A comparison of a new alcohol-free 0.2% chlorhexidine oral rinse to an established 0.2% chlorhexidine rinse with alcohol for the control of dental plaque accumulation.

OBJECTIVES: To compare the clinical efficacy of two formulations (alcohol and alcohol free) of 0.2% chlorhexidine (CHX) rinses on plaque, gingivitis and discoloration of teeth. METHODS: This double-blind crossover study consisted of one group of 10 volunteer dental students that followed two 21-day experimental gingivitis test periods. During these periods, the subjects abstained from oral hygiene except for the oral rinse provided. The study started after an initial two-week preparation programme that included a professional prophylaxis and repeated oral hygiene instructions. This was repeated for the 14-day washout period between the two rinses, including prophylaxis as per the first stage of the study. A calibrated examiner performed the clinical measurements at the beginning (baseline) and end of each study stage. The presence and amount of plaque were recorded using the Silness and Löe plaque index (PI) and gingival inflammation by the gingival index (GI) while the discoloration index (DI) was recorded on the buccal and lingual surfaces of the six anterior teeth of both the mandible and maxilla. RESULTS: Mean PI increased similarly for both solutions; however, the differences between initial and final values were statistically significant only for CHLOREL® . Similarly, the mean values for the GI showed small increases over the course of the study periods, but not statistically significant for either solution. The mean DI increased significantly for both solutions. Regarding the comparison of the initial and final values ​​between the solutions, per index, no statistically significant differences were observed. CONCLUSION: The non-alcoholic chlorhexidine rinse had comparable levels of action as the generally recognized gold standard alcoholic rinse.

Emissions of total volatile organic compounds and indoor environment assessment in dental clinics in Athens, Greece.

OBJECTIVE: To quantify the amount of Total Volatile Organic Compounds (TVOCs) emitted from five dental substances commonly used in a dental clinic. METHOD: An assessment of the indoor air quality in two clinics of the Athens University Dentistry Faculty was conducted. RESULTS: It was found that TVOC emissions from Kalocryl and Bacillol reached extremely high values affecting the air in the dental clinics at short and long distances from the source. Six pollutants TVOCs, CO2, PM10, PM2.5, SO2 and NO(x) were measured and indoor sources associated with dental activities were identified. Very high concentrations of TVOCs were found which exceeded the acceptable levels by a factor of 20, associated with the nature of the dental activities and the ventilation conditions. The CO2 concentration levels were high and the indoor conditions were considered unsatisfactory, associated with the number of occupants and the ventilation conditions. PM concentrations were high due to the nature of the dental activities and they exceeded the outdoor levels by a factor of 5 to 6. The concentrations of the gaseous pollutants NO(x) were low while the SO2 concentrations were hardly detectable.

Indoor air quality in a dentistry clinic.

The purpose of this work is to assess, both experimentally and theoretically the status of air quality in a dentistry clinic of the Athens University Dentistry Faculty with respect to chemical pollutants and identify the indoor sources associated with dental activities. Total VOCs, CO(2), PM(10), PM(2.5), NO(x) and SO(2) were measured over a period of approximately three months in a selected dentistry clinic. High pollution levels during the operation hours regarding CO(2), total VOCs and Particulate Matter were found, while in the non-working periods lower levels were recorded. On the contrary, NO(x) and SO(2) remained at low levels for the whole experimental period. These conditions were associated with the number of occupants, the nature of the dental clinical procedures, the materials used and the ventilation schemes, which lead to high concentrations, far above the limits that are set by international organizations and concern human exposure. The indoor environmental conditions were investigated using the Computational Fluid Dynamics (CFD) model PHOENICS for inert gases simulation. The results revealed diagonal temperature stratification and low air velocities leading to pollution stratification, accompanied by accumulation of inert gaseous species in certain areas of the room. Different schemes of natural ventilation were also applied in order to examine their effect on the indoor comfort conditions for the occupants, in terms of air renewal and double cross ventilation was found to be most effective. The relative contribution of the indoor sources, which are mainly associated with indoor activities, was assessed by application of the Multi Chamber Indoor Air Quality Model (MIAQ) to the experimental data. It was found that deposition onto indoor surfaces is an important removal mechanism while a great amount of particulate matter emitted in the Clinic burdened severely the indoor air quality. The natural ventilation of the room seemed to reduce the levels of the fine particles. The emission rates for the fine and coarse particulates were found to be almost equal, while the coarse particles were found susceptible to deposition onto indoor surfaces.

Contamination of a toothbrush with antibacterial properties by oral microorganisms.

