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This study investigated the impact of dental prophylaxis on 5-fluorouracil (5-FU)–related oral mucositis (OM) according to the head and neck cancer (HNC) locations and treatment times. A total of 13,969 HNC participants, including 482 5-FU–related OM subjects and 13,487 comparisons were enrolled from the Longitudinal Health Insurance Database for Catastrophic Illness Patients of Taiwan between 2000 and 2008. All subjects were stratified into subgroups based on the times to perform chlorhexidine use, scaling, and fluoride application before 5-FU administration. The dental prophylaxis related to 5-FU–related OM was estimated by multiple logistic regression and represented with odds ratio (OR) and 95% confidence interval (CI). Fluoride gel application and scaling significantly impacted on OM development (p

Objective To evaluate dental prophylaxis influence in tooth color assessment with the use of different methods. Materials and methods Volunteers were consecutively recruited and screened according to appropriate inclusion/exclusion criteria. Each participant's upper right central incisive and canine color was measured before and after dental prophylaxis with a one-week interval. Tooth color assessment was performed by calibrated operators and the patient using a VITA Classical shade guide and by spectrophotometric methods with a proper device (SpectroShade). Color was reported as mean with SD of Commission Internationale De l'Eclairage (CIE) L*a*b* values, ΔEab and ΔE00. One-way analysis of variance and Tukey post hoc were performed to assess differences between methods and paired t test for assessing differences in tooth color coordinates after dental prophylaxis. Values of P < .05 were taken as significant. Results Fifty patients were included. Self-assessed dental prophylaxis effects equated to a significantly different mean ΔE00 value of 2.3 ± 1.7 (P < .01), when compared to the calibrated operator reported 0.8 ± 1.1 and the spectrophotometer 1.0 ± 0.5. Half of volunteer's ΔE00 values surpassed the acceptability threshold, when compared to 28% from investigator and 10% from spectrophotometer. Conclusion Performing a dental prophylaxis did have an influence in tooth color perception with a higher self-perceived effect in the patient assessment. Clinical significance The results of this study suggest that performing professional dental prophylaxis presented a perceived effect in tooth color regardless of the method used being that patients precepted whiter and less yellowish teeth. Since extrinsic stain is considered as one of the factors that could influence tooth color assessment, performing professional dental prophylaxis prior to composite or ceramic color selection in anterior teeth restorations could consequently increase treatment predictability.

Background Controversy exists regarding the need for antimicrobial prophylaxis prior to dental procedures following spinal fusion. In this review, we attempt to synthesize a comprehensive summary of the published literature to provide recommendations on the use of antimicrobial prophylaxis before dental procedures in patients with a history of spinal fusion. Methods We searched PubMed, Web of Science, Cochrane Library, and EMBASE databases from inception to February 2018. Eligible studies included patients with a history of spinal fusion treated with or without antimicrobial prophylaxis in preparation for dental procedures. Two reviewers independently assessed the eligibility of potential studies and extracted data. Outcomes of interest were the indications and efficacy of antimicrobial prophylaxis to protect against infection of spinal prostheses with dental origin. Results A total of 1,909 articles were initially screened. After inclusion and exclusion criteria were applied, one study was found specifically relating to dental prophylaxis and spine surgery. The survey, as well as objective studies and professional organization guidelines on dental prophylaxis in patients with total hip and knee replacements, were reviewed to add context to the controversy. Conclusions There is a significant paucity of literature regarding dental prophylaxis in spine surgery patients. Although there has been a recent movement away from recommending antimicrobial prophylaxis before dental work in patients with other forms of orthopaedic prostheses, the gap in the literature addressing spine patients represents an important question that requires more targeted and specific research.

Aim This study aimed to clarify whether dental plaque disclosing before professional prophylaxis would improve the visualization of dental plaque, therefore optimizing the procedure. Materials and methods The sample comprised both the smooth and occlusal surfaces of the teeth of 25 children from 18 to 36 months. A randomized crossover clinical trial was conducted with two groups: GI-with disclosing and GII-without disclosing (washout/1 month). The teeth were stained with 1% malachite green solution to assess the amount of dental plaque on smooth and occlusal surfaces. Results Dental plaque removal was more effective and statistically faster (391.27 seconds ±142.2) in GI. The plaque index and the prophylaxis duration were inversely related in GI. The child's behavior did not affect the plaque removal effectiveness, regardless of plaque disclosure (p > 0.05). Conclusion Dental plaque disclosing in young children is an effective and less time-consuming method that improves the quality of the professional dental prophylaxis. Clinical significance Biofilm control is important for the success of programs for prevention of early childhood caries (ECC) and considering the particularities inherent to the dental care of infants, it is necessary that periodic professional prophylaxis is effective in eliminating the oral biofilm, ideally reducing chair time. Although dental plaque disclosing has been traditionally performed on educational basis during oral hygiene instruction, this resource can be safely employed to help professional prophylaxis in infants. How to cite this article de Alencar CRB, de Oliveira GC, et al. Dental Plaque Disclosing as an Auxiliary Method for Professional Dental Prophylaxis in Early Childhood. Int J Clin Pediatr Dent 2019;12(3):189-193.

