogeny consists of a combination of bacteremia and two other factors: Cardiac injury, which can be congenital or/and acquired, and a debilitated immunological system (patients who have transplanted organs, or those who have auto-immune diseases, such as pemphigus vulgaris, systemic lupus erythematosus). The main goal is to prevent or to fight against the transient bacteremia, reducing its intensity and duration, and also to kill the bacteria in at-risk patients. In this way, infectious endocarditis can be prevented; the dental surgeon plays an important role in the prevention of this condition, which joins medical and dental aspects. This can be done by antibiotic prophylaxis. The dentist needs to be acquainted with the medical protocols of the heart health societies.

Background Concern that some catheter related bloodstream infections (CRBSI) arise from dental treatment in home parenteral nutrition (HPN) patients results in recommendation of antibiotic prophylaxis. Clinical guideline 64 is widely recognised and observed. There is a lack of consistent guidance for other patient groups viewed at risk from procedural bacteraemia. Methods 1. An email survey of the British Association for Parenteral and Enteral Nutrition (BAPEN) HPN group, requesting physicians' opinions, observations and practises relating to oral health and CRBSI prevention; 2. Comparison of oral health parameters and dental treatment in relation to patient reported 12 month CVC infection history, using chi-square analysis to assess associations in 52 HPN patients. Results 1. Sixty-eight percent of the UK HPN Group responded. Fifty percent linked oral health/dental treatment with the possibility of CRBSI, 39% were unsure. Sixty-one percent had recommended parenteral prophylactic antibiotics (82% IV, 18% IM), mainly following the historic infective endocarditis (IE) dental prophylaxis guidelines. Infection with streptococci, prevotella and fusobacteria caused most concern. Amoxicillin, metronidazole, co-amoxyclav and gentamycin were the most prescribed antibiotics. Thirty-six percent might delay HPN if oral health was poor; 57% had recommended dental examination and 25% dental extractions, to prevent or treat CRBSI. 2. Associations between patient recalled CVC infection and their current dental status, the interval since dental treatment or the prophylaxis received over the previous 12 months did not achieve significance. Conclusions Opinion varies among UK HPN providers on the role of dental treatment and oral health in CRBSI and on prescribing prophylactic antibiotics for dental treatment. Prophylaxis guidance specific to this patient group is required.

Background The purpose of this systematic review was to assess the efficacy of routine dental prophylaxis applied before professionally applied topical fluoride (PATF) or at a regular recall visit in the prevention of caries or gingivitis. Types of studies reviewed Ovid MEDLINE and its allied versions; CINAHL; Cochrane Library; EMBASE; Health and Psychosocial Instruments; HealthSTAR; International Pharmaceutical Abstracts; and ACP Journal Club were searched for English and Human articles from 1966 to 2007 for original in vivo English publications assessing rubber cup dental prophylaxis. In vitro studies, case series, case reports or letters to editors (not containing primary data), editorials, review articles and commentaries were excluded but were read to identify any potential studies. Results One hundred and eighty-nine articles were searched for relevancy resulting in six original studies that met our inclusion criteria. There was a unanimous agreement in four studies that a dental prophylaxis is not warranted before a PATF for caries prevention in children. A generalisation on dental prophylaxis before PATF cannot be applied to adolescents and adults. Available evidence (two other studies) fails to demonstrate any benefit in the prevention of gingivitis from further dental prophylaxis at interval used for recall examinations. Clinical implication To prevent caries in children, dental prophylaxis need not be provided either at a recall visit or before PATF. Dental prophylaxis at intervals of four months or more is not justified for the prevention of gingivitis in the general population.

Antibiotic prophylaxis has been recommended to prevent infective endocarditis in patients with valvular heart disease undergoing dental procedure. Erythromycin and clindamycin have been recommended as alternative agents in those who are allergic to penicillin. We report a penicillin-allergic patient who developed infective endocarditis despite clindamycin prophylaxis. Viridans-group Streptococcus that was later identified as Streptococcus sanguinis resistant to clindamycin was isolated from her blood. Initial therapy with clindamycin did not improve her symptoms. Her symptoms responded to linezolid therapy. She underwent mitral valve replacement because of deteriorating cardiac function. Postoperatively, she was treated successfully with linezolid and levofloxacin intravenously for 4 weeks. She remained well on her 30-month follow-up. Viridans-group Streptococcus, as a group, has been shown to be increasingly resistant to various antimicrobial agents including clindamycin and erythromycin. Although the percentage of resistant viridans-group Streptococcus strains is still low in most areas, local resistance should be monitored. If this trend should continue, the value of these antibiotics as prophylactic agent should be reevaluated.

