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1.
Br J Nutr ; 125(5): 591-597, 2021 03 14.
Artigo em Inglês | MEDLINE | ID: mdl-32746948

RESUMO

Energy-dense food advertising affects children's eating behaviour. However, the impact of high-sugar food advertising specifically on the intake of sweet foods is underexplored. This study sought to determine whether children would increase their intake of sugar and total energy following high-sugar food advertising (relative to toy advertising) and whether dental health, weight status and socio-economic status (SES) would moderate any effect. In a crossover, randomised controlled trial, 101 UK children (forty male) aged 8-10 years were exposed to high-sugar food/beverage and toy advertisements embedded within a cartoon. Their subsequent intake of snack foods and beverages varying in sugar content was measured. A dental examination was performed, and height and weight measurements were taken. Home postcode provided by parents was used to assign participants to SES quintiles. Children consumed a significantly greater amount of energy (203·3 (95 % CI 56·5, 350·2) kJ (48·6 (95 % CI 13·5, 83·7) kcal); P = 0·007) and sugar (6·0 (95 % CI 1·3, 10·7) g; P = 0·012) following food advertisements compared with after toy advertisements. This was driven by increased intake of the items with most sugar (chocolate and jelly sweets). Children of healthy weight and with dental caries had the greatest intake response to food advertising exposure, but there were no differences by SES. Acute experimental food advertising exposure increases food intake in children. Specifically, high-sugar food and beverage advertising promotes the consumption of high-sugar food items. The debate around the negative health effects of food advertising on children should be widened to include dental health as well as overall dietary health and obesity.


Assuntos
Publicidade/estatística & dados numéricos , Açúcares da Dieta/administração & dosagem , Lanches , Bebidas Adoçadas com Açúcar , Televisão , Peso Corporal , Criança , Cárie Dentária/epidemiologia , Dieta Saudável/estatística & dados numéricos , Ingestão de Energia , Feminino , Humanos , Masculino , Sobrepeso/epidemiologia , Obesidade Infantil/epidemiologia , Jogos e Brinquedos , Classe Social , Reino Unido/epidemiologia
2.
J Clin Periodontol ; 44 Suppl 18: S85-S93, 2017 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-28266120

RESUMO

BACKGROUND: The non-communicable diseases dental caries and periodontal diseases pose an enormous burden on mankind. The dental biofilm is a major biological determinant common to the development of both diseases, and they share common risk factors and social determinants, important for their prevention and control. The remit of this working group was to review the current state of knowledge on epidemiology, socio-behavioural aspects as well as plaque control with regard to dental caries and periodontal diseases. METHODS: Discussions were informed by three systematic reviews on (i) the global burden of dental caries and periodontitis; (ii) socio-behavioural aspects in the prevention and control of dental caries and periodontal diseases at an individual and population level; and (iii) mechanical and chemical plaque control in the simultaneous management of gingivitis and dental caries. This consensus report is based on the outcomes of these systematic reviews and on expert opinion of the participants. RESULTS: Key findings included the following: (i) prevalence and experience of dental caries has decreased in many regions in all age groups over the last three decades; however, not all societal groups have benefitted equally from this decline; (ii) although some studies have indicated a possible decline in periodontitis prevalence, there is insufficient evidence to conclude that prevalence has changed over recent decades; (iii) because of global population growth and increased tooth retention, the number of people affected by dental caries and periodontitis has grown substantially, increasing the total burden of these diseases globally (by 37% for untreated caries and by 67% for severe periodontitis) as estimated between 1990 and 2013, with high global economic impact; (iv) there is robust evidence for an association of low socio-economic status with a higher risk of having dental caries/caries experience and also with higher prevalence of periodontitis; (v) the most important behavioural factor, affecting both dental caries and periodontal diseases, is routinely performed oral hygiene with fluoride; (vi) population-based interventions address behavioural factors to control dental caries and periodontitis through legislation (antismoking, reduced sugar content in foods and drinks), restrictions (taxes on sugar and tobacco) guidelines and campaigns; however, their efficacy remains to be evaluated; (vii) psychological approaches aimed at changing behaviour may improve the effectiveness of oral health education; (viii) different preventive strategies have proven to be effective during the course of life; (ix) management of both dental caries and gingivitis relies heavily on efficient self-performed oral hygiene, that is toothbrushing with a fluoride-containing toothpaste and interdental cleaning; (x) professional tooth cleaning, oral hygiene instruction and motivation, dietary advice and fluoride application are effective in managing dental caries and gingivitis. CONCLUSION: The prevention and control of dental caries and periodontal diseases and the prevention of ultimate tooth loss is a lifelong commitment employing population- and individual-based interventions.


