ABSTRACT
PURPOSE: Dentistry has undergone a shift in caries management toward prevention and improved oral hygiene and diagnosis. Caries prevention now represents one of the most important aspects of modern dental practice. The purpose of this cross-sectional study was to demonstrate the use of adenosine triphosphate- (ATP-) driven bioluminescence as an innovative tool for the rapid chairside enumeration of oral bacteria (including plague streptococci) and assessment of oral hygiene and caries risk. METHODS: Thirty-three pediatric patients (7- to 12-year-old males and females) were examined, and plague specimens, in addition to stimulated saliva, were collected from representative teeth within each quadrant. Oral specimens (n=150 specimens) were assessed by plating on enriched and selective agars, to enumerate total bacteria and streptococci, and subjected to adenosine triphosphate- (ATP-) driven bioluminescence determinations using a luciferase-based assay system. RESULTS: Statistical correlations, linking ATP values to numbers of total bacteria, oral streptococci and mutans streptococci, yielded highly significant r values of 0.854, 0.840, and 0.796, respectively CONCLUSIONS: Our clinical data is consistent with the hypothesis that ATP measurements have a strong statistical association with bacterial number in plague and saliva specimens, including numbers for oral streptococci, and may be used as a potential assessment tool for oral hygiene and caries risk in children.
Subject(s)
Adenosine Triphosphate/analysis , Colony Count, Microbial/methods , Dental Caries Activity Tests/methods , Dental Caries/diagnosis , Luminescent Proteins/analysis , Adenosine Triphosphate/metabolism , Bacteria/classification , Bacteria/metabolism , Bacterial Proteins/analysis , Bacterial Proteins/metabolism , Child , Colony Count, Microbial/instrumentation , Cross-Sectional Studies , Dental Caries/microbiology , Dental Caries Activity Tests/instrumentation , Dental Plaque/metabolism , Dental Plaque/microbiology , Dental Plaque Index , Female , Humans , Luciferases/metabolism , Luminescent Measurements/instrumentation , Luminescent Measurements/methods , Luminescent Proteins/metabolism , Male , Reproducibility of Results , Saliva/metabolism , Saliva/microbiology , Sensitivity and Specificity , Statistics, NonparametricABSTRACT
Children with prosthetic cardiac valves and other invasive mechanical devices that direct blood flow require anticoagulant medication for prevention of thrombosis. Dental surgery for these children has historically consisted of decreasing and/or discontinuing the oral anticoagulant and instituting heparin therapy prior to the planned dental procedure, which can result in thromboembolism and increased morbidity and mortality. This case report demonstrates that oral anticoagulation need not be decreased or discontinued prior to extraction of multiple carious primary teeth in a child at risk for thromboembolism.