A 36-year-old patient who was otherwise healthy had acute osteomyelitis of the humeral shaft develop after routine prophylactic dental cleaning and ultrasonic scaling. Haemophilus aphrophilus grew on cultures of material obtained during biopsy of the humerus, and pathologic examination confirmed the diagnosis of acute osteomyelitis. Haemophilus aphrophilus, a fastidious gram negative bacillus, is part of the normal oral flora and is a rare pathogen. Osteomyelitis caused by Haemophilus aphrophilus has not been reported to occur after routine dental prophylaxis. The patient was treated successfully with surgical debridement and appropriate antibiotics.

A 68-year-old man with stable chronic myelogenous leukemia received a single dose of clindamycin before having a tooth extracted. He was neutropenic 6 days later, with an absolute neutrophil count of 945 cells/mm3. His neutrophil count returned to normal within 2 weeks. Clindamycin has been implicated in drug-induced neutropenia; however, a review of the literature produced only three reports of this reaction. Only one provided the duration of the neutropenia. To our knowledge, this case report is only the second that provides the duration of the clindamycin-induced neutropenia. Clinicians should be made aware of this potential adverse event.

SUMMARY Institutionalized patients with moderate and severe handicapping conditions may have difficulty receiving routine dental treatment. One reason that prevents their access is negative practitioner expectations. Traditionally, this group has been treated in a hospital setting. This study assesses the ability of dental hygiene students in the general clinic setting to provide dental prophylaxis to patients with moderate and severe handicapping conditions. Of the 38 patients, 31 (82%) were successfully treated in the clinic or quiet room. The results suggest that greater numbers of patients can be treated in private practice situations when simple treatment adjuncts and mild physical restraint are used.

This study was conducted to evaluate the effect of dental prophylaxis prior to the topical application of acidulated phosphate fluoride solution applied twice a year in schoolchildren. Experimental groups were: Group I--control group, had no treatment. Group II--twice yearly topical application of acidulated phosphate fluoride solution with prior professional prophylaxis with rubber cup and non fluoride paste. Group III--twice yearly topical application of acidulated phosphate fluoride solution with prior toothbrushing with a non-fluoridated prophy paste. After 18 months analysis of 160 children in each study group led to the following conclusions: 1. Acidulated phosphate fluoride topical applications are effective in the prevention of dental caries. 2. The omission of a professional prophylaxis prior to topical fluoride application does not affect significantly the caries preventive effect.

This report deals with the influence of the self-fulfilling prophecy on dental prophylaxis. The aim was to test if this phenomenon had any influence on the treatment of patients, they and their therapeutist's perception of each other and the result of the prophylactic work. Sixty patients and 34 students were involved. The patients were randomly classified as “good” or “bad”. Twenty-seven students had a patient from each group. Dental plaque and gingival inflammation were recorded before and after the treatment. No difference in improvement between the two groups could be shown. Both patients and students were interviewed about their experiences and feelings during the treatment. All patients were satisfied with their therapeutist. The students generally accepted the classification although they were made aware of the self-fulfilling prophecy. This was confirmed by a significantly higher frequency of patient drop-outs, broken appointments and critical notes about the patients in the “bad” group compared to the “good”. The conclusions are that the self-fulfilling prophecy can be initiated by even minor notes in patient files, and that this affects the treatment of patients.

Dental prophylaxis, today considered one of the most important services of the profession, has not always been regarded as a significant aspect of dentistry by practitioners as well as by patients.