Assuntos
Cárie Dentária/prevenção & controle , Doenças Periodontais/prevenção & controle , Humanos
3.
Caries Res ; 51(3): 188-197, 2017.
Artigo em Inglês | MEDLINE | ID: mdl-28245470

RESUMO

The purpose of this study was to determine whether or not the dual constant-depth film fermenter (dCDFF) is able to produce caries-like enamel lesions and to ascertain further information regarding the performance of this fully functional biological caries model. Conditions were defined by the continuation (CF) or cessation (FF) of a saliva-type growth medium supply during 50-mM sucrose exposures (8 times daily). Hydroxyapatite (n = 3) and bovine enamel (n = 3) substrata were included within each condition and samples extracted after 2, 4, 8, and 16 days. Community profiles were generated for fastidious anaerobes, Lactobacillus spp., Streptococcus spp., mutans streptococci (MS), and Veillonella spp. using selective culture techniques and enamel demineralisation assessed by transverse microradiography. Results demonstrated that the dCDFF model is able to produce caries-like enamel lesions with a high degree of sensitivity where reduced ionic strength within the FF condition increased surface layer mineral deposition. Between conditions, biofilm communities did not differ significantly, although MS in the biofilms extracted from the FF condition rose to a higher proportion (by 1.5 log10 units), and Veillonella spp. were initially greater within the CF condition (by 2.5 log10 units), indicating an enhanced ability for the clearance of low-pKa acids following exposures to sucrose. However, both conditions retained the ability for caries-like lesion formation.


Assuntos
Biofilmes/crescimento & desenvolvimento , Cárie Dentária/microbiologia , Esmalte Dentário/microbiologia , Placa Dentária/microbiologia , Animais , Bovinos , Contagem de Colônia Microbiana , Durapatita/química , Desenho de Equipamento , Humanos , Concentração de Íons de Hidrogênio , Técnicas In Vitro , Lactobacillus/crescimento & desenvolvimento , Microrradiografia , Modelos Biológicos , Politetrafluoretileno/química , Saliva/microbiologia , Streptococcus/crescimento & desenvolvimento , Sacarose , Desmineralização do Dente/microbiologia , Veillonella/crescimento & desenvolvimento
4.
Gerodontology ; 34(3): 343-356, 2017 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-28543778

RESUMO

OBJECTIVE: To describe the bacterial profile of the oral flora during the first 2 weeks following a stroke, examining changes in the condition of the oral cavity and infections. BACKGROUND: Dysphagia is common after a stroke and can lead to aspiration pneumonia. Oral flora changes associated with stroke have been implicated as a possible source of bacteria that can cause systemic infections. MATERIALS AND METHODS: Seventy-seven participants were recruited over a period of 9 months. Fifty participants had a complete set of swabs from four different oral sites and a saliva sample taken at three time points over a 14-day period. Molecular identification of bacteria was performed on the pooled DNA extracted. RESULTS: A total of 103 bacterial phylotypes were identified, 29 of which were not in the Human Oral Microbiome Database (HOMD). Fourteen of the twenty most common bacterial phylotypes found in the oral cavity were Streptococcal species with Streptococcus salivarius being the most common. The condition of the oral cavity worsened during the study period. Fifteen (30%) patients had at least one infection. CONCLUSIONS: There appears to be huge diversity of bacterial organisms in the oral cavity of stroke patients, and as most phylotypes identified were only found in one or two participants, no particular patterns linked to infection or the condition of the oral cavity could be discerned.


