Microbial characteristics of dental caries in HIV positive individuals

BACKGROUND: Dental caries is a multifactorial disease that affects many people. Even though microorganisms play a crucial role in causing dental caries, diagnosis is routinely macroscopic. In order to improve early detection especially in HIV patients who are disproportionately affected, there is need to reconcile the macroscopic and microscopic characteristics of dental caries. Therefore, the aim of this study was to characterize the oral microbiota profile along the decayed, missing, filled teeth (DMFT) index using amplicon sequencing data. METHODS: Amplicon sequencing of the V6-V8 region of the 16S rRNA gene was done on DNA recovered from whole unstimulated saliva of 59 HIV positive and 29 HIV negative individuals. The microbial structure, composition and co-occurrence networks were characterized using QIIME-2, Phyloseq, Microbiome-1.9.2 and Metacoder in R. RESULTS: We characterized the oral microbiota into 2,093 operational taxonomic units (OTUs), 21 phyla and 239 genera from 2.6 million high quality sequence reads. While oral microbiota did not cluster participants into distinct groups that track with the DMFT index, we observed the following: (a) The proportion of accessory microbiota was highest in the high DMFT category while the core size (∼50% of richness) remained relatively stable across all categories. (b) The abundance of core genera such as Stomatobaculum, Peptostreptococcus and Campylobacter was high at onset of dental caries, (c) A general difference in oral microbial biomass. (d) The onset of dental caries (low DMFT) was associated with significantly lower oral microbial entropy. CONCLUSIONS: Although oral microbial shifts along the DMFT index were not distinct, we demonstrated the potential utility of microbiota dynamics to characterize oral disease. Therefore, we propose a microbial framework using the DMFT index to better understand dental caries among HIV positive people in resource limited settings

Prevalence of signs and symptoms of temporomandibular joint dysfunction in subjects with different occlusions using the Helkimo index

Magister Scientiae Dentium - MSc(Dent)The controversy surrounding the role of malocclusion and orthodontic treatment in temporomandibular joint (TMJ) dysfunction led to this study. The purpose of this study was to establish the prevalence and compare the status of signs and symptoms of TMJ dysfunction in four groups of adolescents and young adults. The groups consisted of 14 persons with normal occlusions, 23 with untreated malocclusions, 20 with malocclusions currently undergoing treatment, and 18 with treated malocclusions. The Helkimo index was used to collect the TMJ dysfunction data. The results showed that the untreated malocclusion group had the most number of persons with signs and symptoms of dysfunction, but the differences between the groups in the distribution of persons according to the anamnestic and clinical dysfunction indices were not statistically significant. There were also no statistically significant differences in the distribution of signs and symptoms between boys and girls. According to anamnesis, the most frequently reported symptoms were joint sounds and headaches or neckaches occurring more than twice a week. Amongst the clinical signs and symptoms, the most commonly occurring were joint sounds on auscultation and muscle tenderness on palpation. In light of the small study sample and the absence of any substantial differences between the four groups, the role of malocclusion and orthodontic treatment in the aetiology of TMJ dysfunction remains obscure.South Afric

Extensive dental caries in a HIV positive adult patient on ART; case report and literature review

Abstract Background The estimated number of people living with human immunodeficiency virus (HIV) (PLHIV) in Uganda is 1.5 million (7.3%). As of June 2016, 60% (898,197) of PLHIV were enrolled and receiving antiretroviral therapy (ART). In scientific literature, the effect of HIV and ART on dental caries remains equivocal. At the Prosthetics Clinic of the Department of Dentistry, Makerere University College of Health Sciences, we have seen a number of PLHIV who require replacement of missing teeth with partial or complete dentures as a result of extensive caries. Here we report a case of an HIV positive female patient with extensive dental caries resulting in complete edentulous jaws, associated with psychological stress and stigmatization. Case presentation A 52-year-old patient, HIV positive for fourteen (14) years and receiving antiretroviral therapy (ART) for the last four years wanted to replace her missing teeth for effective feeding and cosmetic reasons. A diagnosis of partially edentulous maxillary and mandibular arches, cervical caries of tooth # 12, 15, 25, 34 and retained roots of tooth # 11, 13, 22 and 35 was made. Following oral health education and mouth preparation, this patient received a set of removable acrylic full upper and lower dentures. Conclusion This case may represent the long-term effects of HIV and ART on oral health status especially tooth surfaces in some PLHIV. Further evaluation is required to ascertain if this was an isolated case or it is a common finding among HIV positive adult patients receiving long-term ART in sub-Saharan Africa. Information emerging from these studies would establish the magnitude of dental caries among PLHIV and guide the development of appropriate oral health care guidelines in the management of people living with HIV