Frequent professional scaling and regular tooth brushing are the main public health measures available for preventing and controlling periodontal disease but their frequency and efficacy are still incompletely understood. This investigation was carried out on 1,416 rural children and 189 factory workers in Lucknow area in the age groups 14 +/- 1, 17 +/- 1 and 28 +/- 2 years of age to evaluate the optimum requirement of these measures to the extent they will be economical and usable in the public health programs. The prevalence of gingivitis and periodontal disease in Lucknow children and adult samples was found to vary between 93 to 100%. Periodontal disease (including gingivitis and loss of attachment) and calculus accumulation showed considerable reduction (P less than 0.01) with any type of treatment. Scaling alone will not reduce the plaque formation for which regular tooth brushing is essential. Yearly and half-yearly scaling along with tooth brushing instructions will considerably improve and maintain the oral hygiene thereby reducing the prevalence and severity of periodontal disease, plaque, and calculus accumulations. However, more intensive measures (quarterly prophylaxis) will further improve the periodontal health and reduce calculus accumulation. The apical migration of the epithelial attachment can practically be stopped by rendering scaling half yearly, without any instructions in oral hygiene and elimination of dental plaque.

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Background Dental procedures may cause stress and increase the salivary cortisol levels. It is important to known if apparently simple procedures such as professional dental prophylaxis at low speed (DP) are stressful for children with dental behaviour management problems (DBMP) to help with behaviour guidance strategies. This longitudinal study aimed to evaluate if DP changes a physiological marker of stress (salivary cortisol) in children with DBMP who were referred to dental treatment under sedation. Methods One paediatric dentist carried out a DP with rubber cup and pumice followed by dental examination in 39 children aged 2–5 years, prior to the dental sedation appointment. Children’s saliva was collected at three different moments: upon waking (UW), on arrival at the dental office reception area (RA) and 25 min after the dental prophylaxis (DP). The saliva samples were analysed using an enzyme immunoassay kit. The Wilcoxon test was used in paired comparison (P

Attitudes to teeth and dental health have been tested in ninety-seven 19-year-olds. Of this number, 29 in group A and 32 in group B had for 3 years participated to varying extent in a systematic plaque control program based on professional tooth cleaning. Seventeen of the total, who after 1 year's participation in the program declined further treatment, constituted group C. The control group D consisted of 19 young people who had had only fluoride mouthrinsings each second week during the first year of the trial. Regardless of grouping, all had had fluoride mouthrinsings during the whole of their earlier schooling. Ten questions concerning their attitude to teeth and dental health were answered on a graphic rating scale, the ends of the scale marking the most positive and negative attitudes, respectively. The results showed no marked differences in attitudes among the four groups: only a few significant differences were found at the 5% level. The differences in clinical variables recorded among the groups did not correspond to significant differences in measured attitudes. Great differences, on the other hand, were found at an individual level. All subjects had consistently positive attitudes except in their views of their own future state of dental health; the large scatter (deviation) in the answers on this point reveals uncertainty of their ability to retain their present (good) state of dental health. Analysis of data showed close correlation between attitudes to their own present and future state of dental health and the number of decayed and filled tooth surfaces (DFS prevalence) at the end of the trial. There was no corresponding correlation between the opinion as to how to look after one's own teeth and the individual's gingival condition at the end of the trial.

A questionnaire concerning “the awareness of oral health and dental treatments in the past one year”was sent to 4, 000 persons in general (Group A) and 1, 000 bank clerks (Group B) .Of the two groups, 35.5 percent of the persons in general and 62.4 percent of the bank clerks answered the questionnaire.The answers to the questionnaire on the epidemiological survey of the periodontal disease of the two groups have been reported previously.The findings on the condition of the various dental treatments are described in this report.1) In Group A, the percentage of the subjects who received restoration by filling, crown or post-crown in the past one year was 32%, 23% and 9%, respectively. The mean number of teeth in a subject who was treated by filling, crown or post-crown was 2. 2, 1.9 and 2. 1, respectively.2) In Group A, the percentage of the subjects whose teeth were extracted was 16% and the mean number of extracted teeth was 2.7. The percentage and the number increased with age after the age of 35. Both the percentage of the subjects whose teeth were extracted in the past one year and the mean number of extracted teeth in Group B were much smaller than those in Group A.3) In Group A, the percentage of the subjects who received treatment for fixed bridge, removable partial denture (maxilla or mandibulla) or complete denture (maxilla or mandibulla) was 9%, 3 to 4% and 0.2 to 0.6%, respectively.These data will help to reveal the current status of the various dental treatments in Japan.