Assuntos
Microbioma Gastrointestinal , Boca/microbiologia , Acidente Vascular Cerebral/microbiologia , Idoso , Idoso de 80 Anos ou mais , DNA Bacteriano/genética , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , Saliva/microbiologia , Streptococcus
5.
J Vet Dent ; 33(1): 26-38, 2016 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-27487653

RESUMO

The aim of this work was to evaluate Quantitative Light-induced Fluorescence (QLF) as an alternative to the established Logan and Boyce method for determining plaque coverage of dogs' teeth. In a series of studies in conscious and anesthetized dogs, QLF showed good intra-photographer repeatability (coefficient of variation [CV] of 7.5% for undisclosed teeth) and inter-photographer reproducibility (CV of 3.2% for undisclosed teeth and 8.5% for disclosed teeth). The QLF software accurately identifies areas of plaque as demonstrated by comparison to the variability of 5 human scorers, manually marking plaque on QLF-acquired images (P = 0.1). There was good agreement with the modified Logan and Boyce method in the percentage reduction in plaque accumulation measured when dogs were fed an oral care chew versus no chew. To see a 15% difference in plaque accumulation, which is considered sufficient by the Veterinary Oral Health Council to differentiate between 2 treatments, a retrospective power analysis (90%) of the data established that only 7 dogs would be required, compared to 19 dogs for the modified Logan and Boyce method. QLF is a reliable method for measuring dental plaque in dogs with the added advantage that it is not subjective and requires fewer animals.


Assuntos
Placa Dentária/veterinária , Odontologia/veterinária , Doenças do Cão/diagnóstico , Fluorescência , Animais , Placa Dentária/diagnóstico , Cães , Feminino , Luz , Masculino , Reprodutibilidade dos Testes , Estudos Retrospectivos
6.
ScientificWorldJournal ; 2014: 374694, 2014.
Artigo em Inglês | MEDLINE | ID: mdl-24511282

RESUMO

The aim of this study was to investigate the purported link between oral hygiene and preterm birth by using image analysis tools to quantify dental plaque biofilm. Volunteers (n = 91) attending an antenatal clinic were identified as those considered to be "at high risk" of preterm delivery (i.e., a previous history of idiopathic preterm delivery, case group) or those who were not considered to be at risk (control group). The women had images of their anterior teeth captured using quantitative light-induced fluorescence (QLF). These images were analysed to calculate the amount of red fluorescent plaque (ΔR%) and percentage of plaque coverage. QLF showed little difference in ΔR% between the two groups, 65.00% case versus 68.70% control, whereas there was 19.29% difference with regard to the mean plaque coverage, 25.50% case versus 20.58% control. A logistic regression model showed a significant association between plaque coverage and case/control status (P = 0.031), controlling for other potential predictor variables, namely, smoking status, maternal age, and body mass index (BMI).


Assuntos
Higiene Bucal , Nascimento Prematuro/etiologia , Adulto , Biofilmes , Estudos de Casos e Controles , Placa Dentária/microbiologia , Feminino , Fluorescência , Humanos , Recém-Nascido , Pessoa de Meia-Idade , Gravidez , Fatores de Risco , Adulto Jovem
7.
Int J Biol Macromol ; 258(Pt 1): 128838, 2024 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-38128798

RESUMO

Pseudomonas aeruginosa is one of the leading causes of opportunistic infections such as chronic wound infection that could lead to multiple organ failure and death. Gallium (Ga3+) ions are known to inhibit P. aeruginosa growth and biofilm formation but require carrier for localized controlled delivery. Lactoferrin (LTf), a two-lobed protein, can deliver Ga3+ at sites of infection. This study aimed to develop a Ga-LTf complex for the treatment of wound infection. The characterisation of the Ga-LTf complex was conducted using differential scanning calorimetry (DSC), Infra-Red (FTIR) and Inductive Coupled Plasma Optical Emission Spectrometry (ICP-OES). The antibacterial activity was assessed by agar disc diffusion, liquid broth and biofilm inhibition assays using the colony forming units (CFUs). The healing capacity and biocompatibility were evaluated using a P.aeruginosa infected wound in a rat model. DSC analyses showed thermal transition consistent with apo-lactoferrin; FTIR confirmed the complexation of gallium to lactoferrin. ICP-OES confirmed the controlled local delivery of Ga3+. Ga-LTf showed a 0.57 log10 CFUs reduction at 24 h compared with untreated control in planktonic liquid broth assay. Ga-LTf showed the highest antibiofilm activity with a 2.24 log10 CFUs reduction at 24 h. Furthermore, Ga-LTf complex is biocompatible without any adverse effect on brain, kidney, liver and spleen of rats tested in this study. Ga-LTf can be potentially promising novel therapeutic agent to treat pathogenic bacterial infections.


