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Onychophagia, commonly referred to as nailbiting is a chronic condition that is repetitive and compulsive in nature, and generally seen in both children and young adults. Multiple factors play a role in the development of nailbiting, ranging from genetic components, to underlying psychiatric conditions. Complications of chronic, compulsive nail-biting range from obvious distortion of the nail bed unit, to ungual and oral infection. Dental hygiene is, typically, less well-maintained in patients with nail-biting disorders: teeth may become chipped or notched, and gums many become inflamed. Treatment of nailbiting involves a multidisciplinary team that provides social, psychiatric, dermatologic, and dental care. Treatment ranges from psychotherapy modalities, to medication trials of selective serotonin reuptake inhibitors and N-acetylcysteine. Proper nail hygiene remains a mainstay in the prevention of the complications of chronic nail-biting. Additional supportive measures include the support of self-motivational novels and television episodes that help children learn coping mechanisms.

The information about comorbidities (excluding lymphoma) in primary Sjögren’s syndrome (pSS) is relatively scarce. Cardiovascular disease, infections, musculoskeletal conditions or malignancy are likely the most relevant comorbid conditions in pSS. Different infections (particularly oral candidal infections) and fibromyalgia are extremely frequent in the daily clinical practice. On the other hand, the incidence of cardiovascular events and cancer in pSS is low, so information about them comes from large epidemiological studies or meta-analysis. For this reason, preclinical vascular disease is investigated by different techniques, demonstrating the presence of early atherosclerosis in pSS patients. Coronary events could be slightly more frequent in pSS than in the general population. The overall risk of malignancy in pSS patients seems to be slightly increased, likely due to excess occurrence of lymphoma. An association between pSS and thyroid cancer might exist, although it should be confirmed by further investigations.

Proven cases of vector-transmitted acute autochthonous Chagas disease in the United States are rare (

Non-O1/non-O139 Vibrio cholerae (NOVC) are increasingly being recognized as causes of sporadic cases of gastroenteritis and extra-intestinal invasive infections, such as bacteremia as well as skin and wound infections in immunosuppressed hosts. However, oral infections caused by these microorganisms have rarely been reported. We present a case of oral infection caused by NOVC in a patient undergoing chemoradiotherapy after esophagectomy for esophageal cancer. The patient recovered well after antibiotic treatment. The isolate from the patient was screened for phenotypic and genetic characteristics with reference to their major virulence genes. Our report provides supporting evidence for oral infection due to NOVC in a patient with esophageal cancer and suggests that some putative accessory virulence factors may be crucial in the pathogenicity of this strain. To the best of our knowledge, this is the first documented case of oral infection due to NOVC.

Oral and maxillofacial infection is a common complication in patients undergoing chemotherapy. The treatment of oral diseases in such patients differs from that administered to healthy patients. This paper reports a case of acute osteomyelitis of odontogenic origin following a recent chemotherapy session. The patient's condition was life-threatening because of neutropenic fever and sepsis that developed during the inpatient supportive care. However, the patient showed prompt recovery within 40 days following the use of appropriate antibiotics and routine dressing, without the requirement for surgical treatment, except tooth extraction. As seen in this case, patients undergoing chemotherapy are more susceptible to rapid progression of infections in the oral and maxillofacial areas. Therefore, accurate diagnosis through prompt clinical and radiological examination, identification of the extent of infection, and assessment of the patient's immune system are crucial for favorable outcomes. It is also necessary to eliminate the source of infection through appropriate administration of antibiotics. In particular, a broad-spectrum antibiotic with anti-pneumococcal activity is essential. Proper antibiotic administration and wound dressing are essential for infection control. Furthermore, close consultation with a hemato-oncologist is necessary for effective infection management based on the professional evaluation of patients' immune mechanisms.

Oral infection by Human Papillomavirus (HPV) has recently gained great attention because of its involvement in the development of a subset of head and neck squamous cell carcinoma. The role of specific Alpha-HPVs in this regard has been well established, whereas the contribution of other genera is under investigation. Despite their traditional classification as “cutaneous” types, Beta and Gamma HPVs are frequently detected in oral samples. Due to the lack of a standardized protocol, a large variety of methodologies have been used for oral sample collection, DNA extraction, HPV detection and genotyping. Laboratory procedures influence the evaluation of oral HPV prevalence, which largely varies also according to the population characteristics, e.g., age, gender, sexual behavior, Human Immunodeficiency Virus (HIV) status. Nevertheless, oral infection by Beta and Gamma HPVs seems to be even more common than Alpha-HPVs. The latter is 5–7% in the general population, and increases up to 30% approximately in HIV-infected men who have sex with men. Despite major advances in the evaluation of oral HPV prevalence, its natural history is still little understood, especially for Beta and Gamma HPVs. The latest technologies, such as Next Generation Sequencing (NGS), can be exploited to gain new insights into oral HPV, and to improve the identification of novel HPV types.

Chagas disease was described more than a century ago and, despite great efforts to understand the underlying mechanisms that lead to cardiac and digestive manifestations in chronic patients, much remains to be clarified. The disease is found beyond Latin America, including Japan, the USA, France, Spain, and Australia, and is caused by the protozoan Trypanosoma cruzi. Dr. Carlos Chagas described Chagas disease in 1909 in Brazil, and hepatomegaly was among the clinical signs observed. Currently, hepatomegaly is cited in most papers published which either study acutely infected patients or experimental models, and we know that the parasite can infect multiple cell types in the liver, especially Kupffer cells and dendritic cells. Moreover, liver damage is more pronounced in cases of oral infection, which is mainly found in the Amazon region. However, the importance of liver involvement, including the hepatic immune response, in disease progression does not receive much attention. In this review, we present the very first paper published approaching the liver’s participation in the infection, as well as subsequent papers published in the last century, up to and including our recently published results. We propose that, after infection, activated peripheral T lymphocytes reach the liver and induce a shift to a pro-inflammatory ambient environment. Thus, there is an immunological integration and cooperation between peripheral and hepatic immunity, contributing to disease control.