The effect of a dental prophylactic program based on systematic plaque control has been tested during a 3-year period on youths aged 16–19 years. During their last year at comprehensive school they received professional tooth cleaning every third week by specially trained dental hygiene nurses. At the end of this first experimental year the subjects were offered continued prophylaxis of the same type against caries and gingivitis during 2 more years. Interested subjects were divided equally at random into test groups A and B. In the second year group A received professional tooth cleaning once a month and in the third year once each 6 months. Group B was offered, both in the second and third years, only two prophylactic sessions each year according to this model. Test group C comprised the subjects who expressed no interest in continued professional tooth cleaning. A control group, group D, consisted of pupils of the same ages from a neighboring school area. These received in the first experimental year a prophylactic program based on mouthrinsing each second week with 0.2% sodium fluoride solution. After this first year neither test group C nor the control group D participated in any organized dental health care program. After the first year there were significant differences among the groups, the plaque and gingival indices in the control group D being significantly higher than in test groups A, B and C. At the end of the third year significant improvements in these indices had taken place in groups A and B. The corresponding values in groups C and D did not differ significantly at the three recordings. Significant correlations existed between the plaque and gingivitis scores at the end of the experimental period within the respective groups. Significantly more dental caries (new DPS) developed in the control group D than in test groups A and B during the period of the experiment: on average 3.3 versus 1.0 and 1.2 new DFS, respectively. The figure for caries increment in group C was 2.0. Regardless of grouping, individuals with caries increment during the experimental period had a significantly higher number of risk factors, here defined as the total of upper or lower quartile values for lactobacillus counts, secretion rate and buffering capacity of the saliva, than individuals without caries increment.

A prophylaxis followed by three topical applications of an iodine-potassium iodide solution significantly reduced the levels of Streptococcus mutans in fissure and approximal plaques and in saliva. Reductions persisted 20-24 weeks after treatment in salivary and approximal samples. A prophylaxis alone exerted a small and temporary reduction of S. mutans in occlusal fissure plaque, but did not reduce the levels of this organism in approximal plaque or in saliva. A significant relationship existed between the levels of S. mutans in saliva and the proportions of this organism in plaque. The dorsum of the tongue does not appear to constitute a significant reservoir for S. mutans following disinfecting procedures.

A study of the knowledge about dental health and diseases of youths in their late teens has been conducted. A 10-class questionnaire relating to dental caries and gingivitis/periodontitis was answered by three test groups (A, B, C) totalling seventy-eight 19-year-olds who, during a 3-year period, had undergone professional prophylaxis at different intervals. Nineteen young people of the same age without organized preventive measures since their last attendance at the public dental service constituted a control group (D). The test groups were found to have a significantly better knowledge of factors relating to gingivitis/periodontitis than the control group. In questions relating to caries there were no differences among the groups. Higher points were scored in knowledge of therapy and prevention than of the causes and symptoms of the dental diseases. Several regularly repeated sessions for professional prophylaxis did not lead to better knowledge than only a few. No consistent correlation was found for any of the groups between knowledge and both quantitative tooth cleaning, i.e. type and frequency of use of oral hygiene aids, and qualitative tooth cleaning, expressed as the occurrence of plaque and gingivitis. Nor were significant differences found in these respects between individuals with and without a caries increment during the observation period regardless of grouping.