Assuntos
Gálio , Ratos , Animais , Gálio/química , Gálio/metabolismo , Gálio/farmacologia , Pseudomonas aeruginosa , Lactoferrina/metabolismo , Antibacterianos/farmacologia , Biofilmes
8.
Dent Mater ; 38(1): 94-107, 2022 01.
Artigo em Inglês | MEDLINE | ID: mdl-34823880

RESUMO

OBJECTIVES: Antibiotic resistance is increasingly a growing global threat. This study aimed to investigate the potential use of newly developed scandium-doped phosphate-based glasses (Sc-PBGs) as an antibacterial and anticariogenic agent through controlled release of Sc3+ ions. METHODS: Sc-PBGs with various calcium and sodium oxide contents were produced and characterised using thermal and spectroscopic analysis. Degradation behaviour, ion release, antibacterial action against Streptococcus mutans, anti-matrix metalloproteinase-2 (MMP-2) activity, remineralisation potential and in vivo biocompatibility were also investigated. RESULTS: The developed glass system showed linear Sc3+ ions release over time. The released Sc3+ shows statistically significant inhibition of S. mutans biofilm (1.2 log10 CFU reduction at 6 h) and matrix metalloproteinase-2 (MMP-2) activity, compared with Sc-free glass and positive control. When Sc-PBGs were mounted alongside enamel sections, subjected to acidic challenges, alternating hyper- and hypomineralisation layers consistent with periods of re- and demineralisation were observed demonstrating their potential remineralising action. Furthermore, Sc-PBGs produced a non-toxic response when implanted subcutaneously for 2 weeks in Sprague Dawley rats. SIGNIFICANCE: Since Sc3+ ions might act on various enzymes essential to the biological mechanisms underlying caries, Sc-PBGs could be a promising therapeutic agent against cariogenic bacteria.


Assuntos
Cárie Dentária , Fosfatos , Animais , Antibacterianos/farmacologia , Biofilmes , Cárie Dentária/terapia , Metaloproteinase 2 da Matriz , Fosfatos/química , Ratos , Ratos Sprague-Dawley , Escândio/uso terapêutico , Streptococcus mutans
9.
Am J Orthod Dentofacial Orthop ; 139(2): 181-91, 2011 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-21300246

RESUMO

INTRODUCTION: Our aim was to determine predictors for the presence and degree of demineralization during orthodontic treatment. This study was a post-hoc analysis of recruits for a randomized controlled trial. Two hundred thirty patients were included in this study and assessed for demineralization at debond by using quantitative light-induced fluorescence to determine their eligibility for a randomized controlled trial assessing the effectiveness of various toothpastes at reducing demineralization during retention. METHODS: Data about patients' demographics, treatments, oral hygiene, and pretreatment status of the first permanent molars were extracted from case notes. Data on the presence and severity of white spot lesions (WSLs) were obtained from the trial's data base. Univariate analyses and multiple regression were undertaken to assess for associations between the factors and the presence and severity of WSLs. RESULTS: Sixty-five patients (28.3%) had no WSLs, and 165 (71.7%) had 1 to 12. The mean number of WSLs per patient with demineralization was 2.9 (95% CI, 2.5 and 3.3). Patients with WSLs were significantly (P = 0.002) younger and more likely to have diseased first molars (P = 0.04). Participants with inadequate pretreatment oral hygiene developed more WSLs (P = 0.03). Boys (P = 0.001) and participants with diseased first molars (P = 0.06) had significantly greater demineralization. CONCLUSIONS: Sex, pretreatment age, oral hygiene, and clinical status of the first molars can be used as predictors for the development and severity of WSLs during orthodontic treatment.


Assuntos
Braquetes Ortodônticos/efeitos adversos , Ortodontia Corretiva/efeitos adversos , Desmineralização do Dente/etiologia , Adolescente , Fatores Etários , Análise de Variância , Índice CPO , Testes de Atividade de Cárie Dentária , Feminino , Fluorescência , Previsões , Humanos , Luz , Modelos Lineares , Modelos Logísticos , Masculino , Dente Molar/patologia , Higiene Bucal , Cooperação do Paciente , Fatores de Risco , Fatores Sexuais , Classe Social , Fatores de Tempo
10.
PLoS One ; 16(10): e0258881, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34669730