Febrile neutropenia (FN) is an inflammatory response causing fever that may develop during cancer therapy-induced neutropenia. FN may herald life-threatening infectious complications and should therefore be considered a medical emergency. Patients presenting with FN are routinely subjected to careful history taking and physical examination including X-rays and microbiological evaluations. Nevertheless, an infection is documented clinically in only 20–30% of cases, whereas a causative microbial pathogen is not identified in over 70% of FN cases. The oral cavity is generally only visually inspected. Although it is recognized that ulcerative oral mucositis may be involved in the development of FN, the contribution of infections of the periodontium, the dentition, and salivary glands may be underestimated. These infections can be easily overlooked, as symptoms and signs of inflammation may be limited or absent during neutropenia. This narrative review is aimed to inform the clinician on the potential role of the oral cavity as a potential source in the development of FN. Areas for future research directed to advancing optimal management strategies are discussed.

Objectives Oral infection control is important for patients undergoing cardiac valve replacement (CVR) as prophylaxis for postoperative complications. This study examined the changes in oral health status by preoperative periodontal treatment and its effects on postsurgical complications in CVR patients. Material and methods We recruited 64 patients undergoing CVR who received preoperative periodontal treatment at our hospital as the intervention group and retrospectively reviewed the medical records of 38 patients who had undergone CVR surgery without dental intervention as the control group. Oral health status was assessed at the first visit to our dental office, 1 day before surgery, and >7 days after surgery. Days of high fever, antibiotics use, and postoperative hospitalization were recorded for the intervention and control groups for statistical comparisons. Results In the intervention group, oral health status significantly improved from the initial visit to >7 days after surgery. There were significantly fewer days of high fever (>37.5°C) in the intervention group than in the control group, with comparable results for other events. Conclusions This study's findings suggest that preoperative periodontal treatment can improve oral health status surrounding CVR surgery and could be the contributor of the reduction in the risk of postoperative infection.

PROBLEM Maternal tolerance during pregnancy increases the risk of infection with certain intracellular pathogens. Systemic Salmonella enterica serovar Typhimurium (S.Tm) infection during pregnancy in normally resistant 129X1/SvJ mice leads to severe placental infection, as well as fetal and maternal deaths. However, the effect of oral infection with S.Tm in pregnant mice and the roles of infection-induced inflammation and cell death pathways in contributing to susceptibility to infection are unclear. METHOD OF STUDY Non-pregnant and pregnant C57BL/6J wild-type (WT) and cell death pathway-altered mice (IFNAR1-/- , Caspase-1, 11-/- , RIP3-/- ) were infected orally with S.Tm. Host survival and fetal resorption were determined. Bacterial burden in mesenteric lymph nodes (MLNs), spleen, liver, and placentas was enumerated at various time points post-infection. Serum cytokine expression was measured through cytometric bead array. RESULTS Oral infection of WT mice with S.Tm on days 9-10 of gestation resulted in systemic dissemination of the bacteria, substantial placental colonization, and fetal loss 5 days post-infection. Histopathological examination of the placentas indicated that infection-induced widespread focal necrosis and neutrophil infiltration throughout the spongiotrophoblast (SpT) layer. In the non-pregnant state, IFNAR1-/- mice exhibited increased survival following oral S.Tm infection relative to Caspase-1, 11-/- , RIP3-/- , and WT mice. The increased resistance to S.Tm infection in IFNAR1-/- mice was seen during pregnancy as well, with decreased bacterial burden within MLNs, spleen, and placenta, which correlated with the decreased resorptions relative to WT and Caspase-1, 11-/- mice. CONCLUSION Oral S.Tm exposure leads to placental infection, inflammation, and resorption, whereas IFNAR1 deficiency enhances host resistance both in the non-pregnant and pregnant states.

Periodontal disease is a chronic oral infection that results from prolonged and persistent irritation of the supragingival tissue by dental biofilm buildup and can result in the destruction of conn...

Made available in DSpace on 2021-06-25T10:57:44Z (GMT). No. of bitstreams: 0 Previous issue date: 2021-01-01 Aim: To investigate the effects of liver fibrosis (LF) on the pro-inflammatory mediators and periapical bone resorption of apical periodontitis (AP) in rats. Methodology: Forty male Wistar rats were distributed into four groups: C – control, AP – rats with AP, LF – rats with LF, AP + LF – rats with AP and LF. LF was induced by carbon tetrachloride administration for 8 weeks and surgical bile duct ligation for 4 weeks; AP was induced in the teeth of rats by dental pulp exposure to the oral environment for 30 days. Jaws and livers were removed after euthanasia. Haematoxylin and Eosin (H&E) and Picrosirius Red (PSR) staining were used to confirm fibrosis in the livers. The jaws were analysed using H&E staining, immunohistochemical assays of interleukin (IL)-1β, IL-6 and tumour necrosis factor-alpha (TNF-α). Student’s t-test and Mann–Whitney’s U-test were used for statistical analysis (P

In the last few years, the role of oral microbiota in the setting of oral diseases such as caries, periodontal disease, oral cancer and systemic infections, including rheumatoid arthritis, cardiovascular disease and brain abscess (BA), has attracted the attention of physicians and researchers. Approximately 5–7% of all BAs have an odontogenic origin, representing an important pathological systemic condition with a high morbidity and mortality. A systematic search of two databases (Pubmed and Ovid EMBASE) was performed for studies published up to 5 January 2021, reporting multiple BAs attributed to an odontogenic origin. According to PRISMA guidelines, we included a total of 16 papers reporting multiple BAs due to odontogenic infections. The aim of this review is to investigate the treatment modality and the clinical outcome of patients with multiple BAs due to odontogenic infections, as well as to identify the most common pathogens involved in this pathological status and their role, in the oral microbiota, in the onset of oral infections. A multidisciplinary approach is essential in the management of multiple BAs. Further studies are required to understand better the role of microbiota in the development of multiple BAs.

