Antimicrobial Mouthwashes: An Overview of Mechanisms-What Do We Still Need to Know?

This narrative literature review is the first in a 6-section supplement on the role of mouthwashes in oral care. This introduction briefly summarises current knowledge on antimicrobial mechanisms, relating to some of the most common over-the-counter mouthwash products available worldwide: chlorhexidine, hydrogen peroxide, cetylpyridinium chloride, povidone iodine, and essential oils. The aim of this first article is to describe how mouthwashes "kill" pathogenic microbes when used adjunctively and thus provide a basis for their widespread use to manage key oral diseases, namely caries, gingivitis, and periodontal disease. This article therefore sets the scene for subsequent, more detailed exploration of mouthwashes regarding their clinical effectiveness, impact on the oral microbiome, and possible effects on systemic health as well as natural alternatives and future directions. Other than the clinical effectiveness (for certain agents) of mouthwashes, on many topics there remains insufficient evidence for systematic review or formulation of robust national guidelines. The supplement, therefore, compiled by an international task team, is aimed at general dental practitioners across the globe, as an easy-to-read guide for helping to advise patients on mouthwash use based on the current best available evidence.

Anti-inflammatory and antioxidative effects of the buds from different species of Populus in human gingival fibroblast cells: Role of bioflavanones.

BACKGROUND: Poplar leaf-buds (Populi gemmae) are used traditionally as anti-inflammatory agents to the treatment of skin injuries or cough. They differ in their diverse chemical composition and different types of activities, whose mechanisms are not fully recognized. PURPOSE: Evaluation and comparison of anti-inflammatory activity of leaf-buds extracts from Populus nigra, P. × berolinensis and P. lasiocarpa and flavanones - pinocembrin and pinostrobin towards human gingival fibroblasts (HGF-1) pro-inflammatory stimulated by silver nanoparticles (AgNPs). Determination of antioxidant activity associated with anti-inflammatory properties by means of bioautographic TLC tests. METHODS: Phytochemical analysis was performed by TLC and videodensitometry analysis. The extracts were standardized on the pinocembrin and pinostrobin content. Bioautography was performed using 2,2-diphenyl-1-picrylhydrazyl (DPPH) and riboflavin-light blue tetrazolium chloride (riboflavin-light-NBT) radicals to assess the extracts and both flavanones radical scavenging properties as well as potential inhibition of xanthine oxidase (XO) activity. The protective effects of poplar buds extract and flavanones - pinocembrin and pinostrobin on HGF-1 line exposured to AgNPs were investigated by analysis of interleukin 6 (IL-6) and interleukin IL-1ß (IL-1ß) level measured by ELISA kit. The messenger ribonucleic acid (mRNA) of both cytokines was determined by real-time quantitative PCR. The involvement of cyclooxygenase 2 protein (COX-2) was studied using Western blot analysis. RESULTS: The presence of several flavanones and phenolic acids, which have radical scavenging properties, was revealed in all of the bud poplar extracts analyzed. Treatment with particular flavanones or extracts from buds of P. × berolinensis and P. nigra decreased the IL-6 and IL-1ß release in HGF-1 cells and down-regulation of mRNA for both cytokines was observed. The COX-2 protein expression was demonstrated for pinocembrin and P. × berolinensis buds. These effects were not observed for buds from P. lasiocarpa not containing of flavonoids. CONCLUSION: The potential protective role of pinocembrin and pinostrobin and extracts from buds P. nigra and P. × berolinensis against AgNPs induced inflammation and cytotoxicity in HGF-1 cells is disclosed. In addition, the antioxidant properties of poplar bud extracts have been demonstrated. P. × berolinensis buds showed the highest activity in both the in vitro model and in the bioautographic tests.

Impact of the use of Kampo medicine in patients with esophageal cancer during chemotherapy:a clinical trial for oral hygiene and oral condition.

