Do bib clips pose a cross-contamination risk at the dental clinic?

Although multiple-use dental napkin holders have a relatively low risk of transmitting infection, they do require disinfection between patients. This study sought to: 1) determine the presence of bacterial load on two types of clips of reusable bib chains after dental procedures at the Endodontics and Orthodontics clinics at Tufts University School of Dental Medicine; and 2) evaluate the effectiveness of disinfecting the clips. These specialty clinics represent a wide spectrum of patients, procedures, and appointment times. Bacterial load on the bib clips was determined immediately following dental treatments-both before and after their disinfection-during morning and afternoon sessions. The results revealed that, after treatments, there was a statistically significant difference when comparing the two clinics for bacterial burden on the clips. Furthermore, there was a statistically significant difference in bacterial load on the two types of clips. Disinfection of the bib clips was highly effective in both clinics. Clinically, the results suggest that due to the nature of the treatment, the demographic population, and the type of bib clips used, patients in different clinics may be exposed to varying bacterial concentrations on the bib clips, and thus to different possible cross-contamination risks. Future analyses will be performed to identify the bacterial species in samples from both pre- and post-disinfected clips, and to determine if they harbor disease-causing bacterial species that can pose a potential, yet undetermined risk for cross-contamination.

A survey: how periodontists and other dental professionals view the scope of periodontics.

BACKGROUND: How do periodontists think of themselves when they define their practices? How do other dental professionals view the scope of the specialty of periodontology? A strong component of periodontal residency programs is extracting teeth and preserving or building bony ridges for the eventual placement of implants. Has the discipline of periodontology moved away from retaining and treating the natural dentition? By the use of a rank-order survey, the practice of periodontology was defined by periodontists and other dental professionals. METHODS: In a pilot study, respondents were asked to list the answers to the question, "What is a periodontist?" The results were consolidated into eight statements. The eight statements were placed into an anonymous rank-order survey, and more than 1,200 responses were returned. The responses primarily came from periodontists, hygienists, general practitioners, dental students, and dental hygiene students. RESULTS: "Periodontists surgically treat advanced gum and bone infection problems" was considered the most important statement in all of the cohorts. The least important statement considered by all was, "Periodontists are educators promoting health." Non-periodontist dentists (NPDs) ranked the statement, "Periodontists perform dental implants and related procedures" less importantly (P <0.001) than the periodontists. The non-periodontist cohort (NPC), which includes NPDs and dental hygienists, ranked the statement, "Periodontists' treatments help general dentists and other specialists increase successful therapeutic outcomes" as second most important. CONCLUSIONS: The results of this survey indicate that periodontists ranked the placement of implants and their related procedures higher than the NPC. NPDs appear to value periodontists in treating the natural dentition for their patients. The NPC appreciates that periodontal therapy done by periodontists increases their therapeutic success for their patients.

At-home oral care for adults with developmental disabilities: a survey of caregivers.

BACKGROUND: Little is known about effective at-home oral care methods for people with developmental disabilities (DDs) who are unable to perform personal preventive practices themselves and rely on caregivers for assistance. METHODS: A convenience sample of 808 caregivers (84.5 percent paid, 15.5 percent family members) who accompanied adults with DDs (20 years or older) to appointments at a specialized statewide dental care system completed computer-assisted personal interview surveys. The authors used these data to investigate caregivers' at-home oral care experiences and to explore differences between caregivers who were paid and those who were family members. RESULTS: Caregivers reported that a high proportion (85 percent) of dentate adults with DDs received assistance with tooth cleaning. They also reported a high prevalence of dental problems, and low adherence to brushing (79 percent) and flossing (22 percent) recommendations. More caregivers reported that they felt confident assisting with brushing than with flossing (85 percent versus 54 percent). Family members and paid caregivers differed with respect to confidence and training. CONCLUSIONS: At-home oral care, particularly flossing, presents substantial challenges for adults with DDs. Solutions must be tailored to address the different experiences and distinct needs of the family members and paid caregivers who assist these adults. PRACTICAL IMPLICATIONS: Caregivers play an important role in providing at-home oral care, and they must be included in efforts to improve oral health outcomes for people with DDs.

Comprehensive analysis of aerobic and anaerobic bacteria found on dental bib clips.

Multiple-use dental bib clips are considered to present relatively low risks for transmitting infections and, thus, are thought to only require disinfection between patient visits. This study was designed to: 1) determine the presence and composition of bacterial contaminants on reusable rubber-faced metal bib clips after dental treatment at the hygiene clinic at Tufts University School of Dental Medicine and 2) evaluate the effectiveness of the disinfection for this clip type. Aerobic and anaerobic bacterial contaminant loads on the surfaces of the clips were investigated immediately after hygiene treatments were rendered and again after clips were disinfected. The species and strains of bacterial isolates were identified using 16S rDNA sequencing and Human Oral Microbe Identification Microarray analyses. The results demonstrated that although the use of disinfection proved to be significantly effective, some clips retained at least one bacterium on their surfaces after disinfection. Although the bacterial species present on disinfected clips were typical skin or environmental isolates, some were oral in origin. In the study's settings, bacterial presence on the clips did not indicate an infectious disease problem. The different bacterial loads on clips suggest that cross-contamination risks may not be the same for all clinics, and that this difference may be related to the type of treatments and services performed.

The oral health status of 4,732 adults with intellectual and developmental disabilities.

BACKGROUND: Two reports by the U.S. surgeon general noted the disproportionate impact of oral disease on and lack of oral health information regarding people with disabilities. METHODS: In this retrospective study, the authors used clinical and demographic data (from April 1, 2009, through March 31, 2010) from electronic dental records of 4,732 adults with intellectual and developmental disabilities (IDDs) who were receiving dental care through a state-supported system of dental clinics. The authors used these data to investigate the oral health status of, and associated risk factors for, adults with IDD. RESULTS: The prevalence of untreated caries in the study population was 32.2 percent, of periodontitis was 80.3 percent and of edentulism was 10.9 percent. The mean (standard deviation) numbers of decayed teeth; missing teeth; and decayed, missing and filled teeth were 1.0 (2.2), 6.7 (7.0) and 13.9 (7.7), respectively. CONCLUSIONS: Management of oral health presents significant challenges in adults with IDD. Age, ability to cooperate with dental treatment and type of residence are important considerations in identifying preventive strategies. CLINICAL IMPLICATIONS: The study population demonstrated a high burden of dental disease. Further research is required to identify effective interventions to improve oral health in adults with IDD.