Human papillomavirus (HPV) infections are found in children, but transmission modes and outcomes are incompletely understood. We evaluated oral samples from 331 children in Finland who participated in the Finnish Family HPV Study from birth during 9 follow-up visits (mean time 51.9 months). We tested samples for 24 HPV genotypes. Oral HPV prevalence for children varied from 8.7% (at a 36-month visit) to 22.8% (at birth), and 18 HPV genotypes were identified. HPV16 was the most prevalent type to persist, followed by HPV18, HPV33, and HPV6. Persistent, oral, high-risk HPV infection for children was associated with oral HPV carriage of the mother at birth and seroconversion of the mother to high-risk HPV during follow-up (odds ratio 1.60–1.92, 95% CI 1.02–2.74). Children acquire their first oral HPV infection at an early age. The HPV status of the mother has a major impact on the outcome of oral HPV persistence for her offspring.

Periodontitis begins with bacterial infection of the oral structures and if not properly treated eventually leadsto tooth loss. Over the past decade, a growing body of scientific evidence suggests an exquisite associationbetween oral infection and systemic diseases. The purpose of our study was to compare the tooth mobilitywhich is the main indicator of periodontal diseases with systemic diseases. An institutional study wasconducted using case records of patients attending private dental college from July 2019- March 2020 .A total of 71 case sheets of patients who had recorded tooth mobility index were retrieved and data wascollected. Data analysis was done using SPSS software version 23.0. Chi-square association was done toexplore the relationship between tooth mobility and systemic diseases. From the study results, 50.70%of participants belong to the age group of 36-55 yrs, 40.85% were females and 59.15% were males, thusshowing male predominance in the current study population. 66.197% of study participants have absenceof systemic diseases and 33.803% have systemic diseases. 4.2% of participants with systemic diseasesand 2.12% of participants without systemic diseases have mobile teeth between 17-24 (GROUP IV). Nostatistically significant association was found between tooth mobility and systemic diseases.(P = 0.858).The results of the present study indicate that prevalence of increased number of mobile teeth was foundamong participants with systemic diseases. But the association was not statistically significant. Knowledgeof disease interrelationships and their associations may prove to reduce patient risks and prevent systemicdisease outcomes and hence further studies to be carried out to assess the interrelationships.

The aim was to investigate oral health in randomly selected patients with chronic kidney disease (CKD). Data obtained by structured interview (self-reported lifestyle, oral symptoms and regularity of dental visits) and oral examination of patients with CKD from the Copenhagen University Hospital. Fourteen patients with CKD were screened. Only half of the patients reported regular dental visits and poor dental status was registered in half of the patients. Oral mucosal changes were registered in thirteen patients (93%). Eleven patients (79%) had gingival inflammatory disease. Twelve patients (86%) were carriers of Candida, and three (21%) had oral candidosis. Six patients (43%) had low whole saliva flow rate. Twelve patients (86%) reported at least one oral symptom. Overall, there was no differences in oral symptoms or findings related to kidney transplanted or not transplanted patients. The small sample size most likely influences the results. However, the vast majority of patients with CKD reported oral symptoms and only half consulted a dentist regularly. Poor dental status, oral mucosal changes and gingival disease were prevalent findings. Patients with CKD need focus on daily oral healthcare and regular dental visits. Interdisciplinary cooperation could encourage patients with CKD to focus on oral health.

The ST2 receptor plays an important role in the gut such as permeability regulation, epithelium regeneration, and promoting intestinal immune modulation. Here, we studied the role of ST2 receptor in a murine model of oral infection with Brucella abortus, its influence on gut homeostasis and control of bacterial replication. Balb/c (wild-type, WT) and ST2 deficient mice (ST2-/-) were infected by oral gavage and the results were obtained at 3 and 14 days post infection (dpi). Our results suggest that ST2-/- are more resistant to B. abortus infection, as a lower bacterial colony-forming unit (CFU) was detected in the livers and spleens of knockout mice, when compared to WT. Additionally, we observed an increase in intestinal permeability in WT-infected mice, compared to ST2-/- animals. Breakage of the intestinal epithelial barrier and bacterial dissemination might be associated with the presence of the ST2 receptor, since, in the knockout mice no change in intestinal permeability was observed after infection. Together with enhanced resistance to infection, ST2-/- produced greater levels of IFN-&gamma, and TNF-&alpha, in the small intestine, compared to WT mice. Nevertheless, in the systemic model of infection ST2 plays no role in controlling Brucella replication in vivo. Our results suggest that the ST2 receptor is involved in the invasion process of B. abortus by the mucosa in the oral infection model.

Background: Actinomycosis of the tongue is an uncommon, suppurative infection of lingual mucosa, caused by actinomyces. The clinical diagnosis may present serious difficulties because of its ability to mimic other lesions, including both benign and malignant neoplasms. Methods: Here, we describe the case of a 52-years-old patient affected by an asymptomatic, tumor-like tongue swelling, then diagnosed as actinomycosis. A review of tongue localization of actinomycosis is also reported, with emphasis on clinical findings and therapy. Results and Conclusion: Early diagnosis and treatment, with pus drainage and systemic antibiotic therapy, are pivotal to avoid severe and life-threatening complications.

