Microbial profile of root canals of pulpally infected teeth in Ghanaians

Introduction: Pulpal and periapical infections are initiated by microorganisms when they gain access to the dental pulp. The success of root canal treatment principally depends on the eradication of the micro-organisms in the root canal system. The aim of this study was to evaluate the viable microbial profile of root canals with various stages of infection in Ghanaians. Material and Methods: Forty-four consecutive patients with sixty teeth referred to the Restorative Dentistry Clinic requiring root canal treatment were recruited. Root canal samples were collected from the teeth with sterile paper points. The samples were processed and subjected to microbial analysis and identification using Matrix-assisted laser desorption/ionization-time of flight (MALDI-TOF) mass spectrometry (MS). Results: A total of 259 isolates were recovered from the 60 infected root canals, belonging to twenty different microbial genera. Out of the 259 microbial species isolated, only two were Candida albicans, a fungi; 257 (99.2%) were bacterial isolates belonging to 19 genera. The 19 genera encompassed 53 bacterial species, out of which 26 (49.1%) were identified as facultative anaerobes, 15 (28.3 %.) as obligate anaerobes and 12 (22.6%) were aerobes. Streptococcus species (Streptococcus oralis, Streptococcus mitis, Streptococcus mutans and Streptococcus constellatus) were the most predominant isolates, followed by Prevotella sp, Actinomyces sp, Enterococcus faecalis and Rothia sp respectively. Conclusion: The findings of this study show that infected root canals are polymicrobial in nature. The determination of the microbial profile aids in understanding the pathogenesis of pulpal and periradicular infections and helps in choosing effective antimicrobial irrigation and medicament for root canal treatment

Healthcare professionals’ perspectives on oral health care in acute stroke patients: a qualitative study

Abstract Background Stroke is a major public health problem, with the disabilities of the patients increasing their risk of poor oral health. Currently, in Ghana and Nigeria, no guideline exists for oral health care in stroke patients, while most of our acute stroke care settings have no documented protocol. Aim This study sought to understand the perspectives of healthcare professionals in Ghana and Nigeria about oral healthcare in acute stroke patients. Methods A qualitative inductive approach was employed to explore healthcare professionals’ perspectives. After obtaining informed consent, in-depth interviews were conducted among doctors, nurses, and physiotherapists using semi-structured question guides. Participants’ responses were audiotaped for transcription and analysis. Interviews were conducted until data saturation was reached. Data were analyzed thematically to generate themes and sub-themes using an inductive approach. The results Twenty-five (25) health care professionals (HCP) aged 25–60 years with a mean age of 36.2 ± 4.2 years were interviewed. There were 15 (60.0%) males and 10 (40.0%) females. HCP included nurse practitioners 14 (56.0%), medical doctors 7 (28.0%), and physiotherapists 4 (16.0%). The HCP demonstrated adequate knowledge of stroke and considered oral health important for esthetic and clinical reasons. They, however, reported being unable to give it the required attention due to inadequate collaboration between the various professional cadres, insufficient equipment, and a skewed focus on other clinical needs of the acute stroke patients. Conclusions The findings indicate that HCPs perceived oral health care as very important among patients with acute stroke. However, they reported a lack of collaboration and integration of oral health care in routine stroke care as a major impediment