THAT regtular periodical prophylactic treatnments will bring about an improved condition of the mouth is shown by the figures secured in work among the employees of the Metropolitan Life Insurance Co. during the years 1918, 1919 and 1920. During the past five years, thousands of the employees of the company have received two prophylactic treatments each year. Careful records have been made of mouth conditions. Cleanliness of the mouth has been classified under "Yes," "No," or "Fair." Cases classified under "No" are those which show considerable amount of tartar deposits with inflammatioin of gum tissues. Those classified as "Fair" have slight deposits of tartar and slight gum inflammation while those classified under "Yes" are practically free from tartar or gingivitis. It should be understood that this classification was made solely from the viewpoint of hygiene or whether the patient's health might be affected by mouth conditions. Therefore, those classified under "Yes" must not be understood as being perfectly clean. There may be found stains either from tobacco or other causes, but this was not believed to influence the health condition of the mouth nor of the patient. Figures secured under these classifications should prove of value and of interest. All employees who first came to the Dental Division in 1915, and who have continued to come twice each year are called Class 1; those who first came in 1916, are called Class 2; those in 1917, Class 3; in 1918, Class 4; in 1919, Class 5; and in 1920, Class 6. It was in 1918 when we first ascertained the percentage of "Yes," "No" or "Fair" for the four classes we had at that time. TAABLE I PERCENTAGE TABLE OF YES, NO AND FAIR" IN 1918 Yes No Fair Class 1 started in 1915.... 27% 259% 48% Class 2 started in 1916.... 25% 27% 48%o Class 3 started in 1917.... 18%o 29% 53% Class 4 started in 1918 .... 10% 50% 40%

OBJECTIVE: The primary objective of this study was to determine the prevalence of appropriate use of antibiotics before a dental procedure. DESIGN: Retrospective cohort study. SETTING: Veterans Healthcare Systems. PARTICIPANTS: Veterans who filled outpatient prescriptions for antimicrobial dental prophylaxis at the Veterans Administration Western New York Healthcare System from December 1, 2017, through October 1, 2019. INTERVENTIONS: None. MAIN OUTCOME MEASURES: Use of antibiotic dental prophylaxis was deemed appropriate if in accordance with guideline recommendations. Descriptive statistics were used to summarize data. RESULTS: A total of 130 veterans receiving antibiotics for dental prophylaxis were included in this evaluation. Of those who were included, only 16.9% received appropriate antibiotic dental prophylaxis. Patients with a prosthetic joint were significantly more likely to be inappropriately prescribed antibiotics for dental prophylaxis. Approximately 87% of patients who were inappropriately prescribed antibiotic prophylaxis had prosthetic joints (P < .0001). CONCLUSION: Most antibiotics for dental prophylaxis are prescribed inappropriately. The large amount of inappropriately used antibiotics in this study highlights the need for dental stewardship in our veteran population. Antibiotics for dental prophylaxis therefore represent an important stewardship target in the outpatient setting. This may be an ideal opportunity for senior care pharmacists to intervene upon.

Background Prosthetic joint infection (PJI) of total hip (THA) or total knee arthroplasty (TKA) after dental procedures is uncommon, and antibiotic prophylaxis remains controversial. For high-risk patients, the American Academy of Orthopedic Surgeons recommends amoxicillin prophylaxis. However, no systematic review of the literature of PJIs associated with dental procedures explores if amoxicillin is suitable for the reported organisms. Methods A librarian-assisted search of the major databases (PubMed, Medline, Embase, Scopus) identified 954 articles. Only case reports, case series, and reviews with patient level data were included. After exclusions, 79 articles were fully reviewed. Results Forty-four PJIs after dental procedures were identified, 22 in primary THA, 20 in primary TKA, one in revision THA, and one in a hip resurfacing procedure. Antibiotic prophylaxis was documented for 5 patients. The dental procedure was invasive in 35 (79.5%). Comorbidities were present in 17 patients (38.7%). The organisms reported were Streptococcus spp. in 44%, other aerobic gram-positives in 27%, anaerobic gram-positives in 18%, and gram-negative organisms in 11%. An estimated 46% of organisms may be resistant to amoxicillin. The outcomes of treatment were reported for 35 patients (79.5%). Twenty-seven patients (61.4%) had no clinical signs of PJI at the final follow-up visit. Conclusions Lower extremity PJI associated with dental procedures is often caused by organisms unlikely to be prevented with amoxicillin. Additional studies are warranted to determine the choice and efficacy of antibiotic prophylaxis to prevent dental-associated PJI in the highest risk patients. Insufficient data exist to recommend the optimal treatment for patients with PJI in THA and TKA associated with dental procedures.