Background Chronic kidney disease (CKD) still leads to high mortality rates, mainly due to cardiovascular disease. One important influencing factor is persisting low-grade chronic inflammation partly maintained by gingivitis that favors transient bacteremia during daily activities such as toothbrushing. Methods To examine whether intensive dental prophylaxis can restore oral health, reduce the prevalence of bacteremia and degree of systemic inflammation indicated by CRP levels, we conducted this pilot study examining 30 CKD patients aged 6–26 years, 15 receiving intensive prophylaxis (IP), 15 receiving treatment as usual (TAU) serving as control group. There were three appointments for examination, each 10 ± 1 weeks apart (at baseline, after intervention periods one and two, when TAU also received IP, and the IP group stopped prophylaxis). Results The gingival index (GI) in the IP group decreased by 90% (GI 0.09; p=0.001), resulting in almost healthy gingiva. There was no significant change in CRP or prevalence of bacteremia. General prevalence of bacteremia after toothbrushing was 9.5% affecting 7 (26%) of the participants. In three participants, bacteremia dissolved after IP, in one after TAU. Two patients developed bacteremia ≥ 10 weeks after ending IP. We identified eight different bacterial species. Conclusions We were able to show that IP can effectively treat gingivitis. It might be a promising approach to reduce systemic inflammation and subsequently lower premature cardiovascular disease, despite the lack of statistical significance. Future research requires a larger patient cohort to enable matched treatment groups with long-term follow-up and molecular detection methods for bacteremia. Graphical abstract

Over the past 2 decades, personal digital devices have evolved to become portable, attractive, readily accessible, interactive, and ubiquitous. Although digital and social media have evidence-based benefits, including early learning, exposure to new ideas and knowledge, and increased opportunities for social contact and support, unsupervised and unchecked use of personal digital devices can have negative consequences for the physical and mental health of children in their formative years.The widespread use of portable digital devices has been accompanied by a concomitant rise in the prevalence of physical and mental health issues in children. Research suggests an association between these trends, which also may be considered from a public health perspective. Proposed interventions include the development and implementation of individual family media use plans for children of all ages.

Objective: The aim of this study was to determine if a single photobiomodulation treatment can reduce oral erythema and edema following routine dental prophylaxis in canines. Background: P...

The aim of this study was to investigate the association of different dental prophylactic modalities and osteoradionecrosis (ORN) and determine the risk of ORN under different timing periods of scaling, with the use chlorhexidine mouth rinse after surgery and with different strategies of fluoride gel application in head and neck cancer (HNC) participants. A cohort of 18,231 HNC participants, including 941 ORN patients and 17,290 matched control cases, were enrolled from a Longitudinal Health Insurance Database for Catastrophic Illness Patients (LHID-CIP) in Taiwan. Based on different dental prophylactic modalities before radiotherapy, including chlorhexidine mouth rinse, scaling, and fluoride gel, all HNC subjects were stratified into different groups. The Cox proportional hazard regression was used to compare ORN incidences under different dental prophylactic modalities. The results revealed that scaling and chlorhexidine mouth rinse were significantly related to ORN risk ( P = 0.004 and P < 0.0001). Chlorhexidine mouth rinse was highly correlated to ORN occurrence (hazard ratio [HR], 1.83–2.66), as exposure increased the risk by 2.43-fold among oral cancer patients, regardless of whether they had received major oral surgery or not. Oral cancer patients receiving scaling within 2 wk before radiotherapy increased their incidence of ORN by 1.28-fold compared with patients who had not undergone scaling within 6 mo. There is no significance of fluoride application for dental prophylaxis in increasing ORN occurrence. In conclusion, dental prophylaxis before radiotherapy is strongly correlated to ORN in HNC patients. Chlorhexidine exposure and dental scaling within 2 wk before radiotherapy is significantly related to ORN risk, especially in oral cancer patients. The use of 1.1% NaF topical application did not significantly increase the risk of ORN in HNC patients. An optimal dental prophylaxis protocol to reduce ORN should concern cancer location, cautious prescription of chlorhexidine mouth rinse, and proper timing of scaling.

Introduction. Proper nutrition in pregnancy has effects on the health and well-being of the mother as well as is a key factor responsible for foetal growth and development, which are initiated at conception and last throughout pregnancy. Aim. The aim of the paper was to present relevant data on the role of prenatal maternal nutrition for caries prevention in both mother and child. Material and methods. Pubmed, EMBASE, MEDLINE, guidelines of dental associations and World Health Organization were searched using the following keywords: “diet”, “dentition”, “pregnancy”, “oral health in pregnancy”. Results. The diet of a pregnant woman should be well-balanced and rich in proteins, calcium, phosphorus, fluorine and vitamins (A, C and D). Women should avoid sneaks between meals or at night to avoid dental plaque accumulation and oral pH decrease. Balanced nutrition influences the development of future nutritional habits of the child as taste receptors begin to develop already at month 4 of pregnancy. High maternal consumption of confectionery in this period may in the future increase the child’s tendency to consume sweet food products. Conclusions. There is a need to intensify dental prophylaxis among pregnant women through introduction and promotion of proper nutrition in dental offices, up-dating teaching programs for dental hygienists and education in birth schools.