A simple device using folded Parafilm-M as an artificial blood feeder was designed for studying two important dengue vector mosquitoes, Aedes aegypti and Aedes albopictus. The efficiency of the artificial blood feeder was investigated by comparing the numbers of engorged mosquitoes that fed on the artificial blood feeder versus mice as a live blood source. Significantly more engorged females Aedes aegypti fed on the artificial blood feeder than on mice. In addition, the artificial feeder could serve as a useful apparatus for oral infection via artificial blood meals, and for saliva collection in mosquitoes. Our method enabled us to collect saliva from multiple mosquitoes at once, providing sufficient infected saliva for determination of the virus titer by plaque assay analysis. Our artificial feeder has the advantage that it is simple, inexpensive, and efficient.

Candida-associated denture stomatitis (DS) is a persistent and chronic oral infection of the denture-bearing palatal mucosa. DS stems from the ability of the fungal opportunistic pathogen Candida albicans to adhere to denture material and invade palatal tissue. Although DS is the most prevalent form of oral candidiasis, there are currently no feasible therapeutic strategies for the prevention of this recurrent condition. We developed a peptide-based antimicrobial bioadhesive formulation specifically designed for oral topical formulation. In this study, we aimed to evaluate the applicability of the novel formulation for the prevention of C. albicans colonization on denture material and development of clinical disease. To that end, using the latest technological advances in dental digital design and three-dimensional (3D) printing, we fabricated an intraoral device for rats with universal fit. The device was successfully installed and used to develop clinical DS. Importantly, by taking a preventative therapeutic approach, we demonstrated the potential clinical utility of the novel formulation as a safe and feasible prophylactic agent against DS.

Mayaro virus (MAYV) is an emerging mosquito-borne arbovirus present in Central and South America that causes arthralgia and febrile illness. Domestic mosquitoes Aedes aegypti (Diptera: Culicidae) and Aedes albopictus are potential vectors of MAYV that may allow for transmission to humans in urban settings. The present paper assesses susceptibility to infection, disseminated infection and transmission potential in Florida Ae. aegypti and Ae. albopictus for MAYV. Oral infection was significantly higher in Ae. albopictus (85-100%) than in Ae. aegypti (67-82%). Viral dissemination to the haemocoel in Ae. aegypti and Ae. albopictus mosquitoes was rapid and co-occurred with infection of the salivary glands. Rates of disseminated infection were generally higher in Ae. aegypti (45-85%) than in Ae. albopictus (38-76%), although the difference was significant only at 9 days after feeding on MAYV-infected blood. Both mosquito species exhibited low rates of MAYV infection in saliva expectorates. Viral titres in the bodies of mosquitoes increased in line with the number of days post-blood feeding and were higher in Ae. aegypti than in Ae. albopictus. Although Florida mosquito vectors have the potential to transmit MAYV and thus to initiate an urban cycle after having fed on higher titres of MAYV-infected blood, lower viraemia in infected humans is likely to limit transmission potential.

Necrotizing fasciitis of the face and scalp is a severe bacterial infection that can result in long-term morbidity or even mortality if not properly managed. In a third-world country like Ghana, where most of the population relies on daily income for livelihood, citizens with diseases that have long-term morbidity suffer financial difficulty, particularly when the patient is the breadwinner.This brief clinical study demonstrates the severity of necrotizing fasciitis of the face and scalp originated from oral infection, and its capability to affect any part of the body if proper treatment is not established at early onset of disease. Correct diagnosis, patient education, early antibiotic treatment, and timely surgery are crucial for controlling infection and for preventing irreparable damage. Therefore, public education is crucial in preventing such infection by discouraging use of over-the-counter medication in such situations.

Oral candidiasis (OC) is also referred as ‘thrush’ is caused by the infections of the tongue and other oral mucosal sites and characterized by fungal overgrowth and invasion of superficial tissues. The main causative agent of 95% OC cases is Candida albicans. The prevalence of fungal oral infection was increased due to the increasing use of antibiotic and immunodeficiency condition. However, many factors have been suggested as risk factors for oral colonization. These predisposing factors are divided into local and systemic factors. We present two cases of patient with oral candidiasis that have admitted at Wangaya Regional Hospital, Denpasar, Bali, Indonesia with different precipitating factors in order to remind health provider that oral candidiasis does not only occur in people living with HIV/AIDS (PLWHA).

Mucosal Human Papillomaviruses (HPVs) play a role in the development of a subset of head and neck cancers. Cutaneous HPVs are abundantly present in the oral cavity. The determinants of these infections have not been extensively investigated. We assessed the correlates of oral infection by alpha and beta and/or gamma HPVs in HIV-infected and uninfected men who have sex with men (MSM). Oral rinse-and-gargles were collected with a mouthwash. Alpha and beta/gamma HPVs were detected using the Linear Array HPV genotyping test and a multiplex PCR combined with Luminex technology, respectively. Multiple logistic regression was performed to identify independent predictors of oral HPV infection. Overall, 193 HIV-uninfected and 117 HIV-infected MSM were enrolled. Among HIV-infected MSM, the only determinant of alpha HPV infection was the number of lifetime oral sex partners (AOR: 8.26, 95% CI: 2.26–30.16). The strongest determinant of beta/gamma HPV infection was represented by practicing condomless receptive oral sex (AOR: 10.76, 95% CI: 1.56–74.17). Age was independently associated with alpha HPV infection in HIV-uninfected MSM. Beta/gamma HPV infection was not associated with sexual behavior in these subjects. In conclusion, predictors of oral infection differ between HIV-infected and uninfected MSM, as well as between alpha and beta/gamma HPVs.

Reviewed scientific publications that define the location of foci of chronic infections in dermatology. Indicated by the currently existing problematic issues and their solutions.

This study evaluated the vector competence of Aedes albopictus in transmitting USUV after oral infection under laboratory conditions. Ae. albopictus showed a low vector competence for USUV, although the positive body sample found with a very high number of viral copies at one week post infection indicates that a replication in the mosquito body can occur, and that USUV can escape the midgut barrier. Field data from an extensive entomological arboviruses surveillance program showed a relevant incidence of Ae. albopictus USUV positive pools in the period 2009-2012 while all pools were negative from 2013 on. No conceivable explanation regarding this field evidence was addressed, suggesting that attention must be paid to the trend of development of this vector-pathogen association, being aware of the potential rapid arbovirus' adaptation to new vectors, to prevent possible new disease's emergence.