Chronic kidney disease is common, particularly in geriatric animals. General anaesthesia is usually required for routine procedures (dental prophylaxis, ovariohysterectomy or castration) and emergency procedures, which may have profound effects on the body, especially on cardiac output, subsequent blood pressure and on the perfusion of different vital organs. It is essential to understand the effects of renal dysfunction on the patient, as well as the effects that anaesthesia and surgery may have on the kidneys. The understanding of renal physiology, along with the effect of drug choices, is key to successful management of chronic renal failure.

Objectives Pain is affecting acceptance of supportive periodontal therapy and primary periodontitis prevention. Our objective was to evaluate the efficacy of a 1-week pre-treatment use of dentinal-hypersensitivity-reducing mouth-rinses (DHM) in periodontal maintenance (SPT) or dental prophylaxis patients. Material and methods One hundred fifty-five participants attending for professional mechanical plaque removal (PMPR) were randomly assigned to use a mouth-rinse twice daily for 1 week prior to their next PMPR. Rinses were containing either potassium oxalate (n = 52), arginine (n = 52), or herbal extracts (n = 51). At baseline and reassessment, procedural pain was assessed by visual analogue scale (VAS) and verbal rating scale (VRS). Self-reported efficacy was documented. Results No inter-group differences were estimated between both test groups and the control for baseline and reassessment means (VAS, VRS). In the SPT group, VAS reduction and self-reported efficacy were found (p < 0.05). Conclusion The 1-week use of DHM failed to show a predictable effect on discomfort during PMPR overall. Around 20% of the patients showed a quantifiable benefit from both test mouth-rinses, whereas more than 50% reported a subjective pain reduction. Focusing patients undergoing supportive periodontal therapy, quantifiable effects were found for both test groups. From a patient’s point of view, DHM might be a suitable adjunct to enhance procedural comfort, especially in patients with a history of periodontitis. Clinical relevance The 1-week use of the dentinal-hypersensitivity-reducing mouth-rinses prior to professional-mechanical-plaque-removal showed to be a suitable adjunct to enhance procedural comfort during instrumentation, especially in patients undergoing supportive periodontal therapy. Registration number: DRKS00010811

The parenting style is shifting universally. Children lack the skills needed to deal with life stressful situations like those present in dental setting. Previous studies showed a correlation between parenting style and the child’s dental behaviour. No studies have been performed in the Kingdom of Saudi Arabia (KSA) to relate parenting style to child’s dental behaviour. The purpose of this study is to correlate parenting styles with the dental behaviour of their children, in Riyadh, KSA. Two hundred and eighty-two healthy preschool children aged 3–6 years were recruited in their first dental visit, to a postgraduate Paediatric Dentistry Clinics of the Dental University Hospital at KSU, Riyadh, KSA. The Parenting Styles and Dimensions Questionnaire was completed by the primary caregiver/parents. The behaviour of the children was evaluated after dental prophylaxis and fluoride application in the dental chair using Frankl behavior rating scale. Family and child demographic data were evaluated through a questionnaire. Two hundred and eighty-two healthy Saudi children participated in the study with their parents. Two parenting styles were identified among Saudi parents including authoritative (94%, n = 265) and permissive parenting styles (6%, n = 17). Most of the children behaved positively (n = 205, 72.7%). Significant correlations were detected between parenting style and parent’s dental anxiety (P value 0.02) but not significantly correlated to a child’s dental behaviuor. In the KSU sample studied, two parenting styles were identified among Saudi parents, authoritative and permissive parenting styles. Parenting style was correlated to parental dental anxiety and had an influence on a child’s dental behaviour. Clinically, interesting correlations were identified regarding factors affecting child/s first dental visit behaviour.

To evaluate the heart rate (HR) and behaviour of children and teenagers with Cerebral Palsy (CP) when having a dental appointment. A comparative cross-sectional study was carried out with 60 participants with CP, between 2 and 14 years old (study group—SG), and 60 normotypical individuals (CG). The sample was paired according to age, gender and socioeconomic status. Behaviour was evaluated during dental prophylaxis using the Frankl Scale, and HR was measured at five moments: before the appointment, when sitting in the dental chair, during the clinical examination, during prophylaxis and immediately after prophylaxis. Mann–Whitney, Friedman and Chi-square tests were applied at a significance level of 5%. SG presented significantly higher HR (p

