OVER THE COUNTER ANALGESICS ARE EFFECTIVE IN TREATING ORTHODONTIC PAIN.

ARTICLE TITLE AND BIBLIOGRAPHIC INFORMATION: The efficacy of analgesics in controlling orthodontic pain: a systematic review and meta- analysis. Cheng C, Xie T, Wang J. BMC Oral Health 2020; 20:259. SOURCE OF FUNDING: The systematic review was funded by grants from the National Natural Science Foundation of China (No. 81771114 and No. 81970967). The authors have no actual or potential conflicts of interest. TYPE OF STUDY/DESIGN: Systematic review with meta-analysis of data.

The use of anti-inflammatory drugs to prevent bleaching-induced tooth sensitivity is ineffective and unnecessary.

Data sources The authors searched Medline via PubMed, Scopus, Web of Science, the Cochrane Library and ClinicalTrials.gov for published and unpublished clinical trials. Only randomised clinical trials, with either a parallel or crossover design, reporting the tooth sensitivity of participants undergoing in-office dental bleaching and comparing pain frequency and severity with oral premedication of a non-steroidal or other anti-inflammatory drug compared with a placebo were used in the review. Studies that evaluated the topical administration of drugs or desensitising agents were not reviewed.Study selection In total,5,050 randomised clinical studies were screened and 11 studies were included in the various meta-analyses. Nine studies examined the effect of pre-emptive analgesics on the risk of sensitivity and ten studies evaluated the effect of drugs on the severity of sensitivity; seven of these studies were assessed as having a low risk of bias.Data extraction and synthesis This systematic review and meta-analysis was conducted a priori and registered at the International Prospective Register of Systematic Reviews. There were two reviewers who extracted data from the study tables and independently performed quality assessments of the selected trials using the Office of Health Assessment and Translation risk of bias rating tool for human and animal studies. Risk ratios were calculated for the dichotomous sensitivity risk data and mean difference for measures of sensitivity intensity.Results The authors found no effect of the drugs on the risk of sensitivity. Using a visual analogue scale, the authors identified a small but clinically insignificant reduction in the level of sensitivity in the drug-treated group evaluated up to one hour after bleaching. This was not observed when a numerical rating scale was used to measure pain intensity. For the 24-hour pain data, the authors did not find any significant intensity difference between groups. Mean pain intensity scores were generally low in both experimental groups in all randomised controlled trials reviewed. Based on a visual inspection of the funnel plots of all outcomes, the authors concluded that there was no publication bias.Conclusions The data did not support the pre-emptive use of anti-inflammatory drugs in preventing or reducing the intensity of pain caused by in-office tooth bleaching.

Fever and Other Clinical Indicators May Fail to Detect COVID-19-Infected Individuals.

ARTICLE TITLE AND BIBLIOGRAPHIC INFORMATION: Estimation of the asymptomatic ratio of novel coronavirus infections (COVID-19). Nishiura H, Kobayashi T, Miyama T, et al.Int J Infect Dis 2020;94:154-155. https://doi.org/10.1016/j.ijid.2020.03.020. SOURCE OF FUNDING: Self-funded. TYPE OF STUDY/DESIGN: Cross-sectional population study.

In vitro study of the diagnostic performance of the Spectra Caries Detection Aid.

OBJECTIVE: The Spectra Caries Detection Aid is a fluorescent camera (FC) caries detector device that has been demonstrated to detect occlusal caries extending into dentin with good sensitivity and specificity. This in vitro study examined the diagnostic performance of this device with the goal of defining the numerical reading that best indicates that a tooth has dentin caries. METHODS: Ninety extracted human third molars, that either appeared clinically intact or had early occlusal caries, were used. Teeth were photographed then analyzed using the Spectra Caries detector. Following Spectra readings, the teeth were sectioned perpendicular to the long axis of the tooth. Cuts were made in such a way as to expose the dentino-enamel junction below the pits and fissures. The sectioned teeth were scored as being caries-free, having enamel caries, or dentin caries. Using each tooth's Spectra reading and histological diagnosis, the sensitivity and specificity for various potential dentin caries cut-off values were calculated. Also, the receiver operator curve (ROC) was plotted and the area under the curve calculated. RESULTS: At the manufacture's recommended cut-off for dentin caries diagnosis of 2, the sensitivity is 0.68 and the specificity is 0.78. At a lower cut-off value in the study reported here of 1.8, it was observed that the sensitivity is higher at 0.87, but that the specificity is lower at 0.7. The overall diagnostic performance of the Spectra is good with an ROC area under the curve of 0.82. CONCLUSION: Although lower cut-off values may have higher sensitivity, the use of the manufacture's established cut-off of 2 will result in fewer instances where dentin caries will be diagnosed incorrectly. The use of higher thresholds will discourage restorative treatment of early lesions that are best managed by sealants or other preventive approaches.