The oral cavity is suggested as the reservoir of bacterial infection, and the oral and pharyngeal biofilms formed by oral bacterial flora, which is comprised of over 700 microbial species, have been found to be associated with systemic conditions. Almost all oral microorganisms are non-pathogenic opportunistic commensals to maintain oral health condition and defend against pathogenic microorganisms. However, oral Streptococci, the first microorganisms to colonize oral surfaces and the dominant microorganisms in the human mouth, has recently gained attention as the pathogens of various systemic diseases, such as infective endocarditis, purulent infections, brain hemorrhage, intestinal inflammation, and autoimmune diseases, as well as bacteremia. As pathogenic factors from oral Streptococci, extracellular polymeric substances, toxins, proteins and nucleic acids as well as vesicles, which secrete these components outside of bacterial cells in biofilm, have been reported. Therefore, it is necessary to consider that the relevance of these pathogenic factors to systemic diseases and also vaccine candidates to protect infectious diseases caused by Streptococci. This review article focuses on the mechanistic links among pathogenic factors from oral Streptococci, inflammation, and systemic diseases to provide the current understanding of oral biofilm infections based on biofilm and widespread systemic diseases.

Exposure of the oral cavity and oropharynx to human papillomavirus (HPV) often results in an asymptomatic, transient oral infection that is cleared by the body's immune system; however, a small percentage of these oral infections can persist in a dormant state. Depending on the HPV genotype, a persistent oral infection may lead to benign or malignant disease. High-risk HPV types 16 and 18, which cause most cervical and anal cancers, also are the cause of the rising rate of oropharyngeal squamous cell carcinoma (SCC) in the United States. This article focuses on the epidemiology, transmission, risk factors, and clinical presentation of HPV-associated oropharyngeal SCC, and provides an update on HPV vaccination in the context of the new head and neck cancer epidemic.

BACKGROUND: Pregnancy causes major changes in maternal physiology and metabolism, which may lead to increased susceptibility to oral infection. AIM: Aim of this study is to assess the awareness of dental interns regarding the management of the dental needs of pregnant patients. METHODS: A cross-sectional questionnaire survey was conducted among 188 interns of a private dental college in Saudi Arabia. The questionnaire comprised of 14 knowledge-based questions regarding their training, awareness and practice management of the pregnant patient in dental clinics. Four questions to record and evaluate their training, the number of pregnant patients treated by them and their confidence level in the dental management of the pregnant patient. Excel spreadsheet was used for mathematical calculations. RESULTS: Almost 62% of our participants never treated a pregnant female during their training. About 65% of the interns knew using antibiotics, almost 55% have a clear idea of the safest NSAIDS, and 43% regarded local anaesthesia to be safe when used among pregnant females. Conversely, about 50% of the participants had no clear knowledge of the FDA category of drugs. Only 24% considered dental radiographs to be safe in pregnant patients. 57% thought to postpone the dental treatment in an acute active dental infection in expecting mothers. Results also showed a lack of confidence among interns to provide dental care to gestating female. CONCLUSION: On analysing the results, we found that there is a need to improve the knowledge, awareness and confidence levels among the interns who are the future dentists treating these patients.

Background A large number of systemic diseases can be linked to oral candida pathogenicity. The global trend of invasive candidiasis has increased progressively and is often accentuated by increasing Candida albicans resistance to the most common antifungal medications. Photodynamic therapy (PDT) is a promising therapeutic approach for oral microbial infections. A new formulation of 5-aminolevulinic acid (5%ALA) in a thermosetting gel (t) (5%ALA-PTt) was patented and recently has become available on the market. However, its antimicrobial properties, whether mediated or not by PDT, are not yet known. In this work we characterised them. Methods We isolated a strain of C. albicans from plaques on the oral mucus membrane of an infected patient. Colonies of this strain were exposed for 1 24 h, to 5%ALA-PTt, 5%ALA-PTt buffered to pH 6.5 (the pH of the oral mucosa) (5%ALA-PTtb) or not exposed (control). The 1 h-exposed samples were also irradiated at a wavelength of 630 nm with 0.14 watts (W) and 0.37 W/cm2 for 7 min at a distance of Results and conclusion The 5% ALA-PTt preparation was shown to be effective in reducing the growth of biofilm and inoculum of C. albicans. This effect seems to be linked to the intrinsic characteristics of 5%ALA-TPt, such acidic pH and the induction of free radical production. This outcome was significantly enhanced by the effect of PDT at relatively short incubation and irradiation times, which resulted in growth inhibition of both treated biofilm and inoculum by ∼80% and ∼95%, respectively.

Background Testing for oral high-risk human papillomavirus (HPV) DNA may be useful for identifying individuals at increased risk for HPV-driven oropharyngeal cancer (OPC). However, positivity for HPV DNA provides no information on the transforming potential of the infection. In contrast, the detection of high-risk HPV E6/E7 messenger RNA (mRNA) may help to identify clinically significant infections because of the indispensable role of E6/E7 viral oncoproteins in the carcinogenic process. Methods Oral rinses were collected with a mouthwash from cancer-free individuals at increased risk for oral HPV infection. High-risk HPV DNA and mRNA were evaluated via the testing of the oral rinses with the Linear Array HPV genotyping test and the Aptima HPV assay, respectively. Results Overall, 310 subjects with no clinical evidence of lesions of the oral cavity and oropharynx were included in the study. Thirty-three (10.6%) harbored high-risk HPV DNA in their oral rinse. These cases, together with 10 random samples negative for high-risk HPV DNA, were tested with the Aptima assay. A valid result was obtained for 41 of the 43 specimens (95.3%). Among the 31 cases that were positive for high-risk HPV DNA and had a valid Aptima result, 4 (12.9%) were positive for HPV mRNA. HPV mRNA was not detected in any of the samples negative for high-risk HPV DNA. Conclusions HPV mRNA is detectable in oral rinses of cancer-free subjects. Oral HPV mRNA testing may be useful in the screening and/or early detection of HPV-driven OPC by possibly identifying active and transforming oral infections. The testing of individuals at increased risk for HPV-related OPC via simply and noninvasively collected oral specimens is an attractive option for future screening strategies.