OBJECTIVE: The aim of this study was to investigate the impact of the use of two Kampo medicines on oral mucositis, tongue coating bacteria, and gingiva condition in patients with esophageal cancer undergoing chemotherapy. METHODS: Twenty-three esophageal cancer patients who receive chemotherapy at Tokushima University Hospital, were included. The participants, who received professional oral healthcare, were randomly divided into three groups:7 subjects received Daiokanzoto sherbets, 7 subjects received Hangeshashinto sherbets, and 9 subjects received nothing (control). The numbers of total bacteria and specific periodontopathogenic bacteria in tongue coating were determined in addition to clinical parameters. RESULTS: No difference on the onset of oral mucositis was found among the three groups. However, tongue coating index, gingival index (GI), plaque index, the number of total bacteria, Fusobacterium nucleatum and Campylobacter rectus were decreased during chemotherapy. More specifically, GI as well as the number of F. nucleatum and C. rectus were decreased significantly in the Daiokanzoto group when compared to the control group (psize 8 < 0.05). No such differences were observed for the group receiving Hangeshashinto. CONCLUSION: This clinical trial showed that Daiokanzoto might be effective in attenuating gingival inflammation and reducing the levels of periodontopathogenic bacteria in patients with esophageal cancer. J. Med. Invest. 65:184-190, August, 2018.

Khat (Catha edulis) and its oral health effects: An updated review.

Khat or qat (Catha edulis) is a plant that grows in East Africa and southern Arabia. The leaves and twigs of this small tree are chewed by several millions of people worldwide for their stimulating amphetamine-like effects. The reported prevalence of khat chewing in Europe and the USA is on the rise, especially with global migration. Long-term khat chewing has several detrimental general and oral health effects. The aim of the present study was to review the current literature regarding khat use and its association with oral and dental diseases, with particular emphasis on its link with oral keratotic white lesions and oral cancer. We searched the literature to identify all relevant articles. Studies showed that khat is associated with several oral and dental conditions, including keratotic white lesions, mucosal pigmentation, periodontal disease, tooth loss, plasma cell stomatitis, and xerostomia. There are limited data on the incidence of dental caries among khat chewers. The evidence that khat chewing is a risk factor for oral cancer is still weak, and is mainly based on anecdotal case reports and uncontrolled studies.

Plasma Cell Gingivitis: An Occasional Case Report.

Plasma cell gingivitis, an infrequently observed oral condition, has been clinically characterized by diffuse gingival enlargement, erythema and sometimes desquamation. These lesions are usually asymptomatic, but invariably the patient will complain of a burning sensation in the gingiva and bleeding from the mouth. The diagnosis requires hematological screening in addition to clinical and histopathological examinations. This case report outlines one such case of plasma cell gingivitis in a 15-year-old female caused by use of an herbal, homemade toothpowder. The case presented here highlights the adverse effects and irrational use of herbal agents in dentifrices. At the same time, it emphasizes the need for comprehensive history taking, careful clinical examination and appropriate diagnostic tests in order to arrive at a definitive diagnosis and treatment plan for gingival conditions that are refractory to conventional therapy and to exclude certain malignancies and oral manifestations of systemic diseases.

Periodontopatías en jóvenes y adolescentes adictos a drogas psicoactivas, atendidos en el Centro de Deshabituación de Adolescentes, del municipio Playa / Periodontal diseases in young people and adolescents addicted to psychoactive drugs and attended in the Center for Treatment of Drug Dependency in Adolescents, Playa Municipality

Introducción: En las últimas décadas se ha incrementado el uso y abuso de drogas como el alcohol, el cannabis, la cocaína y el crack, en particular en determinados grupos sociales de especial vulnerabilidad. Por otra parte, no se han estudiado o se han estudiado muy poco las enfermedades de la cavidad bucal, con excepción del cáncer bucal, que pudieran ser consecuencia del uso y abuso del consumo de drogas tanto legales como ilegales, y en Cuba no se han realizado estudios sistemáticos sobre este tema. Objetivo: Determinar la relación entre el consumo de drogas psicoactivas y la existencia de periodontopatías en jóvenes y adolescentes tratados en el CDA. Métodos: Se realizó un estudio observacional, descriptivo, de corte transversal con el objetivo de determinar la incidencia de periodontopatías en adolescentes y jóvenes adictos tratados en el Centro de Deshabituación de Adolescentes (CDA) del Municipio Playa y que se encontraban en rehabilitación. Se analizaron las historias clínicas de los pacientes para determinar el o los tipos de drogas que consumían y el tiempo de consumo. Como método empírico se utilizó la encuesta EMTAJOVEN para determinar fumadores. Resultados: A pesar de que la mayoría de los adictos presentaban un índice de higiene bucal calificado de excelente, se encontró que 28 de los 43 adictos presentaban alguna modalidad de enfermedad periodontal como gingivitis leve, gingivitis moderada y gingivitis con bolsa; ninguno presentó periodontitis. Se comprobó que 35 de los 43 pacientes eran fumadores y 20 de los 28 portadores de gingivitis. Conclusiones: Se concluye que la causa de las diferentes formas de gingivitis presente en estos pacientes no siempre es imputable a la mala higiene bucal y que pudiera deberse a la drogodependencia, en particular el tabaquismo