Background It is hard to prevent 5-fluorouracil (5-FU) related oral mucositis (OM). The aim of this study was to determine the association between dental prophylactic modalities and the risk of OM in HNC patients with 5-FU-related treatment. Methods During 2000 to 2008, 20,715 HNC (ICD-9-CM 140-149) patients with newly 5-FU-related chemotherapy were selected from the registry of LHID-CIP, and the date of 5-FU therapy initiation was defined as the index date. These HNC patients were stratified into three groups according to their cancer locations: oral cancers (ICD-9-CM 140-145), nasopharyngeal cancer (NPC, ICD-9-CM 147) and other cancers (ICD-9-CM 146, 148 and 149).The end date was defined as the date of OM diagnosis, withdrawal from the NHI program, or the 21thday after the day of 5-FU therapy initiation, whichever came first. Patients with OM diagnosis (ICD-9 CM 528.00, 528.01, 528.2, and 528.9). The records of dental treatment was determined for each patient within 180 days prior to the index date, which included fluoride gel application, chlorhexidine mouth rinse, scaling, and major oral surgery. Based on the different dental prophylactic modalities, all HNC subjects were stratified into different groups. Odds ratios (OR) and 95% confidence intervals (CI) were determined by multiple logistic regression model. Results 13,969 HNC participants, including 482 5-FU-related OM subjects and 13,487 controls were enrolled. Fluoride gel application and scaling were significantly related to OM development (p Conclusions This study highlighted a remarkable association between dental prophylactic modalitiesand the risk of 5-FU-related OM in HNC population.Clinical practitioners have to be vigilant about the joint effect of scaling and fluoride gel application in the increased risk of OM. Optimal timing of scaling and appropriate fluoride gel application strategy are necessary in reducing the risk of 5-FU-related OM. Editorial acknowledgement This study is supported in part by Taiwan Ministry of Health and Welfare Clinical Trial and Research Center of Excellence (MOHW105-TDU-B-212-133019), China Medical University Hospital, Academia Sinica Taiwan Biobank Stroke Biosignature Project (BM10501010037), NRPB Stroke Clinical Trial Consortium (MOST 105-2325-B-039-003), Chang Gung Memorial Hospital (CMRPG3I0151), Far Eastern Memorial Hospital (FEMH-2019-C-039), Tseng-Lien Lin Foundation, Taichung, Taiwan, Taiwan Brain Disease Foundation, Taipei, Taiwan, and Katsuzo and Kiyo Aoshima Memorial Funds, Japan. Legal entity responsible for the study The authors. Funding Has not received any funding. Disclosure All authors have declared no conflicts of interest.

OBJECTIVE: This study aimed at assessing, in vivo, whether the prior use of 0.12% chlorhexidine as mouthwash would decrease air contamination caused by aerosolized sodium bicarbonate during dental prophylaxis. The study was conducted with 23 patients aged between 10 and 40 years old who were randomly selected and undergoing fixed orthodontic treatment. METHODS: The study was divided into two phases (T1 and T2) with a 30-day interval in between. In both phases, dental prophylaxis was performed with aerosolized sodium bicarbonate jetted to the upper and lower arches for 4 minutes. In T1, 10 minutes before the prophylaxis procedure, the participants used distilled water as mouthwash for one minute; whereas in T2, mouthwash was performed with 0.12% chlorhexidine. Microbial samples were collected in BHI agar plates for microbiological analysis. Two dishes were positioned on the clinician (10 cm from the mouth) and a third one at 15 cm from the patient's mouth. The samples were incubated for 48 hours at 37°C. Results were expressed in colony-forming units (CFU). RESULTS: Statistical analysis carried out by means of Student's t test, as well as Wilconxon and Kruskal-Wallis tests revealed that the prior use of 0.12% chlorhexidine as mouthwash significantly reduced CFU in the three positions studied (P < 0.001). CONCLUSION: The prior use of 0.12% chlorhexidine as mouthwash significantly reduced contamination caused by aerosolized sodium bicarbonate during dental prophylaxis in the orthodontic clinic. OBJETIVO: avaliar, in vivo, se a utilização prévia do bochecho com clorexidina a 0,12% diminui a contaminação do ar gerada pelo jato de bicarbonato de sódio durante a profilaxia dentária. O estudo foi realizado com 23 pacientes, na faixa etária entre 10 e 40 anos, escolhidos aleatoriamente, que faziam uso de aparelho ortodôntico fixo. MÉTODOS: o estudo foi dividido em duas fases (T1 e T2), com intervalo de 30 dias entre elas. Em ambas, foi realizada profilaxia dentária com jato de bicarbonato de sódio na arcada superior e inferior, durante quatro minutos. Em T1, 10 minutos antes do procedimento, os participantes realizaram bochecho com água destilada durante um minuto, e, em T2, o bochecho foi realizado com clorexidina a 0,12%. Amostras dos microrganismos foram coletadas em placas de ágar BHI para análise microbiológica, sendo duas placas posicionadas no profissional (a 10cm da boca) e uma terceira a 15cm da boca do paciente. Após a coleta, as placas foram incubadas por 48 horas a 37°C. O resultado foi expresso em número de unidades formadoras de colônias (UFC). RESULTADOS: após análise estatística utilizando teste t de Student, teste de Wilconxon e teste de Kruskal-Wallis, observou-se que o bochecho prévio com clorexidina a 0,12% reduziu significativamente a média de UFC nas três posições estudadas (p < 0,001). CONCLUSÃO: os resultados permitem concluir que o bochecho prévio com clorexidina a 0,12% proporcionou uma redução estatisticamente significativa na contaminação gerada por meio do jato de bicarbonato de sódio durante a profilaxia dentária na clínica ortodôntica.