RESUMO

Evidence on the link between starch intake and caries incidence is conflicting, therefore the cariogenicity of starch compared with sucrose was explored using a dual Constant Depth Film Fermenter (dCDFF) biotic model system. Bovine enamel discs were used as a substrate and the dCDFF was inoculated using human saliva. CDFF units were supplemented with artificial saliva growth media at a constant rate to mimic resting salivary flow rate over 14 days. The CDFF units were exposed to different conditions, 2% sucrose or 2% starch 8 times daily and either no additional fluoride or 1450 ppm F- twice daily. Bovine enamel discs were removed at intervals (days 3, 7, 10 and 14) for bacterial enumeration and enamel analysis using Quantitative Light Induced Fluorescence (QLF) and Transverse Microradiography (TMR). Results showed that in the absence of fluoride there was generally no difference in mineral loss between enamel exposed to either sucrose or starch when analysed using TMR and QLF (P > 0.05). In the presence of fluoride by day 14 there was significantly more mineral loss under starch than sucrose when analysed with TMR (P < 0.05). It was confirmed that starch and sucrose are similarly cariogenic within the dCDFF in the absence of fluoride. With the aid of salivary amylase, the bacteria utilise starch to produce an acidic environment similar to that of bacteria exposed to sucrose only. In the presence of fluoride, starch was more cariogenic which may be due to the bacteria producing a more hydrophobic intercellular matrix lowering the penetration of fluoride through the biofilm. This is significant as it indicates that the focus on sugars being the primary cause of caries may need re-evaluating and an increase in focus on carbohydrates is needed as they may be similarly cariogenic as sugars if not more so.


Assuntos
Esmalte Dentário/efeitos dos fármacos , Saliva/microbiologia , Amido/administração & dosagem , Desmineralização do Dente/microbiologia , Animais , Biofilmes/crescimento & desenvolvimento , Bovinos , Esmalte Dentário/microbiologia , Humanos , Lactobacillus/crescimento & desenvolvimento , Veillonella/crescimento & desenvolvimento
11.
Photodiagnosis Photodyn Ther ; 36: 102603, 2021 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-34728422

RESUMO

BACKGROUND: The gold standard for quantifying mineral loss of enamel is transverse microradiography (TMR) and is complimented by the non-destructive quantitative light induced fluorescence (QLF) which measures changes in autofluorescence. Fluorescence loss has been shown to correlate with mineral loss. Building upon the established method, the use of hyperspectral fluorescence imaging (HI) allows the capture of a broader range of wavelengths to quantify fluorescence changes more accurately. METHODS: Bovine Enamel was demineralised within the dual constant depth film fermenter over 14 days and analysed using TMR, QLF and HI. The mineral change values were compared using Pearson's Correlation Coefficient. RESULTS: The analysis showed a statistically significant correlation that was equal between TMR and HI (r = 0.844) and TMR and QLF (r = 0.844), but weaker between QLF and HI (r = 0.811). CONCLUSIONS: The correlations indicate that HI is a promising valid non-destructive method for quantifying mineral loss from bovine enamel that is as accurate as QLF and complements TMR.


Assuntos
Fotoquimioterapia , Desmineralização do Dente , Animais , Bovinos , Fluorescência , Microrradiografia , Fotoquimioterapia/métodos , Fármacos Fotossensibilizantes , Desmineralização do Dente/diagnóstico por imagem
12.
J Biophotonics ; 13(1): e201900190, 2020 01.
Artigo em Inglês | MEDLINE | ID: mdl-31654475

RESUMO

The rapid detection and identification of microorganisms is one of the most important factors in many cases of ill health. The purpose of this study was to determine the fluorescence characteristics of seven oral bacteria using emission spectra with the aim of distinguishing between the bacteria, and to compare fluorescence imaging methods for the direct assessment of oral bacteria. Fluorescence images of each bacterium were obtained under a 405-nm light source using a two-filter system. The emissions of all samples were measured with a fluorescence spectrometer. The complete fluorescence data set collected for each sample employed a three-dimensional data cube. The differences in the autofluorescence characteristics of the seven oral bacteria were determined by principal components analysis (PCA). The fluorescence images of the oral bacteria varied with the genus and the filter system. The three-dimensional excitation-emission matrix fluorescence spectra exhibited distinctive fluorescence features associated with intracellular fluorophores. The seven bacteria could be clearly differentiated on the PCA score plot. The findings of this study indicate that oral bacteria can be identified based on their autofluorescence characteristics. Fluorescence spectroscopy coupled with PCA can be used to detect and classify oral bacteria.