Background: The use and abuse of drugs such as alcohol, cannabis, cocaine, and crack has increased in the last decades, particularly in determined social groups of special vulnerability. On the other hand, the diseases of the oral cavity, except mouth cancer, have not been studied or have been little studied and these diseases could be a consequence of both legal or illegal use and abuse of drug consumption. Also, systematic studies have not been conducted in Cuba about this topic. Objective: To determine the relation between the consumption of psychoactive drugs and the existence of periodontal diseases in young people and adolescents treated in the Center for Treatment of Drug Dependency in Adolescents (CDA). Methods: An observational descriptive cross-sectional study was conducted in order to determine the incidence of periodontal diseases in adolescents and young addicts treated in the Center for Treatment of Drug Dependency in Adolescents (CDA) in Playa Municipality who were under rehabilitation. The clinical histories of patients were analyzed to determine the types of drugs they used to consume and the time of consumption. As an empirical method, The EMTAJOVEN survey was used to determine smokers. Results: Despite the majority of addicts presented an oral hygiene index which was considered excellent, it was found that 28 of the 43 addicts presented some type of periodontal disease such as mild gingivitis, moderate gingivitis, and periodontal pockets associated with gingivitis; none of them had periodontitis. It was confirmed that 35 of the 43 patients were smokers and 20 of the 28 ones had gingivitis. Conclusions: It is concluded that the cause of the different forms of gingivitis present in these patients is not always attributable to a bad oral hygiene, but it could be a consequence of drug dependence, particularly, smoking

Oral mucosal lesions, microbial changes, and taste disturbances induced by adjuvant chemotherapy in breast cancer patients.

OBJECTIVE: The aim of the study was to examine oral mucosal lesions, microbial changes, and taste disturbances induced by adjuvant chemotherapy (CT) in breast cancer patients during and 1 year after treatment. STUDY DESIGN: Forty-five consecutive breast cancer patients, eligible for adjuvant CT with cyclophosphamide, epirubicin or methotrexate, and 5-fluorouracil were followed before, during, 6 months and 1 year after CT and were compared to a control group of 31 breast cancer patients not receiving adjuvant CT. RESULTS: During CT, oral mucosal lesions developed including erythema (n = 10, 22%) and ulceration (n = 7, 16%). Five patients (11%) were diagnosed with oral candidosis. Scores of dental bacterial plaque and gingival inflammation increased during CT and the oral microbial composition changed towards a more acidophilic flora. Taste disturbances were experienced by 84% (n = 38) of the patients in the CT group. CONCLUSION: In breast cancer patients, moderate-intensive adjuvant CT caused oral mucosal lesions, oral candidosis, taste disturbances and a more acidophilic oral microflora. These adverse effects were temporary and the majority of the patients were mildly affected.

A morphologic comparison of gingival changes influenced by cyclosporin and tacrolimus in rats: an experimental study.

BACKGROUND: The aim of this study was to compare the morphologic changes in the gingiva brought about by the administration of cyclosporin and tacrolimus in rats. METHODS: The study was conducted on 30 six-week-old male Sprague-Dawley rats, divided into three groups of 10 rats each, for a period of 4 weeks. Group I rats received cyclosporin (30 mg/kg body weight), and group II rats received tacrolimus (1.5 mg/kg body weight), by means of a gavage. Group III served as control and received olive oil alone. Impressions of the mandibular incisal region were made weekly, and stone casts were prepared for measuring morphologic changes of the gingiva. RESULTS: An increase in the measured gingival dimensions was observed in the test groups as early as week 2 after the commencement of drug administration. Intergroup comparison revealed that the increase in the measured dimensions was greater in group I than group II at the end of 4 weeks. CONCLUSIONS: Cyclosporin and tacrolimus were capable of causing gingival enlargement in Sprague-Dawley rats. However, the magnitude of tacrolimus-influenced gingival enlargement seemed to be comparatively less than cyclosporin.

