Evaluation of knowledge of students in paediatric dentistry concerning cardiopulmonary resuscitation skills in children.

AIM: The study evaluated the theoretical knowledge and practical ability of students in paediatric dentistry concerning basic life support (BLS) and cardiopulmonary resuscitation (CPR) in children and babies. METHODS: Seventy paediatric dentistry students answered a questionnaire and also performed a simulation of the manoeuvres of BLS and CPR on baby and child manikins. RESULTS: The results showed that 41 (58%) students had never received BLS training. When questioned about the correct ratio of compression and ventilation during CPR, most students answered incorrectly. For the CPR of babies in the presence of a first responder only 19 (27.1%) answered correctly (30 × 2), and for babies with two rescuers, 23 (32.8%) answered correctly (15 × 2); in relation to the correct rhythm of chest compressions, 38 (54.4%) answered incorrectly; when asked if they felt prepared to deal with a medical emergency in their dental surgeries, only 12 (17.1%) stated "yes". In the practice evaluation, 51 (73%) students who had been assessed in CPR manoeuvres for children and 55 (78%) in the manoeuvres for babies scored inadequately. CONCLUSIONS: The evaluated students did not have adequate knowledge about CPR in children and babies.

Full mouth periodontal debridement with or without adjunctive metronidazole gel in smoking patients with chronic periodontitis: A pilot study.

BACKGROUND AND OBJECTIVE: The evidence of effectiveness of metronidazole (Mtz) as an adjunct therapy to periodontal procedure in the treatment of patients with chronic periodontitis is not conclusive. The aim of this study was to compare the effect of Mtz (delivered locally as a gel or systemically as a tablet) as an adjunctive therapy with full mouth periodontal debridement (1 h of ultrasonic calculus/plaque removal) in smokers with chronic periodontitis. MATERIAL AND METHODS: This pilot study involved 30 smokers with at least six teeth with a clinical attachment loss of ≥ 5 mm and probing pocket depth (PPD) of ≥ 5 mm. They were randomly assigned into one of three groups (n = 10): (i) 3 g daily of placebo gel applied topically (using a dental tray with the gel overnight) + periodontal debridement; (ii) 3 g daily of a 15% Mtz benzoate gel applied topically (using a dental tray with the gel overnight) + periodontal debridement; and (iii) a daily single dose of 750 mg Mtz (Flagyl(®)) + periodontal debridement. Clinical parameters (visible plaque index, gingival bleeding index [GBI], relative attachment level and PPD) and quantitative analysis (by real-time polymerase chain reaction) of Aggregatibacter actinomycetemcomitans, Porphyromonas gingivalis and Tannerella forsythia were assessed at baseline and at 1, 3 and 6 mo after periodontal debridement. RESULTS: There was no statistically significant difference in the average GBI and visible plaque index values at baseline between the groups (p ≥ 0.05). There was no significant difference between groups in all parameters evaluated (p ≥ 0.05). Significant reductions in GBI at 3 and 6 mo were observed in all groups (p < 0.05). Significant reductions in both PPD and relative attachment level at 1, 3 and 6 mo were observed in all groups (p < 0.05). Significant reductions in bacterial levels at 7 and 30 d were observed in all groups (p < 0.05). CONCLUSION: Adjunctive use of Mtz (gel or tablet) to periodontal debridement had similar clinical and microbiological improvement compared to treatment with placebo + periodontal debridement in smokers with chronic periodontitis up to 6 mo post-treatment. Further studies are necessary to confirm the clinical relevance of these findings.

Antimicrobial activity of garlic against oral streptococci.

The antimicrobial activity of two garlic clones' (1: purple and 2: white) crude extracts against oral microbiota was evaluated in vitro (study 1) and in vivo (study 2). Study 1 consisted of the evaluation of minimum inhibitory (MIC) and bactericidal (MBC) concentrations against nine streptococci strains. In study 2, a 2.5% garlic (clone 2) solution was used as a mouthwash in a 5-week study by 30 subjects. Blood agar and Mitis Salivarius Bacitracin agar were inoculated with subjects' saliva to quantify oral microorganisms and mutans streptococci. Study 1 showed MIC ranging from 0.5 to 32.0 mg ml(-1) for clone 2 and from 8 to 64.0 mg ml(-1) for clone 1. MBC ranged from 1.0 to 128.0 mg ml(-1) and from 8.0 to 128.0 mg ml(-1) regarding clones 2 and 1 respectively. Study 2 showed that 2.5% garlic mouthwash solution had good antimicrobial activity against mutans streptococci and oral microorganisms. Maintenance of reduced salivary levels of streptococci was observed after 2 weeks at the end of mouthwash use. Unpleasant taste (100%), halitosis (90%) and nausea (30%) were reported by subjects after the end of the study. It was concluded that the garlic clones have antimicrobial properties in vitro against streptococci and anticariogenic properties against oral microorganism in spite of its adverse effects.

Antimicrobial susceptibility of air-dispersed microorganisms in dental settings.

To determine the number and the susceptibility of microorganisms collected in a clinical environment against the antimicrobial agents used commonly in dentistry, petri dishes containing trypticase soy agar were exposed to air in different sites of a multi-chair dental clinic before, during, and after multiple clinical procedures and incubated for 24 hours under aerobic conditions. Colonies were identified by Gram stain technique and biochemical tests. Commercial paper disks containing widely prescribed antimicrobial agents (beta-lactams, macrolides, and clindamycin) were used to perform the antimicrobial susceptibility tests. The groups (colony forming units = cfu/m2/min) were submitted to the Kruskal-Wallis test (alpha = 5.0%), considering different clinical situations and environmental sites. During clinical procedures, the number of microorganisms increased (p < 0.05). This study highlights the need for established strategies to prevent resistant bacterial strains from emerging in dental settings.