Assuntos
Bactérias , Imagem Óptica , Fluorescência , Corantes Fluorescentes , Análise de Componente Principal , Espectrometria de Fluorescência
13.
J Dent Educ ; 72(11): 1318-23, 2008 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-18981210

RESUMO

The purpose of this study was to compare detection of enamel and dentinal caries by dental students' and faculty members' visual inspection and by quantitative light-induced fluorescence (QLF). The overall aim was to determine whether QLF is an appropriate technique for use in clinical skills laboratories as a teaching aid for dental undergraduates to detect and assess the removal of enamel and dentinal caries. Sixty students who had no clinical experience with dental caries were asked to select . suitably decayed teeth and mount them in plaster. After recording baseline QLF images, students removed caries according to instructions given by the clinical tutor. On completion of the exercise, the teeth were visually determined to be caries-free by the student, then confirmed by the clinical tutor. A fluorescein in alcohol solution was injected into the cavity for two minutes, rinsed, and dried before QLF images were captured. The images were visually analyzed by two examiners for the presence or absence of caries. From seventy-four images recorded, seventeen were excluded due to exposure of the pulp chamber. The remaining fifty-seven teeth, which by clinical visual examination were judged to be caries-free, were examined using QLF. Fifty-three percent were found to be caries-free, while 47 percent were carious. In this sample of fifty-seven teeth judged to be caries-free by both dental students and faculty members, QLF thus detected caries in almost half of these teeth. These findings suggest that QLF is a useful, noninvasive, nondestructive technique for the detection of caries and can serve as an adjunct to chair-side diagnosis and management of dental caries, which is typically accomplished by visual inspection. QLF may be useful and appropriate as an objective clinical teaching aid for the assessment of dental caries.


Assuntos
Cárie Dentária/patologia , Preparo da Cavidade Dentária/métodos , Dentística Operatória/educação , Educação em Odontologia , Luz , Estudantes de Odontologia , Dente Pré-Molar/patologia , Competência Clínica , Cárie Dentária/diagnóstico , Cárie Dentária/terapia , Esmalte Dentário/patologia , Dentina/patologia , Fluoresceína , Fluorescência , Corantes Fluorescentes , Humanos , Processamento de Imagem Assistida por Computador/métodos , Dente Molar/patologia , Software , Ensino/métodos , Percepção Visual/fisiologia
14.
Contemp Clin Trials Commun ; 11: 1-9, 2018 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-30023454

RESUMO

INTRODUCTION: A new dental contract being tested in England places patients into traffic light categories according to risk (Red = High risk). This reflects health policy which emphasises patients' shared responsibility for their health, and a growing expectation that clinicians discuss health risk in consultations. Alongside this, there are technological developments such as scans and photographs which have generated new, vivid imagery which may be used to communicate risk information to patients. However, there is little evidence as to whether the form in which risk information is given is important. METHODS: The PREFER study is a pragmatic, multi-centre, three-arm, patient-level randomised controlled trial, based in four NHS dental practices, from which 400 high/medium risk patients will be recruited. The study compares three ways of communicating risk information at dental check-ups: 1) verbal only (usual care); 2) a Traffic Light graphic with verbal explanation; 3) a Quantitative Light-Induced Fluorescence (QLF) photograph showing, for example, patches of red fluorescence where dental plaque has been present for two days or more (with a verbal explanation). The study assesses patient preferences using the economic preference-based valuation methodology Willingness-to-Pay (WTP). Any changes in oral self-care (for example in tooth-brushing), will be measured by self-report, and clinical outcome data collected by clinicians and extracted from QLF photographs. Predictors and moderators of any behaviour change will be explored using demographic characteristics and psychological variables from the Extended Parallel Process Model. A cost-benefit framework will explore the financial implications for NHS dentistry of the three risk presentation methods.

