Antifungal prescribing pattern and attitude towards the treatment of oral candidiasis among dentists in Jordan.

AIM: The aim of this study was to evaluate the attitude of Jordanian dentists towards the treatment of oral candidiasis and their current antifungal prescribing habits, shedding more light on the possible influence of their socio-professional factors on the pattern of prescribing and practice. METHODS: A structured validated questionnaire was developed and tested; it was then emailed to a random sample of 600 Jordanian dental practitioners during the period of this cross-sectional survey. The questionnaire recorded practitioners' personal details and their attitude and prescribing of antifungal therapy for oral candidiasis. Statistical significance was based on probability values of <0.05 and was measured using the chi-square and Fisher's exact tests. Multiple logistic regression analysis was used to analyse the influence of respondents' socio-professional factors on their attitude towards oral candidiasis. RESULTS: Of the 423 questionnaires returned, only 330 were included. The attitude of respondents was significantly influenced by their experience [odds ratio (OR) = 0.14; P < 0.001] and workplace (OR = 4.70; P < 0.001). Nystatin was the most commonly prescribed antifungal agent (78.2%), followed by miconazole (62.4%), which was prescribed for topical use. Systemic antifungals were prescribed by 21.2% of respondents, with a significant (P < 0.05) association with the country in which their qualification was obtained. CONCLUSION: The attitude towards the treatment of oral candidiasis is much better among the least-experienced dentists working in private practice. Nystatin and miconazole are the most popular choices of antifungal agents among Jordanian dentists.

Generic and oral quality of life is affected by oral mucosal diseases.

BACKGROUND: The generic and oral health-related quality of life (QoL) has provided opportunity for investigation of the interrelations among generic health, oral health, and related outcomes. The purpose of this study was to identify the generic and oral QoL in the patients with oral mucosal disease (OMD). METHODS: Five hundred and thirty-eight OMDs were recruited in this study. The instruments applied were Chinese version of the 36-item short form health survey (SF-36) and the short-form of Oral Health Impact Profile (OHIP-14). RESULTS: The mean score of sum OHIP-14 was significantly higher in the patients with OMD (10.81 ± 9.01) compared with those in the healthy subjects (HS) (6.55 ± 6.73) (p < 0.001, Mann-Whitney U test). 56.51% of the OMD patients and 12.94% of the HS reported at least one oral negative impact (p < 0.001, Chi-square test). The overall mean score of SF-36 was significantly lower in the patients with OMD (74.54 ± 12.77) compared with those in the HS (77.97 ± 12.39) (p = 0.021, t-test). CONCLUSIONS: Administration of specific and generic questionnaires of QoL can provide us a detailed picture of the impact of OMDs on patients, and both generic and oral QoL were impaired in the patients with OMD.

Iranian dental students' knowledge of and attitudes towards HIV/AIDS patients.

Dental treatment procedures frequently involve blood and saliva that may be contaminated with HIV. The purpose of this cross-sectional survey was to assess Iranian dental students' knowledge of and attitudes towards HIV/AIDS patients. In 2008, a fifty-three-item self-administered questionnaire was conducted on all 750 dental students who participated in the 10(th) Dental Student Congress in Isfahan, Iran. The overall response rate to the questionnaire was 60.7 percent. The total mean knowledge and attitudes scores were 82.1 percent (excellent) and 57.4 percent (negative), respectively. There were no significant differences in the knowledge or attitude scores between male and female students. A majority of the students were aware of the association between HIV and oral candidiasis (98.1 percent), major aphthous (95.8 percent), and Kaposi's sarcoma (93.8 percent). Although a majority of the students had excellent knowledge (78.4 percent), only 1 percent had professional attitudes about treating patients with HIV/AIDS. Therefore, it is important that dental students, as future dentists, develop not only the necessary practical skills but also attitudes that will prepare them to treat HIV/AIDS patients.

Do oral lesions associated with HIV affect quality of life?

OBJECTIVE: To assess the impact of oral lesions on quality of life (QOL) in HIV-positive (HIV+) individuals using the Oral Health Impact Profile (OHIP). STUDY DESIGN: This was a cross-sectional analytic study that compared 2 groups of HIV+ patients. Group 1 (n = 71) consisted of patients who presented with oral manifestations of HIV infection. Patients in group 2 (n = 79) were also HIV positive but had no oral lesions. The QOL measures were assessed by either simple frequency counts or the use of item weights. RESULTS: Oral candidiasis was the most common oral lesion diagnosed. Patients in group 1 reported significantly greater impacts (P < .05) for all 7 subscales in OHIP. CONCLUSIONS: Oral lesions associated with HIV infection negatively affect the oral health-related QOL in infected patients.

Effects of psychological stress and alprazolam on development of oral candidiasis in rats.

Psychological stress has been found to suppress cell-mediated immune responses that are important in limiting the proliferation of Candida albicans. Since anxiolytic drugs can restore cellular immunity in rodents exposed to stress conditions, we designed experiments conducted to evaluate the effects of alprazolam (1 mg/kg of body weight/day), a central benzodiazepine anxiolytic agonist, on the development of oral candidiasis in Sprague-Dawley rats exposed to a chronic auditory stressor. Animals were submitted to surgical hyposalivation in order to facilitate the establishment and persistence of C. albicans infection. Application of stress and treatment with drugs (placebo or alprazolam) were initiated 7 days before C. albicans inoculation and lasted until the end of the experiments (day 15 postinoculation). Establishment of C. albicans infection was evaluated by swabbing the inoculated oral cavity with a sterile cotton applicator on days 2 and 15 after inoculation, followed by plating on YEPD (yeast extract-peptone-dextrose) agar. Tissue injury was determined by the quantification of the number and type (normal or abnormal) of papillae on the dorsal tongue per microscopic field. A semiquantitative scale was devised to assess the degree of colonization of the epithelium by fungal hyphae. Our results show that stress exacerbates C. albicans infection of the tongues of rats. Significant increases in Candida counts, the percentage of the tongue's surface covered with clinical lesions, the percentage of abnormal papillae, and the colonization of the epithelium by fungal hyphae were found in stressed rats compared to those found in the unstressed rats. Treatment with alprazolam significantly reversed these adverse effects of stress, showing that, besides the psychopharmacological properties of this anxiolytic drug against stress, it has consequences for Candida infection.