African swine fever (ASF) was first described in 1921 as a highly fatal and contagious disease which caused severe outbreaks among settlers’ pigs in British East Africa. Since then the disease has expanded its geographical distribution and is currently present in large parts of Africa, Europe and Asia and considered a global threat. Although ASF is typically associated with very high case fatality rates, a certain proportion of infected animals will recover from the infection and survive. Early on it was speculated that such survivors may act as carriers of the virus, and the importance of such carries for disease persistence and spread has since then almost become an established truth. However, the scientific basis for such a role of carriers may be questioned. With this in mind, the objective of this study was to review the available literature in a systematic way and to evaluate the available scientific evidence. The selection of publications for the review was based on a database search, followed by a stepwise screening process in order to exclude duplicates and non-relevant publications based on pre-defined exclusion criteria. By this process the number of publications finally included was reduced from the 3664 hits identified in the initial database search to 39 publications, from which data was then extracted and analysed. Based on this it was clear that a definition of an ASF virus carrier is lacking, and that in general any survivor or seropositive animal has been referred to as carrier. It was also clear that evidence of any significant role of such a carrier is absent. Two types of “survivors” could be defined: 1) pigs that do not die but develop a persistent infection, characterised by periodic viraemia and often but not always accompanied by some signs of subacute to chronic disease, and 2) pigs which clear the infection independently of virulence of the virus, and which are not persistently infected and will not present with prolonged virus excretion. There is no evidence that suggests that any of these categories of survivors can be considered as “healthy” carriers, i.e. pigs that show no sign of disease but can transmit the virus to in-contact pigs. However, localized virus persistence in lymphoid tissues may occur to some extent in any of the categories of survivors, which in theory may cause infection after oral uptake. To what extent this is relevant in reality, however, can be questioned given the virus dose generally needed for oral infection.

Background: Stroke mortality comprises different specific diagnoses as cerebral infarction, different haemorrhagic conditions and unspecified stroke. This study seeks to explore the prediction of oral health indicators versus known cardiovascular disease risk factors for stroke mortality. Methods: Altogether, 12,764 men aged 58 to 77 years were invited to the health screening Oslo II in the year 2000. It included general medical measurements and questionnaire information. Mortality data were supplied by Statistics Norway for the 6530 attending men. Cox proportional hazards regression analyses were used to establish prediction models for mortality. Results: Oral health by number of tooth extractions >10 was found to be an independent predictor for cerebral infarction hazard ratio = 2.92, 95% confidence interval (1.24–6.89). This was independent of HDL-Cholesterol (inversely) hazard ratio = 0.21, 95% confidence interval (0.06–0.76), frequent alcohol consumption (drinking 4–7 times per week) hazard ratio = 3.58, 95% confidence interval (1.40–9.13) and diabetes hazard ratio = 4.28, 95% confidence interval (1.68–10.89). Predictors for cerebral haemorrhage were age, hs-C-reactive protein and body mass index (inversely). Age and total cholesterol (inversely) were predictors for unspecified stroke. Conclusions: Oral health measured by number of tooth extractions >10 was an independent predictor for cerebral infarction in addition to age, HDL-C, hs-C-reactive protein and diabetes. The pattern of risk factors varied between the specific stroke diagnoses.

Objectives The detection of oral Human Papillomavirus (HPV) may be of clinical utility because of the major role HPV plays in the etiology of oropharyngeal cancer. However, oral HPV testing is not standardized and the best sampling method has yet to be identified. We aimed to compare HPV findings in matched oral rinse-and-gargles (rinses), oropharyngeal brushings and oral brushings. Materials and methods HPV-DNA was investigated using Linear Array in samples collected from cancer-free individuals at increased risk for oral HPV. Results 163 oral rinses already tested for HPV were selected. The matched oropharyngeal (n = 163) and oral brushings (n = 100) were analyzed. The detection rate for any HPV, high-risk (HR)-HPVs and HPV16 was significantly higher in rinses than brushings. The overall agreement for any HPV between rinses and oropharyngeal brushings was 51.2% (Cohen K: 0.14, 95% CI: 0.07–0.21). The proportion of positive agreement was 16.8%. The overall agreement for HR-HPVs was 74.1% (Cohen K: 0.20, 95% CI: 0.07–0.33). The genotype-specific profile of rinses and brushings which were concomitantly HPV-positive only partially overlapped in cases with multiple infections, with more genotypes detected in the rinse, which were not isolated in the corresponding brushings. Conclusion The agreement for HPV status between rinses and brushings is poor, particularly for the HPV-positive findings. Despite the fact that the origin of the HPV-infected cells present in the oral rinse is unclear, since they could not be traced back to the oropharynx or oral cavity, oral rinses provided the highest detection rate for HR-HPVs and HPV16.

Yersiniosis is common foodborne gastrointestinal disease caused by the enteric pathogens Yersinia enterocolitica and Yersinia pseudotuberculosis. The mouse model of oral infection serves as a useful tool to study enteropathogenic Yersinia infection in mammals. The following protocol describes two distinct oral infection methods: the commonly used oral gavage method in which the bacterial inoculum is instilled directly into the mouse stomach using a feeding needle, and an alternative method in which mice are fed bread soaked with Yersinia culture.

