Reduced antibiotic prescription rates following physician-targeted interventions in a dental practice.

BACKGROUND: The prescription rate for antibiotics in dental clinics is not declining despite the increase in the antibiotic resistance problem. In this study, we observed the change in antibiotic prescription rates by dentists in a Korean dental hospital for various treatments after conducting interventions targeting dentists. METHODS: The first intervention was to distribute guidelines. The second intervention was to remove the bundled prescription button containing antibiotics from the Electronic Medical Record system. A total of 22,098 treatment records were divided into 12 main treatment categories, and Chi-square tests and logistic regression analyses were performed. RESULTS: After the interventions were applied, the overall prescription rate for antibiotics dropped. The antibiotic prescription rate decreased by an odds ratio of 0.774 (95% CI: 0.686-0.873) after intervention 1 and by an odds ratio of 0.574 (95% CI: 0.501-0.658) after intervention 2. The treatments with significantly reduced antibiotic prescription rates were extraction for orthodontic treatment, dental implant surgery, extraction of an impacted tooth and general extraction. These treatments are typically performed in patients without an active infection. The prescription rate did not change for periodontal treatments or endodontic treatments, which are usually performed in patients with an infection. The prescription rate also remained constant for minor operations and other basic treatments. CONCLUSION: The interventions induced behavioural changes in the dentists and were effective in lowering the antibiotic prescription rates in a dental hospital. In particular, there was a significant reduction in the prescription rates for implant surgery and tooth extraction in the absence of infection.

Lactobacillus reuteri AN417 cell-free culture supernatant as a novel antibacterial agent targeting oral pathogenic bacteria.

Lactobacillus reuteri AN417 is a newly characterized probiotic strain. The activity of AN417 against oral pathogenic bacteria is unknown. We investigated the antibacterial activity of cell-free L. reuteri AN417 culture supernatant (LRS) against three oral pathogens: Porphyromonas gingivalis, Fusobacterium nucleatum, and Streptococcus mutans. P. gingivalis and F. nucleatum have been implicated in periodontal disease, whereas S. mutans causes dental caries. Exposing these oral pathogenic bacteria to LRS significantly reduced their growth rates, intracellular ATP levels, cell viability, and time-to-kill. The minimal inhibitory volume of LRS was 10% (v/v) against P. gingivalis, 20% (v/v) for F. nucleatum, and 30% (v/v) for S. mutans. LRS significantly reduced the integrity of biofilms and significantly suppressed the expression of various genes involved in P. gingivalis biofilm formation. The L. reuteri AN417 genome lacked genes encoding reuterin, reuteran, and reutericyclin, which are major antibacterial compounds produced in L. reuteri strains. LRS treated with lipase and α-amylase displayed decreased antibacterial activity against oral pathogens. These data suggest that the antibacterial substances in LRS are carbohydrates and/or fatty acid metabolites. Our results demonstrate that LRS has antimicrobial activity against dental pathogenic bacteria, highlighting its potential utility for the prevention and treatment of P. gingivalis periodontal disease.

alpha-Galactosidase activity in human saliva.

OBJECTIVE: The purpose of this study was to investigate whether alpha-galactosidase activity is present in whole and glandular saliva and whether alpha-galactosidase activity depends on blood type and secretor status. DESIGN: For the first experiments, 30 healthy participants (15 men, 15 women; mean age, 24.2+/-1.5 years) who were 10 A, 10 B, and 10 O blood type subjects were included. alpha-Galactosidase activity in unstimulated whole saliva (UWS) was assayed by using 4-methylumbelliferyl-alpha-d-galactopyranoside as a substrate. Total protein concentration was determined by bicinchoninic acid assay. The secretor status of the blood group antigens was determined by immunoblotting. alpha-Galactosidase activity in UWS according to gender, blood type, secretor status, sample clarification, and buffer was investigated. Daily variations of alpha-galactosidase activity and alpha-galactosidase isozyme activity were also investigated. For the second experiments, 10 healthy blood type B participants (5 men, 5 women; mean age, 27.0+/-2.7 years) were enrolled. alpha-Galactosidase activity in whole and glandular saliva was investigated. RESULTS: alpha-Galactosidase activity was detected in UWS and was mainly isozyme A activity. There was no difference in alpha-galactosidase activity according to gender, blood type, and secretor status. alpha-Galactosidase activity in UWS was higher in unclarified samples than in clarified ones and showed wide daily variations. alpha-Galactosidase activity in whole saliva was significantly higher than that in glandular saliva. CONCLUSIONS: alpha-Galactosidase activity which is mainly isozyme A activity was detected in human whole and glandular saliva. alpha-Galactosidase activity in UWS did not differ according to blood type and secretor status.

Is yogurt intake associated with periodontitis due to calcium?

The purpose of this study is to determine whether the lower intakes of yogurt, milk, and calcium are associated with periodontitis in a nationally representative sample of Korean adults. This study comprised 6,150 adults 19 or more years old who took both periodontal examination and nutrition survey. The frequency of yogurt and milk intake was examined with a food frequency questionnaire. The amount of calcium intake was calculated with dietary intakes data gained from complete one-day 24-hour recall interviews. Periodontitis was assessed using the Community Periodontal Index (CPI). Multivariate logistic regression analyses were performed for the whole sample and subgroups with the strata of age, gender, or smoking, in a complex sampling design. Less intake of yogurt was significantly associated with periodontitis (odds ratio [OR] 0.82, 95% confidential interval [CI] 0.70-0.97), but neither less intake of milk (OR 1.04, 95% CI 0.89-1.20) nor lower intake of calcium (OR 1.04, 95% CI 0.89-1.21) was significantly associated with periodontitis. In the subgroup analysis, no difference in the association of yogurt intake with periodontitis was found according to the strata of age, gender, and smoking. In conclusion, periodonitis was significantly associated with the less intake of yogurt among the Korean adults, but the calcium contained in yogurt is not likely to cause it.