Quantitation of hepatitis B viral markers in a dental school population.

Ample evidence exists that dentists and dental personnel are vulnerable to hepatitis B disease. Epidemiologic studies, which provide a further understanding of the prevalence, infectious nature, and risks of transmission of the hepatitis B virus, are particularly significant in a dental school environment because of the insidious nature of the virus. Screening should be done for anti-HBs because it is the most reliable marker for hepatitis B infection and is generally believed to confer immunity. However, because no experimental data are available concerning the amount of antibody needed for protection, quantitation of anti-HBs levels in human serum or gingival crevicular fluid would be the first step in ultimately correlating antibody titers to the immune process. In this study, we present quantitative data on the relative antibody titers in a dental school population. Our findings may be of importance for monitoring the effectiveness of vaccination, for improving safety guidelines in dental clinics, and for developing new and rapid oral diagnostic screening methods. Recently, a new method using gingival crevicular fluid has been developed; it permits identification of not only antibody, but also of hepatitis B surface and e antigens (L. Andors, and associates, unpublished data).

Direct measurement of hepatitis B viral antibody and antigen markers in gingival crevicular fluid.

Radioimmunoassay analyses of serum are widely performed to monitor the incidence of hepatitis B virus infection. As an alternative to serum analyses, the authors have explored the feasibility of using gingival crevicular fluid for the detection and quantitation of hepatitis B viral immunologic markers. The results of the study demonstrate that the hepatitis B surface antigen can be easily quantified in gingival fluid. Confirmation of the presence of the hepatitis B e antigen can also be made, but this is more difficult because of the small amounts of gingival fluid currently being assayed. Antibody to the hepatitis B surface antigen can be quantitated in high-titered persons.

The role of C. albicans in denture stomatitis.

Denture stomatitis is an erythematous disorder of the denture-bearing tissues, especially the maxillary hard palate. Frequently it mimics many oral lesions. Early diagnosis of the lesion is essential to assure rational therapy. A diagnostic procedure based upon the enumeration of Candida albicans appeared to be feasible. A control group of twenty fully dentate subjects with no clinical evidence of stomatitis was sampled to establish normal concentrations of C. albicans in the oral flora. Samples were taken from a triangular area of the hard palate, serially diluted in broth, and all dilutions were incubated aerobically. In the control population, C. albicans never exceeded 100 organisms per square centimeter per subject sample. A population of edentulous patients with denture stomatitis, prior to any therapy, was similarly sampled. In many of these patients the concentration of C. albicans always exceeded 10,000 organisms per square centimeter per patient. The patients received denture replacements and antimycotic antibiotic therapy. Follow-up cultures were taken 4 to 6 weeks after completion of therapy. All patients were found to be free of denture stomatitis.