Activity of potent and selective host defense peptide mimetics in mouse models of oral candidiasis.

There is a strong need for new broadly active antifungal agents for the treatment of oral candidiasis that not only are active against many species of Candida, including drug-resistant strains, but also evade microbial countermeasures which may lead to resistance. Host defense peptides (HDPs) can provide a foundation for the development of such agents. Toward this end, we have developed fully synthetic, small-molecule, nonpeptide mimetics of the HDPs that improve safety and other pharmaceutical properties. Here we describe the identification of several HDP mimetics that are broadly active against C. albicans and other species of Candida, rapidly fungicidal, and active against yeast and hyphal cultures and that exhibit low cytotoxicity for mammalian cells. Importantly, specificity for Candida over commensal bacteria was also evident, thereby minimizing potential damage to the endogenous microbiome which otherwise could favor fungal overgrowth. Three compounds were tested as topical agents in two different mouse models of oral candidiasis and were found to be highly active. Following single-dose administrations, total Candida burdens in tongues of infected animals were reduced up to three logs. These studies highlight the potential of HDP mimetics as a new tool in the antifungal arsenal for the treatment of oral candidiasis.

Iron Deficiency Anemia and Its Impact on Oral Health-A Literature Review.

Oral disease interventions primarily focus on behavioral changes like dietary improvements and ensuring better oral hygiene. However, recognizing the influence of biological factors, including genetics and early-life nutrition, is crucial. Iron deficiency (ID) and its advanced form, iron deficiency anemia (IDA), affect nearly two billion people globally, especially children and pregnant women. We conducted a comprehensive search using Medline via EndNote and Web of Science, employing keywords related to iron deficiency anemia (IDA), and we identified 36 studies deemed relevant for inclusion in this literature review. IDA prevalence is notably high among pregnant women and young children. Both IDA and early-childhood caries (ECC) disproportionately affect impoverished populations, highlighting the socioeconomic dimension of this issue. IDA presents with various oral mucosal changes and is closely linked to candidiasis. Additionally, IDA can hinder tooth development and weaken the immune response. Multiple population surveys have revealed a significant association between ECC and IDA. While some studies have explored the IDA-periodontal disease link, the current evidence is relatively limited in its robustness. In conclusion, more comprehensive longitudinal studies are essential to deepen our understanding of the IDA-oral disease connection. Investigating the underlying biological mechanisms is critical to developing effective interventions, particularly for vulnerable populations affected by IDA.

A consortium of Aggregatibacter actinomycetemcomitans, Streptococcus parasanguinis, and Filifactor alocis is present in sites prior to bone loss in a longitudinal study of localized aggressive periodontitis.

