Effect on blood pressure and pulse rate after administration of an epinephrine containing dental local anaesthetic in hypertensive patients.

OBJECTIVE: To document safety for use, through recording changes in blood pressure and pulse rate, after administering 3.6 ml of a 2% lignocaine with 1:100,000 epinephrine dental local anaesthetic in a group of hypertensive patients. METHODOLOGY: The present study was conducted at Shaikh Zayed Medical Complex, Lahore, from May to December 2008, using a convenience sampling technique. The first 60 walk-in patients in the dental outpatient department planned for tooth extraction were enrolled in the study. Out of these 60 patients, 10 had pre-hypertension (BP = 130/90), 10 had stage 1 hypertension (BP =140-159/90-99) and 10 study subjects were suffering from stage 2 hypertension (BP = 160-179/100-109). Thirty age and sex matched normo-tensive patients requiring tooth extraction acted as the control group. All patients were administered two cartridges each of 1.8 ml of dental local anaesthesia containing 2% Lignocaine with 1:100,000 epinephrine. Blood pressure and pulse rate (PR) were the risk indicators that were measured thrice; pre-injection, 2 minutes and 5 minutes after injection. RESULTS: A decrease in systolic in stage 2 hypertension patients after 2 and 5 minutes of injections was noted. The diastolic BP (DBP) fell in all the groups after injections. Mean pulse rate increased from three to four beats per minute in all groups except in stage 2 hypertension patients where it slightly decreased. CONCLUSION: Epinephrine containing dental local anaesthesia decreased systolic blood pressure in stage 2 hypertension patients included in this study. There was an observed decrease of 21 mm Hg in systolic blood pressure hypertension patients but with no adverse effects.

Comparison of the plaque-removing efficacy of toothpaste and toothpowder.

BACKGROUND: Removing dental plaque may play a key role in maintaining oral health. Methods for oral hygiene vary from country to country and from culture to culture. Chewing sticks (miswak) and toothpowders are popular oral hygiene tools in Pakistan. OBJECTIVE: To compare the plaque-removing efficacy of toothpaste and toothpowder with and without manual toothbrushes. MATERIALS AND METHODS: The study was designed as an examiner-blind crossover study. The Silness and Löe plaque index was used to evaluate the plaque distribution. Thirty-six volunteer dental students were recruited for the experiment. After scoring, the subjects were randomly divided into two groups. The first group was asked to brush with toothpaste or toothpowder according to a split mouth protocol. The second group was asked to follow the same protocol except they were asked to use their finger instead of the brush. The remaining plaque was scored again. RESULTS: Plaque-removing efficacy of the toothpowder was higher whether it was used with brush or with finger. There was a significant difference between paste and powder users (p = 0.009). CONCLUSION: The results of this study indicate that toothpowder is an effective means to remove plaque with a brush.

Helicobacter pylori in dental plaque and gastric mucosa: correlation revisited.

Helicobacter pylori (H. pylori) related gastric infection is highly prevalent in developing countries. Prevalence of bacterium in dental plaque from these regions is also reported to be high, but association between simultaneous colonization of H. pylori in both these sites has not been established yet. Aim of this paper is to review possible association between simultaneous oral and gastric H. pylori colonization in dyspeptic patients. Pertinent literature was reviewed and all available evidence collected from Medline and PakMedinet. Studies conducted in the developing world show conflicting results. Some report a positive relation between oral and gastric H. pylori colonization while others deny any association. This may be due to the population sampled or methodology applied. Further studies are recommended to confirm the association between concurrent presence of H. pylori in dental plaque and gastric mucosa of dyspeptic patients using sensitive and specific tests for detection of bacterium in oral samples.