Received : 24 July, 2013 Revised : 7 November, 2013 Accepted : 3 December, 2013 ABSTRACT Objectives : The purpose of this study is to establish the regular scaling checkup service and to improve oral health care on the basis of knowledge, attitude, and belief by Dental Prophylaxis Practice Lab in A university. Methods : Subjects were 324 patients who visited Dental Prophylaxis Practice Lab in A university for the preventive removal of tartar from April to June 8, 2012. Data were analyzed using SPSS version 18.0 through the frequency analysis, chi-test, and logistics regression analysis. Corresponding Author Gyu-Yil Choi Department of Dental Hygiene Chungcheong University 38 Wolgok-Gil, Gangnae-Myeon Cheongwon-Gun Chungcheongbuk-Do, 363-792, korea. Tel : +82-43-230-2475, +82-10-4856-3466 Fax : +82-43-230-2669 E-mail : edugy@hanmail.net Results : In relation to scaling experience by age, 65.3% had experienced scaling checkup and those between 20 to 29 (34.7%) did not receive the scaling therapy. Smokers tended to have received more scaling experience than nonsmokers. Second, the number of untreated dental caries and missing teeth due to dental caries were important because the variables of oral health condition affected the scaling experience. Conclusions : It is necessary to increase the scaling experience and regular dental checkup by providing the education to improve dental clinics visit based on the knowledge and belief towards the scaling.

Background and Purpose— A correlation has been found between periodontal disease (PD) and stroke. This study was conducted to investigate whether dental prophylaxis and periodontal treatment reduce the incidence rate (IR) of ischemic stroke. Methods— We identified 510 762 PD cases and 208 674 non-PD subjects from January 1, 2000, to December 31, 2010. The PD cases were divided into dental prophylaxis, intensive treatment, and no treatment groups. The stroke IRs were assessed among groups during follow-up. Cox regression analysis was used after adjustment for age, sex, and comorbidities to determine the relationship between periodontal treatment and incidence of ischemic stroke. Results— The stroke IR of the non-PD subjects was 0.32%/year. In the PD group, subjects who received dental prophylaxis had the lowest stroke IR (0.14%/year); subjects with intensive treatment or tooth extraction had a higher stroke IR (0.39%/year); and subjects without PD treatment had the highest stroke IR (0.48%/year; P Conclusions— Maintaining periodontal health by receiving dental prophylaxis and PD treatment can help reduce the incidence of ischemic stroke.

Background Dentists prescribe 10% of outpatient antibiotics in the United States, with a significant portion of these being for prophylaxis. We previously found that 80% of prescriptions for prophylaxis prescribed prior to dental visits are unnecessary; however, the sequelae of these unnecessary antibiotics have not been characterized. Our objective was to assess the harms of unnecessary antibiotic prophylaxis using Truven, a national health claims database. Methods This was a retrospective cohort study of patients with dental visits from 2011 to 2015 linked to medical and prescription claims. Patients with commercial dental insurance without a hospitalization or extra-oral infection 14 days prior to antibiotic prophylaxis (≤2 days supply dispensed within 7 days before a dental visit) were assessed for inclusion. Patients with unnecessary antibiotic prophylaxis (defined as antibiotic prophylaxis in patients who both did not undergo a procedure that manipulated the gingiva/tooth periapex and did not have an appropriate cardiac diagnosis) were included and assessed for serious antibiotic-related adverse effects (AAE). The primary endpoint was the cumulative incidence of any AAE within 14 days post-prescription (composite of allergy, anaphylaxis, C. difficile infection, or ED visit). The secondary analyses were the cumulative incidence of each individual AAE and the risk difference of the primary endpoint between amoxicillin and clindamycin. Results Of the 168,420 dental visits with antibiotic prophylaxis, 136,177 (80%) were unnecessary and included for analysis. 3.8% of unnecessary prescriptions were associated with an AAE; primary and secondary endpoints are listed in the Table. ED visits (1.2%) and new allergies (2.9%) were most frequent. Clindamycin was associated with more AAE than amoxicillin (risk difference 322.1 per 1000 person-years, 95% CI: 238.5 - 405.8). Conclusion Even though antibiotic prophylaxis is prescribed for a short duration (≤2 days), it is not without risk. Since most AAE are diagnosed in medical settings, dentists may not be aware of these adverse effects. These data provide further impetus to decrease unnecessary prescribing of antibiotic prophylaxis prior to dental procedures. Disclosures All Authors: No reported Disclosures.