Aggregatibacter actinomycetemcomitans-induced localized aggressive periodontitis (LAP) in African-American adolescents has been documented but is poorly understood. Two thousand fifty-eight adolescents aged 11 to 17 years were screened for their periodontal status and the presence of A. actinomycetemcomitans in their oral cavity. Seventy-one A. actinomycetemcomitans-negative and 63 A. actinomycetemcomitans-positive periodontally healthy subjects were enrolled, sampled, examined, and radiographed yearly for 3 years. Gingival and periodontal pocket depth and attachment levels were recorded. Disease presentation was characterized by bone loss (BL). Subgingival sites were sampled every 6 months to assess (i) the role of A. actinomycetemcomitans in BL and (ii) the association of A. actinomycetemcomitans and other microbes in their relationships to BL. Sixteen of 63 subjects with A. actinomycetemcomitans developed BL (the other 47 subjects with A. actinomycetemcomitans had no BL). No A. actinomycetemcomitans-negative subjects developed BL. Human oral microbe identification microarray (HOMIM) was used for subgingival microbial assessment. On a subject level, pooled data from A. actinomycetemcomitans-positive subjects who remained healthy had higher prevalences of Streptococcus and Actinomyces species, while A. actinomycetemcomitans-positive subjects with BL had higher prevalences of Parvimonas micra, Filifactor alocis, A. actinomycetemcomitans, and Peptostreptococcus sp. human oral taxon 113 (HOT-113). At vulnerable sites, A. actinomycetemcomitans, Streptococcus parasanguinis, and F. alocis levels were elevated prior to BL. In cases where the three-organism consortium (versus A. actinomycetemcomitans alone) was detected, the specificity for detecting sites of future BL increased from 62% to 99%, with a sensitivity of 89%. We conclude that detecting the presence of A. actinomycetemcomitans, S. parasanguinis, and F. alocis together indicates sites of future BL in LAP. A synergistic interaction of this consortium in LAP causation is possible and is the subject of ongoing research.

Design and Initial Evaluation of a Novel Oral Hygiene Technology for a Special Needs Population: A New Way to Clean.

9.4 million People have swallowing problems in the US. In special needs populations, routine oral hygiene procedures such as tooth brushing can result in aspiration of microbial laden fluids leading to a significant systemic challenge. Aspiration may lead to pneumonia in susceptible populations. These circumstances indicate the need for innovative approaches to oral hygiene for special needs, convalescent, the elderly populations, and young children learning to brush who can ingest excess fluoride which causes mottled enamel. Methods include describing some of the design considerations of the new prototype fabrication and microbiological evaluation of this new device, as well a comparison study of the versions 2 and 3 of the oral care device. Results concluded that version 3.0 regarding patient ease of use was better in comparison to version 2, which was the major difference, and 90% in both groups said they would recommend the new toothbrush. In the microbiological evaluation no growth was seen on any plates containing samples from either the experimental or the control after 48 h of incubation.

In vitro evaluation of the Spectra early caries detection system.

OBJECTIVE: The goal of this study was to perform an in vitro evaluation of the Spectra, a new caries detector that uses light-induced fluorescence of healthy tooth structure and bacterial pigments to optically detect caries. The Spectra generates a storable color map image of examined tooth surfaces which shows areas of enamel and dentin caries. In this study, Spectra readings of occlusal surfaces were compared to clinical, radiographic, and histological assessments of caries. METHODS: Two examiners evaluated 41 extracted molars. The teeth were radiographed and then visually assessed. The International Caries Detection and Assessment System (ICDAS) was used to classify the extent of caries. The teeth were then sectioned and assigned a histological score based on the extension of caries into enamel or dentin. RESULTS: Teeth lacking radiographic caries had a mean Spectra reading of 1.5. Teeth having radiographic caries had a mean Spectra reading of 2.0. This difference was statistically significant. In general, higher ICDAS scores were associated with higher Spectra readings. Teeth with histologically evident deep dentin caries had significantly higher Spectra readings than intact teeth or teeth with superficial enamel demineralization. Spectra assessment of occlusal caries agrees with clinical and radiographic methods. CONCLUSION: Spectra images illustrate the full spectrum of caries severity, from enamel demineralization to dentin decay. The Spectra is a promising technology for the diagnosis and for monitoring the progression of occlusal caries.

Effect of human lactoferrin on Candida albicans infection and host response interactions in experimental oral candidiasis in mice.