15.
Eur Stroke J ; 3(4): 347-354, 2018 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31236482

RESUMO

PURPOSE: There appears to be an association between poor oral hygiene and increased risk of aspiration pneumonia - a leading cause of mortality post-stroke. We aim to synthesise what is known about oral care after stroke, identify knowledge gaps and outline priorities for research that will provide evidence to inform best practice. METHODS: A narrative review from a multidisciplinary perspective, drawing on evidence from systematic reviews, literature, expert and lay opinion to scrutinise current practice in oral care after a stroke and seek consensus on research priorities.Findings: Oral care tends to be of poor quality and delegated to the least qualified members of the caring team. Nursing staff often work in a pressured environment where other aspects of clinical care take priority. Guidelines that exist are based on weak evidence and lack detail about how best to provide oral care. DISCUSSION: Oral health after a stroke is important from a social as well as physical health perspective, yet tends to be neglected. Multidisciplinary research is needed to improve understanding of the complexities associated with delivering good oral care for stroke patients. Also to provide the evidence for practice that will improve wellbeing and may reduce risk of aspiration pneumonia and other serious sequelae. CONCLUSION: Although there is evidence of an association, there is only weak evidence about whether improving oral care reduces risk of pneumonia or mortality after a stroke. Clinically relevant, feasible, cost-effective, evidence-based oral care interventions to improve patient outcomes in stroke care are urgently needed.

16.
Eur J Prosthodont Restor Dent ; 15(4): 165-70, 2007 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-18236927

RESUMO

The aim of this study was to evaluate Quantitative Light Induced Fluorescence (QLF) analysis as a means of determining the ability of denture cleaners to remove stain from denture teeth. This study investigated the appearance of acrylic resin denture teeth subjected to QLF conditions in vitro. It aimed to determine if QLF was an appropriate method for detecting stain and its removal on acrylic resin denture teeth in vitro and also to develop a quantitative and reproducible method for assessing the efficacy of denture cleaners using QLF. This study showed that not all acrylic resin denture teeth fluoresced under QLF examination. QLF demonstrated the ability to detect and quantify longitudinal changes in stain removal by the various denture cleaners used in the study.


Assuntos
Higienizadores de Dentadura/química , Dentaduras , Fluorescência , Descoloração de Dente/terapia , Resinas Acrílicas/efeitos da radiação , Análise de Variância , Materiais Dentários/efeitos da radiação , Higienizadores de Dentadura/uso terapêutico , Humanos , Descoloração de Dente/diagnóstico
17.
J Biomed Opt ; 21(8): 84003, 2016 08 01.
Artigo em Inglês | MEDLINE | ID: mdl-27552307

RESUMO

A number of anaerobic oral bacteria, notably Prevotellaceae, exhibit red fluorescence when excited by short-wavelength visible light due to their accumulation of porphyrins, particularly protoporphyrin IX. pH affects the fluorescence of abiotic preparations of porphyrins due to transformations in speciation between monomers, higher aggregates, and dimers. To elucidate whether the porphyrin speciation phenomenon could be manifested within a microbiological system, suspensions of Prevotella intermedia and Prevotella nigrescens were examined by fluorescence spectrophotometry while being titrated against NaOH. The initial pH of the samples was <6, which was then raised toward the maximum found within a diseased periodontal pocket, being ∼pH 8.7. The intensity of the fluorescence emissions increased between 600 and 650 nm with increasing pH. Peak fluorescence emissions occurred at 635±1 nm with a second emission peak developing with increasing pH at 622 nm. A linear relationship was demonstrated between pH and the log10 ratio of 635:622 nm excitation fluorescence intensities. These findings suggest that the pH range found within the oral cavity could affect the fluorescence of oral bacteria in vivo, which may in turn have connotations for any clinical diagnoses that may be inferred from dental plaque fluorescence.


Assuntos
Placa Dentária/diagnóstico , Placa Dentária/microbiologia , Prevotella nigrescens/fisiologia , Humanos , Concentração de Íons de Hidrogênio , Porfirinas/química , Prevotella intermedia/fisiologia , Espectrometria de Fluorescência
18.
Angle Orthod ; 86(6): 991-997, 2016 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-27007753

