Dental and medical practitioners' perception of community water fluoridation as a caries preventive measure.

AIM: To evaluate and compare the perceptions and concerns of dental and medical practitioners towards water fluoridation as a caries preventive measure. METHODS: A self-administered questionnaire comprising 21 questions was designed and validated to assess general knowledge and concerns of fluoride and community water fluoridation (CWF) as a dental caries preventive measure. The questions examined participant's perception regarding effectiveness, advantages, adverse effects, cost-benefit, and concerns pertinent to CWF. Dentists, general physicians and paediatricians were randomly recruited from public medical/dental centres, university clinics, and the private sector to complete the questionnaire. RESULTS: A total of 474 participants (74% response rate) completed the questionnaire (294 dentists and 180 medical practitioners). About 86% of the dentists and 78% of the medical practitioners agreed that CWF has a role in caries prevention. However, only a few of those would advise their patients to drink fluoridated water. There were some concerns about CWF, and the main concern in both groups was dental fluorosis. The level of awareness regarding CWF status in Kuwait amongst the two groups was low. However, the majority in both groups (77%) believed that the water supply should be optimally fluoridated. CONCLUSION: Dental and medical health care professionals agreed that water fluoridation can benefit the oral health of the individuals in the community, however, general knowledge about fluoride benefits, safety, risks and status of public water fluoridation was low.

Transendothelial migration confers a survival advantage to activated T lymphocytes: role of LFA-1/ICAM-1 interactions.

The clearance of activated T lymphocytes by apoptosis is an essential component in the resolution of the immune response; however, certain signals received within inflamed tissue may result in the persistence of activated T cells. Our previous work has shown that, when compared with resting cells, effector cells migrate more efficiently across endothelium, thus such cells may be selectively recruited to sites of inflammation. We hypothesized that transmigration of T cells across endothelium might influence cell survival. We have generated T cell lines by culturing in IL-2 following PHA activation. These T cell lines die rapidly by apoptosis when deprived of IL-2 (53.7 +/- 4.0% survival after 24 h). In contrast, cells that have migrated across human umbilical vein endothelial cells (HUVEC) survived significantly better than control cells (80.3 +/- 3.6%, n= 18, P<0.001). Endothelial cell conditioned medium was also able to reduce apoptosis, but this effect was small when compared with the protective effect of transmigration. Culture of T lymphocytes on fibronectin, or RGD peptides, or in suspension with a range of chemokines active on T cells, including RANTES and lymphotactin had no effect on survival. In contrast, blocking LFA-l/ICAM-l interactions reduced the protective effect of transmigration (42.3 +/- 6.7% reduction). Culture of activated T cells on immobilized ICAM-l alone also increased survival. These results indicate that signals received by activated T cells during extravasation can influence their subsequent survival within tissue, and implicates the involvement of LF A-l/ICAM-l interactions.