OBJECTIVES: To determine the effect of human lactoferrin (hLF) in experimental oral candidiasis and examine the host-pathogen interactions in a mouse model. DESIGN: Experimental groups comprised of 4-6-week-old wild type (C57BL/6J) or lactoferrin knockout (ltf-/-) immunosuppressed mice. Six mice in each group were inoculated with C. albicans or sham infection by swabbing the oral cavity. To determine the effect of hLF on infection and host response, we added hLF (0.5 g/kg/day) to the drinking water. Candida and mice RNA were isolated from gingival tissue and analyzed by qRT-PCR for virulence genes and host expression of inflammatory mediators. RESULTS: Administration of hLF significantly reduced the C. albicans CFUs in both WT and ltf-/- mice (P < .001). Examination of the oral cavity of ltf-/-I mice revealed lesions characterized by white patches and inflammation when compared to WTI mice. Several Candida virulence genes (als, ece, efg, sap) were significantly downregulated on administration of hLF to WTI and ltf-/-I mice (P < .001). The WTI+hLF mice had significantly increased expression of toll-like receptors (TLRs) compared to other group. We observed that hLF increased expression of interleukins, IL-1ß, IL-6, IL-12, IL-17, tumor necrosis factor alpha (TNF-α), transforming growth factor beta (TGF-ß), inducible nitric oxide synthase (iNOS) and myeloperoxidase (MPO) compared to untreated gingival tissue. CONCLUSION: Our study highlights the protective effect of hLF against oral C. albicans infection by its actions on both microbial and host factors. HLF may be of therapeutic value to protect against oral candidiasis.

Alternative Antibiotics in Dentistry: Antimicrobial Peptides.

The rise of antibiotic resistant bacteria due to overuse and misuse of antibiotics in medicine and dentistry is a growing concern. New approaches are needed to combat antibiotic resistant (AR) bacterial infections. There are a number of methods available and in development to address AR infections. Dentists conventionally use chemicals such as chlorohexidine and calcium hydroxide to kill oral bacteria, with many groups recently developing more biocompatible antimicrobial peptides (AMPs) for use in the oral cavity. AMPs are promising candidates in the treatment of (oral) infections. Also known as host defense peptides, AMPs have been isolated from animals across all kingdoms of life and play an integral role in the innate immunity of both prokaryotic and eukaryotic organisms by responding to pathogens. Despite progress over the last four decades, there are only a few AMPs approved for clinical use. This review summarizes an Introduction to Oral Microbiome and Oral Infections, Traditional Antibiotics and Alternatives & Antimicrobial Peptides. There is a focus on cationic AMP characteristics and mechanisms of actions, and an overview of animal-derived natural and synthetic AMPs, as well as observed microbial resistance.

Differential Effects of Antiseptic Mouth Rinses on SARS-CoV-2 Infectivity In Vitro.

Severe acute respiratory syndrome-related coronavirus (SARS-CoV-2) is detectable in saliva from asymptomatic individuals, suggesting a potential benefit from the use of mouth rinses to suppress viral load and reduce virus spread. Published studies on the reduction of SARS-CoV-2-induced cytotoxic effects by mouth rinses do not exclude antiseptic mouth rinse-associated cytotoxicity. Here, we determined the effect of commercially available mouth rinses and antiseptic povidone-iodine on the infectivity of replication-competent SARS-CoV-2 viruses and of pseudotyped SARS-CoV-2 viruses. We first determined the effect of mouth rinses on cell viability to ensure that antiviral activity was not a consequence of mouth rinse-induced cytotoxicity. Colgate Peroxyl (hydrogen peroxide) exhibited the most cytotoxicity, followed by povidone-iodine, chlorhexidine gluconate (CHG), and Listerine (essential oils and alcohol). The potent antiviral activities of Colgate Peroxyl mouth rinse and povidone-iodine were the consequence of rinse-mediated cellular damage when the products were present during infection. The potency of CHG was greater when the product was not washed off after virus attachment, suggesting that the prolonged effect of mouth rinses on cells impacts the antiviral outcome. To minimalize mouth rinse-associated cytotoxicity, mouth rinse was largely removed from treated viruses by centrifugation prior to infection of cells. A 5% (v/v) dilution of Colgate Peroxyl or povidone-iodine completely blocked viral infectivity. A similar 5% (v/v) dilution of Listerine or CHG had a moderate suppressive effect on the virus, but a 50% (v/v) dilution of Listerine or CHG blocked viral infectivity completely. Mouth rinses inactivated the virus without prolonged incubation. The new infectivity assay, with limited impacts of mouth rinse-associated cytotoxicity, showed the differential effects of mouth rinses on SARS-CoV-2 infection. Our results indicate that mouth rinses can significantly reduce virus infectivity, suggesting a potential benefit for reducing SARS-CoV-2 spread.