Made available in DSpace on 2018-11-12T17:27:09Z (GMT). No. of bitstreams: 0 Previous issue date: 2016-06-01. Added 1 bitstream(s) on 2018-11-12T17:35:05Z : No. of bitstreams: 1 S1807-25772016000300177.pdf: 817530 bytes, checksum: c6fdc1c4c6a98458da48e54c4b970737 (MD5) ResumoIntrodução A quantidade de pacientes hipertensivos está aumentando e, a profilaxia com jato de bicarbonato de sódio é bastante empregada na prática clínica usando grande quantidade dessa substância em um período curto de tempo que poderia aumentar a pressão arterial.Objetivo Foi avaliado a alteração da pressão arterial antes e após os dois métodos de profilaxia dental e obtido a opinião de conforto do paciente em relação a esses métodos.Material e método Selecionou-se 20 pacientes, na faixa etária de 18 a 30 anos, que necessitavam de profilaxia para remoção de biofilme dental e foram submetidos aos três tipos diferentes de tratamento: jato de bicarbonato de sódio (G1), profilaxia convencional (G2), e controle (G3), em intervalos de um mês entre eles. Os pacientes foram divididos de forma randomizada. As aferições realizaram-se antes da profilaxia, imediatamente ao fim do procedimento, 15 e 30 minutos após o término do tratamento. O conforto do paciente foi medido por meio de uma Escala Analógica Visual (VAS) após o final de cada tratamento. Os dados foram analisados por meio de teste de Variância.Resultado Houve diferença estatisticamente significante quanto ao conforto dos procedimentos, sendo G2 e G3 melhores que G1. Observou-se aumento da pressão arterial diastólica no grupo jato de bicarbonato de sódio imediatamente após a profilaxia.Conclusão A profilaxia convencional é mais confortável do ponto de vista do paciente e não altera a pressão arterial. AbstractIntroduction The number of hypertensive patients is increasing and prophylaxis with bicarbonate jet are widely performed in clinical practice using large amounts of this substance in a short period of time, which may lead to increased arterial pressure. In the literature there are several studies that analyze the effect of sodium bicarbonate jet on the biofilm and dental structures, but not report the effect on arterial pressure.Aim Evaluated the change in arterial pressure before and after two procedures of dental prophylaxis, jet baking soda application and conventional prophylaxis, and patient opinion of the comfort of each system was obtained.Material and method We selected 20 patients aged 18 to 30 in need of prophylaxis to remove biofilm. The patients were placed into three different treatment groups: sodium bicarbonate jet (G1), conventional prophylaxis (G2) and control (G3), with a one month interval between treatments. Patients were divided into groups randomly. Measurements were performed immediately before and after the procedure, 15 and 30 minutes after the end of treatment. Patient comfort was measured using a Visual Analog Scale (VAS) at the end of each treatment. Data were analyzed by analysis of variance.Result There was a statistically significant difference in the comfort of the procedures, with G2 and G3 being better than G1. Additionally, an increase in the diastolic blood pressure was observed in sodium bicarbonate jet group evaluated just after the procedure.Conclusion The conventional prophylaxis is more comfortable from the patient stand point and does not alter arterial pressure. Universidade Estadual Paulista Instituto de Ciência e Tecnologia Universidade Estadual Paulista Instituto de Ciência e Tecnologia

Clinicians use bisphosphonates in neoplastic and metabolic bone diseases. Osteonecrosis is the main complication of the maxillary bones, along with late mucosal healing with necrotic bone exposure, pain, burning sensation, paresthesia, and is commonly associated with osteonecrosis. In the dental unit of our department, we checked 181 patients, and divided them into three groups: patients who had not undergone therapy, patients who were currently undergoing bisphosphonate therapy, and those who had completed bisphosphonate therapy (but who had not been followed-up). For clinical management, patients were treated with a dental prophylaxis protocol or drug therapy, involving topical and/or systemic administration, and then underwent surgical resections when the osteonecrosis did not improve with any treatment. Variability with the percent of complications was statistically significant in the three groups. Despite the limited number of patients in this study, which will require further investigation, our experience demonstrated that preventive strategies in relation to complications are crucial. At this point, a satisfactory treatment for this pathology does not exist.

Periodontal disease is one of the most prevalent conditions seen in companion animal practice, and there are growing concerns about how it can contribute to the incidence of systemic disease in these animals. Regular oral examinations coupled with effective dental prophylaxis can help prevent periodontal disease and thus can contribute to the overall health and well-being of patients. Dental prophylaxis consists of several steps, including external and internal oral examinations followed by de-scaling (scaling), polishing and periodontal probing to measure attachment loss of the gingiva to the tooth roots. Regular preventive dental care is an area that nurses can play a vital role in to help animals live longer, healthier lives. Good nursing care and skill in dental prophylaxsis and hygiene techniques is paramount to ensure effective prevention of periodontal disease.

To determine the adherence of dental providers to the 2007 American Heart Association (AHA) infective endocarditis prevention guidelines regarding antibiotic drug administration before invasive dental procedures.The study included all adults (≥18 years old) with a moderate-risk (MR) or high-risk (HR) cardiac condition who received dental care at participating dental offices from January 1, 2005, through June 1, 2015, in Olmsted County, Minnesota. Data collected included the date and type of dental procedure performed and receipt of antibiotic prophylaxis (AP).A total of 1351 patients underwent 8854 dental visits at participating dental offices during the study period; 1236 patients had an MR cardiac condition and 115 had an HR condition. The percentage of visits in which antibiotic drugs were used for indicated dental procedures in the MR group declined from 64.6% before to 8.6% after publication of the 2007 AHA guidelines (P.001); for the HR group, AP declined from 96.9% before to 81.3% after publication of the guidelines (P=.02).In this historical cohort in Olmsted County there was a statistically significant reduction in AP in the MR group before invasive dental procedures. In addition, there was an unanticipated significant reduction in AP in the HR group after publication of the 2007 AHA guidelines. These findings can be used to provide feedback and education to medical and dental professionals who are involved in decision making regarding the use of dental prophylaxis for their patients.

Aim To assess extrinsic stain removal efficacy of a power toothbrush and a dental prophylaxis followed by the use of a standardized American Dental Association (ADA) reference manual toothbrush. Methods and Materials This was a randomized, positive-controlled, examiner-blind, parallel group, twoweek study. A Lobene stain examination was performed at baseline. Subjects were randomized to one of two treatment groups: Group 1: Oral-B® Vitality™ Pro White power toothbrush or Group 2: Subjects receiving a dental prophylaxis then using a standardized ADA reference manual toothbrush. Subjects were instructed to brush their teeth with the assigned toothbrush and a fluoride dentifrice in front of a mirror twice per day for 2 minutes. Stain was reassessed following 2 weeks of brushing. Results A significant reduction (p 0.1). Conclusions The Oral-B Vitality Pro White power toothbrush showed effective stain removal at a level similar to receiving an oral prophylaxis followed by the use of an ADA reference manual toothbrush. Clinical Significance In this small study the Oral-B Vitality Pro White power toothbrush achieved statistically significant stain removal between dental visits. Citation Terézhalmy GT, Walters PA, Bartizek RD, Grender JM, Biesbrock AR. A Clinical Evaluation of Extrinsic Stain Removal: A Rotation-Oscillation Power Toothbrush versus a Dental Prophylaxis. J Contemp Dent Pract 2008 July; (9)5:001-008.