OBJECTIVES: The aim of this study was to examine the contamination and the survival rate of periodontopathic and cariogenic species on new toothbrushes with antibacterial properties (coated bristles with triclosan), after a single use in periodontitis patients. The decontamination effect of the use of toothpaste was also evaluated. METHODS: Ten patients, who consulted the Department of Periodontology, for treatment of chronic periodontitis, were selected. In each patient four different toothbrushes were used. Two quadrants, randomly selected, were each brushed using a different antibacterial toothbrush. In one of these two quadrants toothpaste was used. The same happened with the remaining quadrants, only with regular toothbrushes. After brushing, the toothbrushes were rinsed and stored in room temperature and a dry environment. After 0, 4 and 24h, four tufts, from each toothbrush, were cut and processed for selective and non-selective culturing techniques, followed by identification and quantification of all species found. RESULTS: Immediately after brushing the toothbrushes harbored a significant number of microorganisms, with no statistically significant difference between the two types of brushes (regular and antibacterial). The reduction of microorganisms from 0 to 4h after brushing was statistically significant (p<0.05). The difference was less obvious from 4 to 24h. When toothpaste was used, brushes harbored significantly (p<0.05) lower numbers of colony-forming units (CFU) compared to those without the use of toothpaste. CONCLUSIONS: The antibacterial toothbrush with triclosan coated tufts failed to limit the bacterial contamination. The toothpaste, on the other hand, significantly reduced the contamination of toothbrushes.

Contamination of interdental brushes by periodontopathogens.

Experimental studies have shown that intraoral transmission of bacteria can occur. Of course, the question arises as to how this transmission may happen. In this study, the contamination of interdental brushes by periodontopathogens is examined and compared to the microbial load of the periodontal pockets. In ten untreated chronic periodontitis patients, four interdental sites were professionally brushed with one interdental brush per patient. Subsequently, samples from the depths of the pockets (of the specific interdental sites) were obtained with paper-points. The interdental brush samples and the samples of the subgingival plaque, obtained by the pooled paper-points, were processed for dark-field microscopy examination as well as anaerobic culturing. The results showed that, although significant differences could be found between the brushes and paper-points with direct microscopy, the culturing did not uncover many differences. On the contrary, the detection frequencies of specific bacterial species were almost the same between the two. The total anaerobic colony-forming units (CFU), P. gingivalis, F. nucleatum, and E. corrodens found on the brushes showed a significant correlation with the subgingival plaque samples (P<0.005). These results suggest that, in untreated situations, interdental brushes are contaminated relatively easily by putative periodontopathogens in numbers comparable to their presence in periodontal pockets. This contamination could be a factor in the intraoral spread of bacteria.

Expectations and perceptions of Greek patients regarding the quality of dental health care.

OBJECTIVE: The aim of this study was to investigate the perceptions and expectations of patients regarding the quality of dental health care they received and the criteria they used to select a dentist. DESIGN: Descriptive study. METHODS: Two questionnaires referring to the expectations and the perceptions of dental health care were handed to patients. Likert-type scales were used to evaluate the characteristics examined. These characteristics have been classified in four quality dimensions: 'assurance', 'empathy', 'reliability' and 'responsiveness'. STUDY PARTICIPANTS AND SETTING: Two hundred consecutive patients who visited the Dental Clinic of the School of Dentistry, University of Athens, Greece, in 1998-1999. RESULTS: The patients' top priority was adherence to the rules of antisepsis and sterilization. Women of the middle and lower socio-economic groups were more demanding than men of the same groups, while men of the upper socio-economic group appeared to be more demanding than women (P = 0.02). Their perceptions of the dental service provided reflected their satisfaction regarding the adherence to the rules of antisepsis and sterilization, but also showed their moderate satisfaction regarding most of the other characteristics and their dissatisfaction regarding information on oral health and hygiene. CONCLUSION: Expectations and demands regarding empathy (approach to the patient) and assurance were placed at the top of the patients' priorities. A highly significant quality gap was observed between the desires of the patients and their perceptions (P< 0.01) and the largest gap was noted concerning information they received about oral health diseases. The largest quality gap was also observed in characteristics regarding responsiveness.

[Protective measures against AIDS]. / Metra prolepses sto odontoiatreio gia to AIDS.

The Human Immunodeficiency Virus (HIV) has the same epidemiology and way of transmission as the Hepatitis B Virus (HBV). The HIV is destroyed by physical or chemical means easier than HBV and the HIV concentration in the blood is less than that of HBV. This fact leads us to the conclusion that there is the risk of transmission of HIV in the surgery but it is much less than that of HBV. Consequently the protective measures taken for HBV in the surgery are adequate for the protection from HIV. Each patient before undergoing treatment should be questioned by his dentist on his general state of health. The dentist must follow strictly the sterilization and disinfection procedures of the instruments and surfaces. The dentist should himself realise that the use of gloves, eyeglasses and mask will reduce the risk of transmission of HIV.