Aggregatibacter actinomycetemcomitans as an early colonizer of oral tissues: epithelium as a reservoir?

This study examined in vivo and in vitro colonization by Aggregatibacter actinomycetemcomitans, an organism highly associated with aggressive periodontitis. Thirteen volunteers (5 were A. actinomycetemcomitans positive for buccal epithelial cells [BECs] and teeth, 5 were A. actinomycetemcomitans positive for teeth only, and 3 were A. actinomycetemcomitans-negative controls) had two mandibular stents fabricated. Each stent contained 3 removable hydroxyapatite (HA) tooth surrogates. One HA square was removed from a stent at 5 time points over 7 h to assess the transfer of A. actinomycetemcomitans from teeth or BECs to HA. Streptococcus, Actinomyces, A. actinomycetemcomitans, and total anaerobic counts were evaluated on each square over time. In vitro experiments evaluated binding, desorption, transfer, and reattachment of A. actinomycetemcomitans wild-type and mutant strains to BECs and saliva-coated HA (SHA). Streptococcus and Actinomyces formed 80% of the cultivable flora on HA in all subjects. Transfer of A. actinomycetemcomitans to HA was not seen in subjects with A. actinomycetemcomitans on teeth only. All 5 subjects with A. actinomycetemcomitans on BECs showed transfer of A. actinomycetemcomitans to HA. In vitro, A. actinomycetemcomitans desorbed from BECs and transferred to SHA. A. actinomycetemcomitans binding to SHA was irreversible and did not transfer to BECs. The adhesin Aae showed specificity for BECs. Fimbrial mutants showed the greatest reduction in binding to SHA. A. actinomycetemcomitans migrated from BECs to HA in vivo and to SHA in vitro; however, A. actinomycetemcomitans movement from teeth and SHA to BECs did not occur. In vivo, A. actinomycetemcomitans colonized HA within 6 h and thus can be considered an early colonizer. BECs are a likely reservoir for A. actinomycetemcomitans tooth colonization.

Differential effects of antiseptic mouth rinses on SARS-CoV-2 infectivity in vitro.

SARS-CoV-2 is detectable in saliva from asymptomatic individuals, suggesting a potential benefit from the use of mouth rinses to suppress viral load and reduce virus spread. Published studies on reduction of SARS-CoV-2-induced cytotoxic effects by antiseptics do not exclude antiseptic-associated cytotoxicity. Here, we determined the effect of commercially available mouth rinses and antiseptic povidone-iodine on the infectivity of SARS-CoV-2 virus and of a non-pathogenic, recombinant, SARS-CoV-2 infection vector (pseudotyped SARS-CoV-2 virus). We first determined the effect of mouth rinses on cell viability to ensure that antiviral activity was not a consequence of mouth rinse-induced cytotoxicity. Colgate Peroxyl (hydrogen peroxide) exhibited the most cytotoxicity, followed by povidone-iodine, chlorhexidine gluconate (CHG), and Listerine (essential oils and alcohol). Potent anti-viral activities of povidone iodine and Colgate peroxyl mouth rinses was the consequence of rinse-mediated cellular damage. The potency of CHG was greater when the product was not washed off after virus attachment, suggesting that the prolonged effect of mouth rinses on cells impacts anti-viral activity. To minimalize mouth rinse-associated cytotoxicity, mouth rinse was largely removed from treated-viruses by centrifugation prior to infection of cells. A 5% (v/v) dilution of Colgate Peroxyl or povidone-iodine completely blocked viral infectivity. A similar 5% (v/v) dilution of Listerine or CHG had a moderate suppressive effect on the virus, but a 50% (v/v) dilution of Listerine or CHG blocked viral infectivity completely. Prolonged incubation of virus with mouth rinses was not required for viral inactivation. Our results indicate that mouth rinses can significantly reduce virus infectivity, suggesting a potential benefit for reducing SARS-CoV-2 spread.