This clinical study evaluated the color longevity after one-year of at-home bleaching with 10% carbamide peroxide (CP) in smokers and nonsmokers.Sixty patients, 30 smokers and 30 non-smokers were subjected to bleaching with 10% CP during three hours daily for three weeks. The color was measured at baseline and one week, one month and one year after the completion of dental bleaching using the spectrophotometer Vita Easyshade (ΔE*), shade guide Vita classical organized by value and Vita Bleachedguide 3D-MASTER (ΔSGU). In the one-year recall, the color was assessed before and after dental prophylaxis with Robinson brush and prophylaxis paste. Data from color evaluation were analyzed by two-way repeated measures ANOVA and Tukey's test for the contrast of means (α=0.05).Twenty-seven smokers and 28 non-smokers attended the one-year recall. For both study groups, only the main factor assessment time was statistically significant for ΔSGU (Vita classical) and ΔE* (p0.001). Effective whitening was observed for both groups at baseline, which was stable at one-month and one year after dental prophylaxis. A slight darkening was observed after one year when the color was measured without prophylaxis. For the Vita Bleachedguide 3D-MASTER, color rebound was observed irrespectively of dental prophylaxis.The bleaching with 10% CP remained stable in both groups as long as extrinsic stains from diet and cigarette smoke were removed by professional dental prophylaxis.NCT02017873.The results of this study indicate that the bleaching is effective in smokers even after one-year, but dental prophylaxis may be necessary to remove extrinsic stains caused by diet and smoking.

Background: One of dentist’s main roles is to coordinate the management of medically compromised children. The term of medically compromised refers to those children who have medical conditions which affect the dental treatment or manifest as a specific oral and dental problem. Patient’s visit to Special Care for Dentistry Clinic Dr. Hasan Sadikin Hospital Bandung showed a remarkable increase. From under 10 new visit in 2003, now July–December 2008 showed 81 new visit. Purpose: This paper discusses several medical problems (cardiovascular, hematology, respiratory system, and genetic disorder) in children and the role of dentist in the treatment of those patients in the hospital. Review: The increase of attention by all level to these medically compromised children in the hospital also increases the dentist’s role in supporting the prognosis of the disease and patient’s quality of life. The most important effort is oral and dental prophylaxis to prevent oral pathology which is caused by the manifestation of disease as well as the side effects of treatment. Conclusion: It is, concluded that role of the dentist in managing these patients is giving preventive efforts and dental treatment that may be improve patient’s quality of life. The preventive effort and dental treatment is customize according to the patients condition. Nevertheless, cooperation from the dentist and other professional is needed in treating these patients.

Background Despite the common application of dental prophylaxis as part of patient therapy, there is little reported that describes the microbiological impact of this treatment. Methods The authors gave 20 healthy college-aged subjects three dental prophylaxes with a fluoride-containing prophylaxis paste during a two-week period and instructed them in oral hygiene. They evaluated the microbiological composition of dental plaque samples collected before and after treatment using DNA probe analysis. They analyzed 40 representative bacterial species in seven bacterial complexes by checkerboard DNA–DNA hybridization assay techniques. Results After three dental prophylaxes, the patients' mean Gingival Index score decreased from 0.82 to 0.77, the mean Plaque Index score decreased from 0.72 to zero, and the total number of bacteria per tooth decreased to approximately one-third of the original number. The authors computed two different measures of bacterial presence. The reduction in bacterial numbers was statistically significant and occurred in many species. Bacterial proportion (DNA percentage or percentage of the bacteria per tooth) did not change significantly. Greater reductions in bacterial count occurred in species that showed high numbers before treatment. The total bacterial count decreased by approximately 72 percent of its original level before prophylaxis was initiated. Conclusions Professional dental prophylaxis did not target any particular bacteria or bacterial groups but removed bacteria nonspecifically and in proportion to their initial numbers. Clinical Implications Repeated dental prophylaxes effect a reduction in bacterial amount that is commensurate with the initial amount, but they do does not alter composition. This suggests that mild gingivitis may be a bacterially nonspecific effect of plaque accumulation and emphasizes the need for regular plaque removal to maintain optimal gingival health.

Ya-Ling Lee,1,2 Hsiao-Yun Hu,2,3 Pesus Chou,2 Dachen Chu2,4,5 1Department of Dentistry, Taipei City Hospital, 2Institute of Public Health and Community Medicine Research Center, National Yang-Ming University, 3Department ofEducation and Research, Taipei City Hospital, 4Department ofHealth Care Management, National Taipei University of Nursing and Health Sciences, 5Department ofNeurosurgery, Taipei City Hospital, Taipei, Taiwan Purpose: To investigate the association between periodontal disease (PD) and acute ­myocardial infarction (AMI), and evaluate the effect of dental prophylaxis on the incidence rate (IR) ofAMI.Methods: The Longitudinal Health Insurance Database 2000 from the National Health Insurance program was used to identify 511,630 patients with PD and 208,713 without PD during 2000–2010. Subjects with PD were grouped according to treatment (dental prophylaxis, intensive treatment, and PD without treatment). The IRs of AMI during the 10-year follow-up period were compared among groups. Cox regression analysis adjusted for age, sex, socioeconomic status, residential urbanicity, and comorbidities was used to evaluate the effect of PD treatment on the incidence of AMI.Results: The IR of AMI among subjects without PD was 0.19%/year. Among those with PD, the IR of AMI was lowest in the dental prophylaxis group (0.11%/year), followed by the intensive treatment (0.28%/year) and PD without treatment (0.31%/year; P