Objective Investigating patients’ perceptions regarding need for antibiotic prophylaxis during dental procedures after undergoing joint arthroplasty. Methods Questionnaire was administered to patients presenting at: 1)an orthopaedic office; 2)a dental office; regarding perceptions of antibiotic prophylaxis. Results 36 orthopaedic patients responded “Yes” to always taking prophylaxis; 36 patients responded “No” (36/72, 50.0% compliance). Five dental patients responded “Yes” to always taking prophylaxis; 19 patients responded “No” (5/24, 20.8% compliance) (p = 0.017). 67/135 orthopaedic patients (49.6%) endorsed some form of dental prophylaxis, versus 34/58 dental patients (58.6%) (p = 0.27). Conclusion Patient perceptions of the need for dental prophylaxis vary within orthopaedic and dental practices.

Background: Periodontal disease has become a major public health problem in India with a high prevalence. Conventionally, it is believed that regular dental prophylaxis and maintenance of oral hygiene is sufficient for the prevention or control of gingival diseases, and yet there are patients undergoing various periodontal surgeries in everyday life. Periodontology treats the body as one unit, and hence, there should be in-depth knowledge of systematic diseases and their relation with the oral cavity. The awareness about the scope of periodontology and the major as well as minor surgeries is very low among the population as among the undergraduate students. This questionnaire survey was undertaken to judge the same and subsequently, if required, provide awareness. Methodology: The blinded questionnaire survey was undertaken among all the dental colleges from Pune, namely, Dr. D. Y. Patil Dental college (Pimpri), Sinhgad Dental College (Pune), Rangoonwala Dental College (Pune), and Bharti Vidyapeeth Dental College (Pune). A total of 150 students from the final year of all colleges voluntarily participated in the study. As it was a triple blinded study, no gender bias was obtained in the result. Results: On getting the results and statistical analysis using SPSS Version 11.5 software, it was found that dental undergraduate students (Bachelor of Dental Surgery) had superficial knowledge about maintenance of periodontal health, namely the students could tell the importance of chlorhexidine mouth wash but were unable to tell the appropriate method of use. Many students were not able to differentiate between the symptoms of the periodontal abscess and periapical abscess. The importance of implant landmarks and basic knowledge about the pull of frenal attachment was lacking among the majority of the participants among all the three colleges. Conclusion: It can be stated that periodontal awareness among dental undergraduates was lacking in regard to its application toward the surgeries and its importance with systemic diseases as diabetes and hypertension. This bridge of ignorance must be crossed so that patients can be rightly educated by in earliest stage, and the importance of the branch of periodontology can be duly given. Note: Please note source file has more reviewer queries found, please check and confirm

Objective Antimicrobial peptide, KSL‐W, formulated as an antiplaque chewing gum (APCG), was tested to evaluate the dental plaque inhibition activity and safety in an IRB approved and FDA regulated 4‐day plaque regrowth clinical study. Methods This Phase 2 two‐armed placebo‐controlled, double blind, randomized (1:1), multiple dose, and single‐center study was evaluated in a proof of concept for the APCG containing 30 mg antimicrobial peptide KSL‐W. Twenty six generally healthy subjects were consented and randomized into the study. The subjects were administered a dose three times per day for four treatment days following a complete dental prophylaxis. Participants were prohibited from conducting oral hygiene care (teeth brushing, flossing, and/or mouth wash rinse) for the duration of the trial. Twelve to 16 hr prior to the baseline visit, the subjects were to abstain from oral hygiene care. The Quigley–Hein Turesky plaque index (QHT) score and the oral soft tissue clinical exams were obtained at both Day 0 and Day 4. Results All randomized study subjects that received either APCG or placebo gum completed the study with no significant adverse events recorded. The APCG significantly inhibited the regrowth of dental plaque over the course of 4 days. The whole mouth data demonstrated a difference in the QHT between the APCG and the placebo gum of 1.14 (SE = 0.27) and 95% confidence bounds of 0.58, 1.70 with a two‐tailed P value of .0003. Conclusion Considering the limited sample size, the proof of concept analysis in this Phase 2 study confirmed that APCG is effective against dental plaque formation and safe for human use. (ClinicalTrials.gov Study ID# NCT02864901).