An improved cost-effective, reproducible method for evaluation of bone loss in a rodent model.

AIM: This study was designed to investigate the utility of two "new" definitions for assessment of bone loss in a rodent model of periodontitis. MATERIAL AND METHODS: Eighteen rats were divided into three groups. Group 1 was infected by Aggregatibacter actinomycetemcomitans (Aa), group 2 was infected with an Aa leukotoxin knock-out, and group 3 received no Aa (controls). Microbial sampling and antibody titres were determined. Initially, two examiners measured the distance from the cemento-enamel-junction to alveolar bone crest using the three following methods; (1) total area of bone loss by radiograph, (2) linear bone loss by radiograph, (3) a direct visual measurement (DVM) of horizontal bone loss. Two "new" definitions were adopted; (1) any site in infected animals showing bone loss >2 standard deviations above the mean seen at that site in control animals was recorded as bone loss, (2) any animal with two or more sites in any quadrant affected by bone loss was considered as diseased. RESULTS: Using the "new" definitions both evaluators independently found that infected animals had significantly more disease than controls (DVM system; p<0.05). CONCLUSIONS: The DVM method provides a simple, cost effective, and reproducible method for studying periodontal disease in rodents.

Macrophage inflammatory protein-1alpha: a salivary biomarker of bone loss in a longitudinal cohort study of children at risk for aggressive periodontal disease?

BACKGROUND: Periodontitis develops in a time-dependent manner. Cross-sectional studies document one moment in time but fail to capture the progressive nature of disease. Radiographic measures of bone loss are relatively insensitive but are reliable markers of irreversible disease. Longitudinal studies are needed to identify biomarkers that can precede radiographic evidence of bone loss and, thus, mark the period prior to clinical evidence of irreversible disease. A longitudinal study of students susceptible to localized aggressive periodontitis (LAgP) was conducted to evaluate chemokines/cytokines found in saliva derived from periodontally healthy children who subsequently developed alveolar bone loss. METHODS: Students were screened, sampled for Aggregatibacter actinomycetemcomitans (previously Actinobacillus actinomycetemcomitans [Aa]), and divided into a cohort of Aa+ and Aa- students. Ninety-six periodontally healthy Aa+ and Aa- students were recalled every 6 to 9 months following screening. Examinations, saliva collections, and radiographs were performed. After seven students developed bone loss, the levels of 21 cytokines were assessed and matched to saliva from seven Aa+ and seven Aa- students who remained healthy for > or =1 year. Subsequently, saliva from an additional 27 students who remained healthy was analyzed. RESULTS: Nineteen cytokines were not detected or were detected at low levels. Macrophage inflammatory protein (MIP)-1alpha was elevated 50-fold in seven Aa+ students who developed disease 6 to 9 months prior to radiographic detection of bone loss compared to levels in 21 Aa+ and 20 Aa- students who remained healthy (P <0.001). Interleukin (IL)-1beta was also elevated (P = 0.01). MIP-1alpha had a specificity of 96.8% and a sensitivity of 100%, whereas IL-1beta showed 90.3% specificity and 85.7% sensitivity relative to bone loss. MIP-1alpha levels were also related to increasing probing depth and the number of pockets >6 mm. CONCLUSION: The superior sensitivity and specificity of MIP-1alpha, which correlated well with probing depths and the onset of bone loss, suggested that it could be used as an early biomarker for LAgP.

The original desensitizers: strontium and potassium salts.

Many patients complain of teeth that are painful when exposed to a variety of harmless thermal and tactile stimuli. Sensitive tooth necks and root surfaces frequently are the unintentional by-products of aggressive oral hygiene practices and periodontal treatment. Dentists and the afflicted patients have resorted to many remedies for this common form of dental pain. In the past, many of these purported treatments were based on a fragmentary knowledge of the anatomic substrate and physiological processes underlying dentin sensitivity. Much progress has been made identifying dentin permeability and intradental nerve excitability as physiological parameters that can be modified by desensitizing agents. In this paper, rather than provide a comprehensive or critical review of desensitizing treatment, I will discuss the rationale and some of the history behind two early and popular classes of dentifrice-applied desensitizing agents; strontium and potassium salts.

