Old age and other factors associated with salivary microbiome variation.

BACKGROUND: Many factors can contribute to the exact makeup of the salivary microbiome. Differences in the oral microbiome occur with old age, which may be due to oral conditions and diseases associated with old age, such as edentulism, as well as other unknown causes. METHODS: The salivary microbiome was sampled in patients from a large urban clinic. For all subjects age, gender, periodontal status, caries status, presence of edentulism, medications, and tobacco usage were recorded. Multifactor analysis was used to study variation in salivary microbiome profiles linked to these factors. RESULTS: In the population sampled, there were significantly higher numbers of edentulous subjects, and increased levels of polypharmacy found with aging. Large differences in alpha diversity and beta diversity of the salivary microbiome in the old age group were largely linked to edentulism. However, multivariable analysis revealed, even after adjusting for differences in edentulism, polypharmacy, tobacco usage, periodontal disease, caries level, and gender, that old age itself was associated with lower levels of taxa Porphyromonas endodontalis, Alloprevotella tannerae, Filifactor alocis, Treponema, Lautropia Mirabilis and Pseudopropionibacterium sp._HMT_194. Surprisingly, of these taxa, most were ones known to reside on or near tooth surfaces. CONCLUSIONS: Another factor or factors beyond edentulism, polypharmacy and periodontal disease play a role in the differences seen in oral microbiome with old age. The nature of this factor(s) is not known.

Oral microbial taxa associated with risk for SARS-CoV-2 infection.

Hypothesis and objective: The oral and digestive tract microbial ecosystem has sparked interest because of its impact on various systemic diseases and conditions. The oral cavity serves not only as a reservoir for many potentially virulent microbiota but also as an important entry point and portal to the human body system. This is especially significant in the transmissibility of the virulent current pandemic virus SARS-CoV-2. The oral and digestive microbiome influences the inflammatory burden and effectiveness of the immune system and serves as a marker of activity of these host processes. The host immune response plays a role in infection susceptibility, including SARS-CoV-2. The purpose of this study is to investigate the role of specific salivary oral microbiome in susceptibility to SARS-CoV-2 infection. Methods and results: One hundred six subjects of known medical and dental history who consented to provide saliva samples between January 2017 and December 2019 were included in this study. Sixteen had become COVID-19 positive based on the PCR test by 3/01/2021. A comparison of oral microbiome bacteria taxa profiles based on 16S rRNA sequencing revealed differences between the two groups in this pilot study. Conclusions: These bacteria taxa may be markers of increased susceptibility to SARS-CoV-2 infection in the unvaccinated population.

Gingival Sculpting: A Simple Gingival Depigmentation Technique Using Bur Abrasion and Scalpel Combined - A Case Report.

INTRODUCTION: Dentofacial esthetics demands have increased tremendously in the past decade. Psychological impact of unsatisfactory esthetic appearance can manifest in decreased sense of self-esteem and can negatively affect social and professional interactions. Esthetic awareness of dental patients has extended to include requests of gingival color modification. Gingival pigmentation can be physiological due to ethnic pigmentation or can be a result of various pathological processes. Different surgical modalities, tools and materials have been used in management of gingival pigmentation. This case report is introducing a simple, cost effective, minimally invasive technique of gingival sculpting for the purpose of significantly reducing gingival pigmentation. CASE PRESENTATION: A healthy 32-year-old male patient presented with a chief complaint of gingival pigmentation that is causing him distress and low self-esteem. Gingival sculpting technique was used. This simple technique uses a combination of two methods, bur abrasion and scalpel blade with copious irrigation. The procedure resulted in minimal intra and postoperative complications and excellent esthetic results achieved instantly and maintained at 3 months postoperatively. High patient esthetic satisfaction was achieved. CONCLUSION: Gingival sculpting is minimally invasive procedure that can be performed at any dental office. It renders excellent esthetic results using minimal chair time and down time for the patient. It is well tolerated by the patient with minimal bleeding, postoperative pain, and rapid healing time. Long-term follow-up is needed to ensure stability and lack of recurrence.

Salivary microbiome with gastroesophageal reflux disease and treatment.

The effect of oral microbial composition on periodontal health and on systemic health has been, and is being established. The oral microbiome, in turn, can be altered by local and systemic diseases and conditions. Gastroesophageal reflux disease (GERD), has been associated with increased acidity in the oral cavity resulting in dental erosion, and controversially a reduced risk of periodontal disease. We hypothesized that presence of GERD was linked to a modified microbial profile in untreated GERD patients and that the use of proton pump inhibitor (PPI) drugs: potent disruptors of gut microbiome, in GERD patients might result in a salivary microbiome that is further distinct. Untreated GERD patients showed multiple differences in salivary microbiome as compared to healthy controls. Taxa found at lower levels related to the presence of GERD not treated by PPI included: Prevotella melaninogenica, Prevotella pallens, Leptotrichia, and Solobacterium moorei and thirteen others. In contrast, GERD patients chronically using PPI showed minimal differences in salivary taxa compared to healthy controls not using PPI.

Oral health management considerations for patients with sickle cell disease.

Sickle cell disease (SCD) can affect many systems in the body including the oral cavity. This necessitates modifications in oral health care management of these patients. The purpose of this paper is to make recommendations for management of SCD patients according to their oral health care needs based on the known findings.

Postdoctoral periodontal program directors' perspectives of resident selection.

BACKGROUND: Applications for postdoctoral periodontal programs have recently increased. The National Board Dental Examinations (NBDE) has adopted a pass/fail format. The purpose of this study is to examine the criteria used by accredited postdoctoral periodontal programs in the United States to evaluate potential applicants. A secondary purpose was to determine whether the absence of NBDE scores would change program directors' selection process. Basic demographic information of the program directors was also collected. METHODS: A questionnaire was sent to all 54 program directors of accredited postdoctoral periodontal programs in the United States. The raw data were compiled, descriptive analyses were performed, and results were tabulated and ranked when applicable. RESULTS: Thirty-five of 54 program directors (64.8%) responded to the survey. The five most important factors in selecting residents were: 1) interview ratings; 2) dental school clinical grades; 3) dental school periodontics grades; 4) personal statement; and 5) letters of recommendation. The majority of the programs (94%; n = 33) require an interview, and many (86%; n = 30) have a committee that makes the final decision on candidate acceptance. More than half of the respondents (56%; n = 17) stated that the pass/fail format of the NBDE would affect the decision-making process. CONCLUSIONS: This study describes the criteria used by postdoctoral periodontal programs to help select applicants. Interview ratings, dental school grades, personal statements, and letters of recommendation were found to be the most important factors. Results from this study may be helpful for prospective postdoctoral periodontal program applicants in the United States.