Increasing evidence suggests an independent association between periodontitis and a range of comorbidities, among others: cardiovascular disease, type 2 diabetes and rheumatoid arthritis. Shared in...

Nowadays, there is a high prevalence of periodontal disease worldwide, and knowing the etiology is basic for its control. Biofilms that colonize the oral cavity are among the most complex of nature. Besides pathogenic microorganisms, genetic and environmental factors contribute to the development of this disease. Periodontal disease can be increased by several risk factors such as smoking, systemic diseases, medications such as steroids, antiepileptics, drugs for cancer therapy, poor placement of dental bridges, dental crowding, lack of teeth, pregnancy and contraceptive use. The objective of this review is to provide an overview of periodontal disease, as well as the microbiology aspects of this worldwide prevalent oral infection. Key words: Periodontal disease, oral microbiology, periodontitis.

Objetivo: Apresentar o relato de um caso de proposta terapêutica para seroma, diagnosticado por ecografia, que se desenvolveu após dez dias da cirurgia de bichectomia em paciente de 35 anos do gênero feminino. Detalhamento do caso: A indicação estética de bichectomia foi realizada para delineamento facial, ressaltando contornos do rosto e promovendo jovialidade. Diversas intercorrências podem ser observadas neste tipo de procedimento, no entanto, o diagnóstico de seroma parece apresentar raridade. Após dez dias, observou-se presença de grande edema, de consistência rígida, na região da cirurgia do lado esquerdo. A paciente foi tratada com antibiótico e drenagens do exsudato até o completo colabamento das paredes internas da lesão. Considerações finais: A ocorrência de seroma após bichectomia pode estar associado a focos prévios de infecção bucal e ao uso de eletrocautério e que a proposta terapêutica por meio de antibioticoterapia por 20 dias associada a drenagens periódicas conforme a formação do edema por exsudato resultou em cura da lesão e manutenção da saúde.

Infection of the jaws that could be life-threatening within a few days due to spread of bacteria into perioral fascial spaces. Discuss the clinical and radiological features and what is your provisional diagnosis?

Introduction: The association of herpes papillomavirus (HPV; oncogenic human papillomavirus) with malignant neoplasms of the oral cavity, mainly epidermoid carcinoma, has been evident. Objective: This study aims to identify the repercussions caused by HPV aggregation on oral cavity cancer under the synergistic view of the agents involved. Methodology: Literature review was carried out in the SciELO and PubMed databases. At first, 2 search strategies were used through the MeSH terms HPV AND oral cancer and HPV AND oral infection, thus, 30 articles were found, of which, after applying the inclusion and exclusion criteria, 2 were used. In PubMed, the HPV AND oral cancer strategy was applied and 11 articles were found, of which only 1 was selected. There is also use of other relevant studies on the subject, which add knowledge to the present study. Discussion: Thus, through evaluation and review of articles, there is a relationship between HPV and oral carcinomas, but there is no concrete and quantitative basis for this association. Conclusion: Based on the research, there is evidence of the contribution of HPV in some types of oral carcinomas; however, this theme has been and will be the reason for many research studies.

Both mucosal and cutaneous Human Papillomaviruses (HPVs) can be detected in the oral cavity, but investigations regarding the epidemiology of cutaneous HPVs at this site are scarce. We assessed mucosal (alpha) and cutaneous (beta and gamma) HPV infection in oral samples of HIV-infected and uninfected men who have sex with men (MSM). Oral rinse-and-gargles were collected from 310 MSM. Alpha HPVs were detected using the Linear Array, whereas beta and gamma HPVs were detected using multiplex PCR and Luminex technology. An amplicon-based next-generation sequencing (NGS) protocol was applied to a subset of samples collected from 30 HIV-uninfected and 30 HIV-infected MSM. Beta HPVs were significantly more common than alpha types (53.8% vs. 23.9% for HIV-infected subjects, p &lt, 0.0001, 50.3% vs. 17.1% for HIV-uninfected subjects, p &lt, 0.0001). Gamma HPVs were also frequently detected (30.8% and 25.9% in HIV-infected and uninfected MSM, respectively). NGS produced 2,620,725 reads representative of 146 known HPVs (16 alpha-PVs, 53 beta-PVs, 76 gamma-PVs, one unclassified) and eight putative new HPVs, taxonomically assigned to the beta genus. The oral cavity contains a wide spectrum of HPVs, with beta types representing the predominant genus. The prevalence of beta and gamma HPVs is high even in immunorestored HIV-infected individuals. NGS confirmed the abundance of cutaneous HPVs and identified some putative novel beta HPVs. This study confirms that cutaneous HPVs are frequently present at mucosal sites and highlights that their pathological role deserves further investigation since it may not be limited to skin lesions.

The capability of the Candida albicans Candida (CAC) to colonize surfaces can be signify as a risk factor for oral infection, thus, denture wearing approves of a stable factor that can affect oral health status...

An odontogenic infection is a polymicrobial, mixed infection (aerobic and anaerobic bacteria). It comprises various clinical conditions, whose importance varies depending on their frequency and potential severity. It is the most common type of oral infection and its treatment involves up to 10% of all antibiotic prescriptions. Facial cellulitis is a diffuse inflammation of soft tissue that is not confined or limited to a specific region and tends to spread. The objective of this review is to update the aspects considered in the care of children with facial cellulitis of odontogenic origin and the multidisciplinary management between dentists and pediatricians.La infección odontogénica es una infección polimicrobiana y mixta (aerobios/anaerobios). Comprende diversos cuadros clínicos, cuya importancia deriva de su frecuencia y gravedad potencial. Es el tipo de infección más frecuente en la cavidad bucal y su tratamiento supone hasta el 10% del total de prescripciones de antibióticos. La celulitis facial es una inflamación difusa de los tejidos blandos que no está circunscrita o limitada a una región y tiende a diseminarse. El objetivo de esta revisión es actualizar las consideraciones para la atención del niño con celulitis facial de origen dental y el manejo multidisciplinario entre el odontólogo y el pediatra.