The objective of the study was to investigate various aspects of evidence-based dental prophylaxis education in postdoctoral pediatric dentistry training programs in the United States. An anonymous nationwide postal survey of fifty-two postdoctoral pediatric dentistry program directors was conducted in September 2001. The survey had a response rate of 75 percent with all geographic regions of the nation represented and with a preponderance of university-based programs (62 percent). Most of the training programs (74 percent) routinely recommended dental prophylaxis for all recall patients. The proportion of programs that recommended dental prophylaxis for the following indications were: plaque, stain and/or calculus removal--97 percent; caries prevention--59 percent; prior to topical fluoride application--67 percent; prior to sealant application--62 percent; and for behavioral modification--77 percent. Most training programs (77 percent) defined dental prophylaxis as both rubber cup pumice prophylaxis and toothbrush prophylaxis. However, only one-half of the training programs (51 percent) had modified their teaching to substitute toothbrush prophylaxis in lieu of rubber cup pumice prophylaxis. In conclusion, only one half of postdoctoral pediatric dentistry training programs in the United States teach evidence-based practice of dental prophylaxis for recall patients.

Background: In 2007, the American Heart Association (AHA) infective endocarditis (IE) prevention guidelines recommended that antibiotic prophylaxis before invasive dental procedures for the “moderate risk” (MR) group, which represented the bulk of patients who were to receive prophylaxis before 2007, be eliminated. This decision was met with much concern among some healthcare providers and that concern persists today. We therefore evaluated dental office records in Olmsted County (OC), Minnesota to determine whether patients included in the MR group continue to receive antibiotic prophylaxis despite the 2007 AHA recommendations. Methods: Eligible patients include all adult (≥18 years) residents of OC, classified as having MR cardiac condition for IE (i.e. mitral valve prolapse [MVP], bicuspid aortic valve [BAV], hypertrophic obstructive cardiomyopathy [HOCM], acquired valvular dysfunction [AVD]), with at least one dental visit between January 1, 2005 and June 1, 2015. Eight dental offices located within OC were sampled to identify both dental procedures and whether antibiotic prophylaxis was administered according to AHA guidelines. Results: We identified 334 MR patients. Approximately 62% of MR patients received antibiotic prophylaxis prior to the change in AHA guidelines in 2007. There was a decrease to 7% post-2007 AHA guidelines (P Conclusion: Following publication of the 2007 AHA IE prevention guidelines, there was a rapid, 9-fold decrease in antibiotic prophylaxis in patients with MR cardiac conditions who underwent invasive dental procedures in OC. These data are also critical as we attempt to evaluate the impact, if any, of this practice on the incidence of IE due to viridans group streptococci.

BackgroundPeriodontal disease (PD) is one of the most common chronic inflammatory diseases. Esophageal cancer (EC) is also a common cause of death due to cancer among males. Systemic inflammatory processes have been shown to increase the risk of cancer. We conducted a retrospective cohort study to investigate the association between PD and EC.MethodsA total of 718,409 subjects were recruited from the Taiwan National Health Insurance Research Database (NHIRD) and followed from January 1, 2000 to December 31, 2010. Of these, 519,831 subjects were diagnosed with PD and were grouped according to the most advanced treatment they received: dental prophylaxis, intensive treatment, or no treatment. The IRs of EC were compared among groups.ResultsA total of 682 patients developed EC, resulting in an overall IR of 0.11 case-number per 1000 person-years (‰/y). The dental prophylaxis group had a significantly lower IR of EC (0.06‰/y) than other groups (pConclusionFor this cohort, subjects received dental prophylaxis reduced the risk of EC compared to all PD and no PD groups among males.

Sometimes we do things in dentistry, or indeed in other parts of our lives because that is ‘the norm’; that is what we have deemed ‘accepted practice’. But what are these norms, these protocols based on? Is there any evidence for them, or are we carrying out procedures with no proven track record, and simply because it seems logical?

The objective of this study was to compare, in client-owned patients, the analgesic effects of the centrally acting analgesics tramadol and buprenorphine in continuous intravenous anaesthesia (TIVA) with propofol. The study included forty dogs aged two to seven years and weighing 6-27 kg undergoing prophylactic dental treatment. The animals were classified into ASA (American Society of Anaesthesiologists) I. and II. risk groups. One group of dogs received intravenous administration of tramadol (2 mg/kg) and the second one buprenorphine (0.02 mg/kg) 30 min prior to sedation induced by midazolam (0.3 mg/kg) and xylazine (0.5 mg/kg) i.v . General anaesthesia was induced by propofol (2 mg/kg) and maintained by a 120-minute propofol infusion (0.2 mg/kg min). Arterial blood pressure, heart rate, respiratory rate, saturation of haemoglobin with oxygen, body temperature and deep pain sensation elic - ited by haemostat forceps pressure on the fingers were recorded at ten minute intervals. The tramadol group of dogs showed significantly better blood pressure values (P < 0.001), minimal tendency to bradycardia (P < 0.05) and respira- tory rate (P < 0.001), without any negative effects on oxygen saturation. Significantly better deep pain sensation was achieved in the tramadol group ( P < 0.001). Blood gas/acid base profile analysis showed a non-significant increase in the tramadol group of dogs. In conclusion, in comparison with buprenorphine, tramadol provided significantly better results with respect to degree of analgesia, as well as the tendency towards cardiopulmonary complications arising during anaesthesia. Significantly better analgesia and a lower depressive effect of tramadol on vital functions allows better control and management of the continuous intravenous propofol anaesthesia.