RESUMO

OBJECTIVE: To assess the use of Quantitative Light-induced Fluorescence-Digital as an oral hygiene evaluation tool during orthodontic treatment. MATERIALS AND METHODS: In this prospective, randomized clinical trial, 33 patients undergoing fixed orthodontic appliance treatment were randomly allocated to receive oral hygiene reinforcement at four consecutive appointments using either white light (WL) or Quantitative Light-induced Fluorescence-Digital (QLF) images, taken with a device, as visual aids. Oral hygiene was recorded assessing the QLF images for demineralization, by fluorescence loss (ΔF), and plaque coverage (ΔR30). A debriefing questionnaire ascertained patient perspectives. RESULTS: There were no significant differences in demineralization (P  =  .56) or plaque accumulation (P  =  .82) between the WL and QLF groups from T0 to T4. There was no significant reduction in demineralization, ΔF, in the WL, or the QLF group from T0-T4 (P > .05); however, there was a significant reduction in ΔR30 plaque scores (P < .05). All the participants found being shown the images helpful, with 100% of the QLF group reflecting that it would be useful to have oral hygiene reinforcement for the full duration of treatment compared with 81% of the WL group (OR 2.3; P < .05). CONCLUSIONS: Quantitative Light-induced Fluorescence-Digital can be used to detect and monitor demineralization and plaque during orthodontics. Oral hygiene reinforcement at consecutive appointments using WL or QLF images as visual aids is effective in reducing plaque coverage. In terms of clinical benefits, QLF and WL images are of similar effectiveness; however, patients preferred the QLF images.


Assuntos
Placa Dentária , Higiene Bucal , Desmineralização do Dente , Adolescente , Adulto , Criança , Cárie Dentária , Esmalte Dentário , Feminino , Fluorescência , Humanos , Masculino , Aparelhos Ortodônticos , Ortodontia , Estudos Prospectivos , Adulto Jovem
19.
Photodiagnosis Photodyn Ther ; 13: 344-346, 2016 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-26216344

RESUMO

BACKGROUND: Oxygen is generally considered essential for lethal photosensitisation by photodynamic processes. The oral anaerobes, Prevotella intermedia and P. nigrescens are known to be photosensitive, but are also extremely sensitive to the cytotoxic effects of oxygen. METHODS: The Prevotellaceae were exposed to two 405 nm light sources for different exposure times in an anaerobic chamber. Viable counts of the light exposed samples were compared to light-free controls to determine the proportion of bacteria killed. RESULTS: Lethal photosensitivity was demonstrated against P. intermedia and P. nigrescens. The proportions of bacteria killed by either the light-emitting diode or laser pointer were similar at a given energy density (J/cm(2)). CONCLUSIONS: Lethal photosensitivity was demonstrated in two species of Prevotella under anaerobic conditions.


Assuntos
Apoptose/fisiologia , Oxigênio/metabolismo , Porfirinas/metabolismo , Prevotella/fisiologia , Prevotella/efeitos da radiação , Tolerância a Radiação/fisiologia , Anaerobiose/fisiologia , Anaerobiose/efeitos da radiação , Apoptose/efeitos da radiação , Relação Dose-Resposta à Radiação , Luz , Prevotella/classificação , Doses de Radiação , Especificidade da Espécie
20.
PLoS One ; 11(7): e0158835, 2016.
Artigo em Inglês | MEDLINE | ID: mdl-27441707

RESUMO

The quantification of fluorescence in dental plaque is currently being developed as a diagnostic tool to help inform and improve oral health. The oral anaerobe Prevotella intermedia exhibits red fluorescence due to the accumulation of porphyrins. pH affects the fluorescence of abiotic preparations of porphyrins caused by changes in speciation between monomers, higher aggregates and dimers, but this phenomenon has not been demonstrated in bacteria. Fluorescence spectra were obtained from suspensions of P. intermedia that were adjusted to pHs commensurate with the range found within dental plaque. Two fluorescent motifs were identified; 410 nm excitation / 634 nm emission (peak A) and 398 nm excitation / 622 nm emission (peak B). A transition in the fluorescence spectra was observed from peak A to peak B with increasing pH which was also evident as culture age increased from 24 hours to 96 hours. In addition to these 'blue-shifts', the intensity of peak A increased with pH whilst decreasing with culture age from 24 to 96 hours. A bacterium's relationship with the local physiochemical environment at the time of image capture may therefore affect the quantification of dental plaque fluorescence.


Assuntos
Prevotella intermedia/metabolismo , Espectrometria de Fluorescência/métodos , Fluorescência , Concentração de Íons de Hidrogênio , Prevotella intermedia/crescimento & desenvolvimento , Fatores de Tempo
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