Pathological lesions associated with multiple causes (infections, physical, chemical and thermal agents) of oral mucosa are equally widespread in all spheres of dental practice. The actual importance of pharmaceutical therapy of lesions of oral mucosa is associated with the lack of reliable traditional topical drugs - ointments, gels, pastes, lacquers, discs - caused by their little efficiency associated with poor maintaining of permanent concentration, short contact period, discomfort and long-term treatment. All the mentioned facts caused the development of various pharmaceutical forms with prolonged activity with improved adhesion to oral mucosa, prolonged saving of useful properties and protecting the lesion from oral infection and external influences and reducing the intensity of painful sensations during mastication and mimics. These drugs form the group of barrier drugs and drugs with prolonged release of medicine of the wide specter. During all the time of existence this group of drugs has undergone and is still undergoing several changes targeted on improvement of adhesion and maintaining of constant concentration of medicine in the lesion and extension of indications for use. The development of new pharmaceutical forms is still continuing.Поражения слизистой оболочки полости рта вследствие воздействия различных патологических агентов - инфекционных, механических, химических, термических - в равной степени встречаются во всех сферах стоматологической практики. Актуальность проблемы медикаментозной терапии поражений слизистой оболочки полости рта изначально была обусловлена тем, что традиционно используемые аппликационные средства - такие как мази, гели, пасты, лаки, диски - были недостаточно эффективны в связи с невозможностью обеспечения постоянной концентрации медикаментозного препарата в очаге поражения, а также кратковременностью его контакта, дискомфортом и длительностью лечения. В связи с этим были разработаны различные лекарственные формы пролонгированного действия, характеризующиеся улучшенной фиксацией к слизистой оболочке полости рта, сохранением своих свойств на протяжении длительного времени, предохраняющие зону поражения от инфицирования микрофлорой полости рта и внешних воздействий, а также уменьшающие интенсивность болевых ощущений при жевании и мимических движениях - барьерные средства и средства с пролонгированным выделением медикаментозных препаратов. В связи с этим разработан широкий спектр местных барьерных лекарственных форм пролонгированного действия с улучшенной фиксацией к слизистой оболочке полости рта, предохраняющих зону поражения от внешних воздействий, а также уменьшающих интенсивность болевых ощущений в зоне поражения. На протяжении всего периода существования данная группа препаратов претерпевала и продолжает претерпевать ряд изменений, направленных как на улучшение адгезии и поддержания постоянной концентрации действующих веществ в очаге, так и расширение показаний к применению. Разработка новых лекарственных форм на данный момент продолжается.

Background: Severalin vitrooral biofilm growth systems can reliably construct oral microbiome communities in culture, yet their stability and reproducibility through time has not been well characterized. Long-termin vitrogrowth of natural biofilms would enable use of these biofilms in bothin vitroandin vivostudies that require complex microbial communities with minimal variation over a period of time. Understanding biofilm community dynamics in continuous culture, and whether they maintain distinct signatures of health and disease, is necessary to determine the reliability and applicability of such models to broader studies. To this end, we performed next-generation sequencing on biofilms grown from healthy and disease-site subgingival plaque for 80 days to assess stability and reliability of continuous oral biofilm growth.Results: Biofilms were grown from subgingival plaque collected from periodontitis-affected sites and healthy individuals for ten eight-day long generations, using hydroxyapatite disks. The bacterial community in each generation was determined using Human Oral Microbe Identification by Next-Generation Sequencing (HOMINGS) technology, and analyzed in QIIME. Profiles were steady through the ten generations, as determined by species abundance and prevalence, Spearman’s correlation coefficient, and Faith’s phylogenetic distance, with slight variation predominantly in low abundance species. Community profiles were distinct between healthy and disease site-derived biofilms as demonstrated by weighted UniFrac distance throughout the ten generations. Differentially abundant species between healthy and disease site-derived biofilms were consistent throughout the generations.Conclusions: Healthy and disease site-derived biofilms can reliably maintain consistent communities through ten generations ofin vitrogrowth. These communities maintain signatures of health and disease and of individual donors despite culture in identical environments. This subgingival oral biofilm growth and perpetuation model may prove useful to studies involving oral infection or cell stimulation, or those measuring microbial interactions, which require the same biofilms over a period of time.

Ocular toxoplasmosis is the most common cause of retinochoroiditis worldwide in humans. Some studies highlighted the idea that ocular lesions differ according to the route of infection but none of them mimicked the natural route. The current study aimed to investigate the ophthalmic outcomes in congenital and oral routes of infection with Toxoplasma in experimental animals. Mice were divided into three groups; group I: congenital infection, group II: acquired oral infection and group III: non-infected. We used Me49 chronic low-virulence T. gondii strain. We found that retina is the most affected part in both modes of infections. However, the retinal changes are different and more pronounced in case of congenital infection. The congenitally infected mice showed retinal lesions e.g. total detachment of retinal pigment epithelium from the photoreceptor layer and irregular arrangement of retinal layers. More severe damage was observed in mice infected early in pregnancy. While the postnatal orally infected mice showed fewer changes. In conclusion, the routes of Toxoplasma infection affect the ophthalmic outcomes and this may be the case in human disease. Although both are vision threatening, it seems that the prognosis of postnatal acquired ocular toxoplasmosis is better than that of congenital disease.

We report the case of a 40 year-old woman who presented third molar pericoronitis in neutropenia. she had undergone extraction of the right third mandibular molar. This may have been due to an infection in the extraction socket or part of the crown. There was no inflammation seen after transplant of umbilical cord blood. Keywords: Neutropenia, Pericoronitis, Oral infection