[Metal intolerance. A frequent condition, but difficult to diagnose]. / Metall-Unverträglichkeit. Eine häufige Erkrankung, aber schwierig zu diagnostizieren.

Many of the methods and devices used for incompatibility testing of metals and alloys today are of questionable scientific value. Neither epicutaneous testing nor other diagnostic adjuncts from the realm of alternative medicine, nor patient-history data contained in so-called dental alloy passports, are generally able to yield any useful information. Analysis is particularly difficulty in situations where metallic components are cemented in place in the oral cavity. For many years now, the so-called splinter test has proven its value as a means of non-destructively identifying the type of alloy used. It can also be used for detecting persistent corrosion-prone adhesive oxides and soldering joints as causative agents of metal-related noxious processes. This article presents a number of case reports to demonstrate the reliability and the precision of the splinter test. Over a period of 10 years, more than 1600 splinter analyses have been performed at the University of Basle Center of Dentistry. According to a pertinent survey, these analyses were able to contribute to full treatment success in 63% of the cases, to partial success in 27% of the cases, and to no success in only 10% of the cases.

Articaine hydrochloride: a study of the safety of a new amide local anesthetic.

BACKGROUND: Articaine is an amide local anesthetic introduced clinically in Germany in 1976 and subsequently throughout Europe, Canada and, in 2000, the United States. METHODS: The authors report on three identical single-dose, randomized, double-blind, parallel-group, active-controlled multicenter studies that were conducted to compare the safety and efficacy of articaine (4 percent with epinephrine 1:100,000) with that of lidocaine (2 percent with epinephrine 1:100,000). RESULTS: A total of 1,325 subjects participated in these studies, 882 of whom received articaine 4 percent with epinephrine 1:100,000 and 443 of whom received lidocaine 2 percent with epinephrine 1:100,000. The overall incidence of adverse events in the combined studies was 22 percent for the articaine group and 20 percent for the lidocaine group. The most frequently reported adverse events in the articaine group, excluding postprocedural dental pain, were headache (4 percent), facial edema, infection, gingivitis and paresthesia (1 percent each). The incidence of these events was similar to that reported for subjects who received lidocaine. The adverse events most frequently reported as related to articaine use were paresthesia (0.9 percent), hypesthesia (0.7 percent), headache (0.55 percent), infection (0.45 percent), and rash and pain (0.3 percent each). CONCLUSIONS: Articaine is a well-tolerated, safe and effective local anesthetic for use in clinical dentistry.

The status of periodontal health and oral hygiene of Miraa (catha edulis) chewers.

Two hundred and thirty one miraa chewers and 199 non miraa chewers were assessed for gingivitis, loss of attachment and oral hygiene status. The mean gingivitis score among miraa chewers was 1.6 and 1.7 among non miraa chewers (P less than 0.05). The mean facial gingivitis score among miraa chewers was 1.5 and 1.6 among non miraa chewers (P greater than 0.05). The mean distal gingivitis score among miraa chewers was 1.5 and 1.7 among non miraa chewers (P less than 0.05). The mean lingual gingivitis score among miraa chewers was lower than that of non miraa chewers (P less than 0.05). The means of loss of attachment of the teeth of miraa chewers were equal to those of non miraa chewers. Although the mean surface plaque scores of miraa chewers were generally lower than those of non miraa chewers, only the mean lingual plaque score of miraa chewers was found to be significantly lower than that of non miraa chewers (P less than 0.05). It is concluded that the oral hygiene status of miraa chewers was generally better than that of non miraa chewers and there was no evidence to show that chewing miraa is detrimental to periodontal health.

Plasma cell gingivitis related to the use of herbal toothpaste.

Plasma cell gingivitis is an uncommon condition, characterised by a sharply demarcated, erythematous and oedematous gingivitis, often extending to the mucogingival junction. The condition is generally considered to be a manifestation of hypersensitivity, but often no antigenic agent can be identified. This report describes a case of plasma cell gingivitis, apparently associated with the use of a herbal toothpaste.