Comparative effects of e-cigarette smoking on periodontal status, salivary pH, and cotinine levels.

BACKGROUND: The nicotine in e-cigarette liquid can negatively impact periodontal tissues by altering the salivary pH and elevating cotinine levels. Thus, the study aimed to determine the periodontal parameters, salivary pH, and cotinine levels among cigarette, e-cigarette, and never-smokers. METHODS: A total of 144 participants were recruited (48 cigarette smokers, 48 e-cigarette smokers, and 48 never-smokers). Clinical periodontal parameters, including plaque index (PI), gingival index (GI), periodontal probing pocket depth (PPD), and clinical attachment loss (CAL) were recorded, excluding third molars. The level of unstimulated whole salivary pH was measured using a portable pH meter and the levels of salivary cotinine were measured using Enzyme-Linked Immunosorbent Assay (ELISA). RESULTS: Data were analysed statistically using analysis of variance. Mean scores of PPD, percentage of pocket depth ≥ 4 mm, and CAL (p < 0.05) were significantly higher among cigarette smokers than those in e-cigarette and never-smokers, while GI (p < 0.05) were significantly higher among e-cigarette smokers. The unstimulated salivary pH was more acidic among cigarette smokers (p < 0.05) and e-cigarette smokers (p < 0.05) than in never-smokers. The cotinine levels were higher among cigarette smokers (p < 0.05) and e-cigarette smokers (p < 0.05) than in never-smokers. CONCLUSIONS: Clinical periodontal parameters were poorer in cigarette smokers than in e-cigarette smokers and never-smokers. Meanwhile, cigarette and e-cigarette smokers have more acidic salivary pH and higher cotinine levels than in never-smokers.

The Efficacy of Apple Cider Vinegar at Different pH Values as an Antimicrobial Agent: An In Vitro Study.

AIMS AND BACKGROUND: This study evaluates the antimicrobial activities of commercially available 5% apple cider vinegar (ACV) against Enterococcus faecalis, Streptococcus mutans, and Lactobacillus casei. Materials and methods: Minimal inhibitory concentration (MIC) and minimal bactericidal concentration (MBC) were conducted using the broth microdilution method. Sodium hypochlorite (NaOCl) of 5.25% was used as a positive control, and comparisons were also made with acetic acid (AA) as the main ingredient in ACV. The three test bacteria treated with the most effective ACV dilution were visualized under a transmission electron microscope (TEM) for structural changes. RESULTS: Minimal inhibitory concentration was determined at 0.625% of the concentration of ACV against S. mutans and E. faecalis and 1.25% of the concentration of ACV against L. casei with two-fold serial dilutions. A concentration of 5 × 10-1% with 10-fold serial dilutions was found to be the MIC value for all three bacteria. No significant differences were found when compared with the positive control (NaOCl) (p = 0.182, p = 0.171, and p = 0.234), respectively, for two-fold serial dilutions and (p = 1.000, p = 0.658, and p = 0.110), respectively for 10-fold serial dilutions. MBC was observed to be 5% ACV for both E. faecalis and S. mutans. However, positive microbial growth was observed on the agar plate when cultured with L. casei. An independent sample t-test showed no significant differences (p > 0.05) in the antimicrobial activities between 5% ACV and 5% pure AA. TEM revealed cell wall and cytoplasmic membrane disruptions on all three bacteria at MIC value. CONCLUSION: Apple cider vinegar has antimicrobial activities against Enterococcus faecalis, Streptococcus mutans, and Lactobacillus casei at their respective MIC values. CLINICAL SIGNIFICANCE: Apple cider vinegar can be an alternative antimicrobial dental pulp disinfectant to sodium hypochlorite. Apple cider vinegar can be used safely, especially in children's dental pulp therapy and deep caries management, when adequate tooth isolation is not readily achievable. Thus, adverse reactions commonly associated with other frequently used chemical disinfectants can be avoided.