Dental products and evidence-based dentistry.

Dentists make frequent product recommendations to their patients. Many dental products are intended to exert a therapeutic action such as caries prevention or desensitization. The purpose of this article is to highlight the contributions the principles of evidence-based dentistry (EBD) can make in guiding therapeutic product recommendations. Dental practitioners are exposed to product claims in advertising and in the professional literature. All studies are not equivalent in making treatment decisions. Although useful for screening active ingredients and providing other background information, laboratory studies should not directly inform clinical decision-making. Properly designed and conducted randomized controlled clinical trials assess the impact of an intervention on a disease-relevant outcome measure (like pain scores or periodontal pocket depth). Where available, systematic reviews can help clinicians determine if there are trends and agreement in clinical trial results. Clinical studies need to be evaluated for publication and other forms of bias. In order to use study results in clinical decision-making, the clinical significance of the trial results must be considered. Determining that a result is statistically significant is inadequate since it does not inform the clinician of the magnitude of the treatment effect. Although clinical studies may generate observations that are valid for the conditions and selected population that was used in the trial, the results may not predict how well an intervention will work in actual use by a diverse group of consumers. In order to better inform clinical judgment, practice-based research networks examine the effectiveness of interventions under real-world circumstances. Applying these basic EBD principles should allow dental practitioners to use consumer products to promote oral health.

The effect of iron deficiency anemia on experimental dental caries in mice.

OBJECTIVE: The objective of this study was to examine the relationship between iron deficiency and caries susceptibility in a mouse model. MATERIALS AND METHODS: Three-week-old C57BL/J6 mice were fed a cariogenic diet containing either standard iron (48 ppm Fe) or low iron (4 ppm Fe) levels. Concurrently, groups of mice with both diets were orally inoculated with Streptococcus mutans (1 × 108) cells on three consecutive days. At the end of the 5th week after infection, mice were sacrificed and jaws were collected for caries scoring, rating the number and severity of lesions using a modified Keyes method applicable to mice. RESULTS: Blood analysis by the end of the 5th week revealed marked reduction in the hemoglobin and hematocrit levels of the mice fed the iron deficient diet (IDA and IDA-S. mutans). Anemic mice in both groups lacked the incisor enamel pigmentation observed in mice fed an iron deficient diet. Anemic infected mice had the highest caries severity scores reflecting extensive deep lesions (P < 0.05). S. mutans infected mice fed a standard iron diet had similar numbers of lesions and severity scores as un-infected IDA animals (p < 0.05). IDA did not alter S. mutans CFU counts in infected animals (P < 0.05). CONCLUSION: These results demonstrated that IDA mice are at a higher risk of developing deep dental caries compared to non-anemic mice; highlighting the protective role of iron against dental caries.

Comparison of Dental Students' PAT Scores with Their Performance in Preclinical Technique Courses: Identifying the Need for Early Interventions.

The aim of this study was to determine if lower scores on the Perceptual Ability Test (PAT) of the Dental Admission Test (DAT) predicted which dental students required remediation in three preclinical restorative dentistry courses at Rutgers School of Dental Medicine. The academic records of 489 dental students from the graduating Classes of 2010 through 2015 were evaluated. The results showed that, for all three courses (Preclinical General Dentistry I, Preclinical General Dentistry II, and Preclinical Fixed Prosthodontics), the remediating students had significantly lower mean PAT scores than did the passing students. A one-unit decrease in a student's PAT score was associated with a 43% increase in the odds of remediating the Preclinical General Dentistry I lab, a 29% increase in the odds of remediating the Preclinical Fixed Prosthodontics lab, and a 47% increase in the odds of remediating the Preclinical General Dentistry II lab. The mean PAT score for passing students was 18.84 (standard deviation 2.35), and the mean PAT score for students requiring remediation was 17.03 (standard deviation 2.18). Studies like this can be useful because if students at risk of failing these courses are identified early and appropriate supports are provided, the need for remediation may be reduced if not eliminated.