International audience; Infective endocarditis (IE) is an infectious disease which mainly affects elderly patients. Staphylococcus aureus is the main microorganism and IE, which used to be associated with a previously known heart disease, is now associated with healthcare procedures. For a long time, it was thought necessary to prevent IE with antibiotics before starting many invasive procedures. But in the last few years, there has been a change, with a drastic limitation on the situations in which antibiotic prophylaxis is required. Epidemiological studies emphasize changes in the profile of IE, which is moving from a streptococcal disease in patients with previously known heart disease to a staphylococcal healthcare-associated disease in elderly patients suffering from many comorbidities or having intracardiac devices. These changes should lead us to question the validity of our current management of antibiotic prophylaxis. There are already recommendations from the American Heart Association (AHA) for the prevention of implantable cardiovascular electronic device implantation, but apart from this particular situation, should we not extend prophylaxis to more comprehensive prevention in patients who have comorbidities? To find an answer, we need to acquire more data on the pathophysiology of IE while continuing epidemiological surveillance of the disease.

The American Heart Association (AHA) published updated infective endocarditis (IE) prevention guidelines in 2007 and continued to recommend antibiotic prophylaxis (AP) prior to invasive dental procedures for “high risk” (HR) IE patients. We therefore evaluated dental office records in Olmsted

Prophylactic instruments may cause surface deterioration of metal crown margins, which could cause or aid the retention and accumulation of plaque. In this investigation, highly polished metal disks of high content gold (RX Y), low content gold (Aspen), silver palladium (RX 91), and nickel-chrome alloy (REX III) had their surfaces tracked with an explorer, hand scaler, curette, and a Dentsply Cavitron instrument. The surface roughness was measured with a profilometer. The results indicate that the high content gold was the least resistant to surface deterioration and the ultrasonic scaler caused the most surface deterioration to all the metals.

Article Title and Bibliographic Information Efficacy of dental prophylaxis (rubber cup) for the prevention of caries and gingivitis: a systematic review of literature. Azarpazhooh A, Main PA. Br Dent J 2009;207:E14. Reviewer Alice M. Horowitz, PhD Purpose/Question To determine the efficacy of rubber cup prophylaxis before the application of fluoride for the prevention of dental caries or at a regular recall appointment for the prevention of gingivitis Source of Funding Information not available Type of Study/Design Systematic review Level of Evidence Level 1: Good-quality, patient-oriented evidence Strength of Recommendation Grade Grade A: Consistent, good-quality patient-oriented evidence

Searches were made for relevant papers using Medline, CINHAL (Cumulative Index to Nursing and Allied Health Literature), Cochrane Central Register of Controlled Trials, Cochrane Database of Systematic reviews, Database of Abstracts of Reviews of Effects, Embase, Health and Psychosocial Instruments, HealthSTAR, International Pharmaceutical Abstracts, and ACP (American College of Physicians) Journal Club. Further articles were identified by reviewing the references and bibliographies of the retrieved articles. Articles were limited to original human studies assessing rubber cup dental prophylaxis. All other studies, including in vitro studies, reviews and case series, were excluded. Only studies in English with prophylaxis given at a recall appointment at intervals of 4 months were included. The quality of articles was assessed independently and evidence levels rated. A qualitative synthesis is presented. Four articles relating to dental prophylaxis and caries prevention and two articles relating to dental prophylaxis and gingivitis prevention were included. Four studies found that a dental prophylaxis was not warranted before professionally applied topical fluoride (PATF) for caries prevention in children. A generalisation about dental prophylaxis before PATF cannot be applied to adolescents and adults. Available evidence from two other studies fails to demonstrate any benefit in the prevention of gingivitis from further dental prophylaxis at the interval used here for recall examinations. To prevent caries in children, dental prophylaxis need not be provided either at a recall visit or before PATF. Dental prophylaxis at intervals of 4 months or more is not justified for the prevention of gingivitis in the general population.

The effect of professional dental prophylaxis with sodium bicarbonate jet on salivary counting of mutans streptococci and lactobacilli in 32 children ranging from 7 to 10 years of age, has been assessed. Whole stimulated saliva was collected before the prophylaxis, immediately after it and 30 days later, and the number of CFU/ml in the saliva was detected through the Caritest system. A statistically significant immediate decrease on salivary levels of both microorganisms was observed, 50% for mutans streptococci and 27% for lactobacilli. For mutans streptococci this decrease continued through the 30 days period; the same did not occur with lactobacilli, that returned to their baseline values. Avaliou-se o efeito da profilaxia dentária profissional com o jato de bicarbonato de sódio na contagem salivar de estreptococos do grupo mutans e de lactobacilos em 32 crianças entre 7-10 anos. Coletou-se saliva total estimulada antes e 60 minutos após o procedimento, e decorridos 30 dias, sendo o número de UFC/mL saliva detectado através do sistema Caritest. Constatou-se uma redução imediata, estatisticamente significativa, nos níveis salivares de ambos os microrganismos, sendo de 50% para estreptococos do grupo mutans e de 27% para lactobacilos. Para os estreptococos do grupo mutans, esta redução persistiu pelo período de 30 dias, o mesmo não ocorrendo para os lactobacilos, que retornaram aos seus valores iniciais.

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.