Influence of the Oral Microbiome on General Health

The prevalence of edentulism is common worldwide. While improvements in access to healthcare and dental care are reducing the prevalence rate of edentulism, the rapidly growing number of elderly as a percent of the global population will sustain a need for denture therapy for the foreseeable future. While denture use has positive impacts on the quality of life, their use is associated with some problems and risks. Denture stomatitis, a chronic infection-related inflammatory disorder of the oral mucosa, is extremely common and has been reported to occur in up to two-thirds of denture wearers. Importantly, epidemiology studies have shown edentulism and denture wearing, while not proven as causative factors, to be associated with significant increases in risk for serious systemic diseases, such as chronic obstructive pulmonary disease (COPD), cardiovascular diseases, diabetes, and arthritic disorders. A common linkage across these diseases is an association between increased risk for the disease and chronic inflammation. The nature of surface properties and porosity of denture materials contributes to the attachment of microorganisms and the establishment and growth of the adherent biofilm. Hence, proper denture cleansing is critical in maintaining oral hygiene and general health and perhaps to reduce the risk factors for systemic disease

Oral Health: The Need for Both Conventional Microbial and Molecular Characterization

This study aims to consider the microbial distribution in oral disease, as well as gene analysis and expression, in elucidating: 1, the fundamental underpinnings of oral disease, and 2, the potential relationship between oral diseases and systemic health. A key focus is identifying the microbiota associated with oral disease manifestations characterized by both conventional microbiological and molecular methods. Variations in the observed microbial populations characterized by conventional and molecular approaches have been identified for caries, periodontitis, peri-implantitis, and stomatitis. The discovery of therapeutic approaches for oral disease will require comprehensive microbial and genomic analysis. This study evaluated the current state of the relevant microbial and genomic information for several prevalent oral diseases

Team Skills: Comparing Pedagogy in a Graduate Business School to That of a College of Pharmacy Professional Program

Aim/Purpose: To measure the change in team skills resulting from team projects in professional and graduate school courses, a pilot study was conducted among students in two courses in a graduate school of business and one in the pharmacy school of the same institution of higher learning. This pilot study evaluated (a) students receiving training and practice in working as part of a classroom team were able to translate the formal training into the belief they had improved routine team interactions and experienced benefits from the intervention, and (b) determine whether changes in perceived team skills acquired by graduate business students differed from those of pharmacy school students. Background: This pilot study examined the usefulness of adding a teamwork skills module imported from a graduate school of business to increasing team skills in a pharmacy curriculum. Methodology: Thirty-five students (22 in a graduate school of business and 13 in a school of pharmacy) took a survey comprised of 15 questions designed on a 5-point scale to self-evaluate their level of skill in working in a team. They were then exposed to a seminar on team skills, which included solving a case that required teamwork. After this intervention the students repeated the survey. Contribution: As the pharmacy profession moves to be more integrated as part of inter-professional healthcare teams, pharmacy schools are finding it necessary to teach students how to perform on teams where many disciplines are represented equally. The core of the pharmacy profession is shifting from dependence on the scientific method to one where team skills are also important. Findings: The small size of the pilot sample limited significance except in the greater importance of positive personal interaction for business students. Directional findings supported the hypothesis that the business culture allows risk-taking on more limited information and more emphasis on creating a positive environment than the pharmacy culture given its dependence on scientific method. It remains moot as to whether directly applying a teaching intervention from a business curriculum can effectively advance the team skills of pharmacy students. Recommendations For Practitioners: Educators in professional schools such as pharmacy and medicine may find curricular guidance to increase emphasis on learning teamwork skills. Recommendations for Researchers: Researchers are encouraged to explore cross-disciplinary exchanges of teaching core business skills. Impact on Society : The question is posed that as pharmacy schools and the pharmacy profession integrate more into the business of pharmacy whether this difference will close. Future Research: A full study is planned with the same design and larger sample sizes and expanding to include students in medical, as well as pharmacy classes

Managing Denture Biofilm Related Diseases

The oral cavity harbors more than 700 microbial species and is one of the most complex ecosystems ever described. While the majority of these microbes are considered commensal, some of them are responsible for oral infectious diseases such as dental caries, periodontitis, halitosis and stomatitis. The advancement of modern science has greatly furthered our understanding of oral microbes and their roles in host health and disease. It has also led to the development of new tools for early detection, effective treatment, and prevention of oral microbial infections. This perspective provides a general understanding of oral microbiology, and its clinical relationship to oral infectious diseases, with a specific focus on denture-related microbial infections. The perspective also discusses the potential for developing innovative interventions for managing denture-related disease based on recent advances in our understanding of oral microbiology and denture-associated biofilms

Oral Biofilms: Development, Control, and Analysis

The oral cavity harbors hundreds of microbial species that are present either as planktonic cells or incorporated into biofilms. The majority of the oral microbes are commensal organisms. Those that are pathogenic microbes can result in oral infections, and at times can initiate systemic diseases. Biofilms that contain pathogens are challenging to control. Many conventional antimicrobials have proven to be ineffective. Recent advances in science and technology are providing new approaches for pathogen control and containment and methods to characterize biofilms. This perspective provides (1) a general understanding of biofilm development; (2) a description of emerging chemical and biological methods to control oral biofilms; and (3) an overview of high-throughput analytical approaches to analyze biofilms

Marijuana Compounds: A Nonconventional Approach to Parkinson’s Disease Therapy

Parkinson’s disease (PD), a neurodegenerative disorder, is the second most common neurological illness in United States. Neurologically, it is characterized by the selective degeneration of a unique population of cells, the nigrostriatal dopamine neurons. The current treatment is symptomatic and mainly involves replacement of dopamine deficiency.This therapy improves only motor symptoms of Parkinson’s disease and is associated with a number of adverse effects including dyskinesia. Therefore, there is unmet need for more comprehensive approach in the management of PD. Cannabis and related compounds have created significant research interest as a promising therapy in neurodegenerative and movement disorders. In this review we examine the potential benefits of medical marijuana and related compounds in the treatment of both motor and nonmotor symptoms as well as in slowing the progression of the disease.The potential for cannabis to enhance the quality of life of Parkinson’s patients is explored

Development of In Vitro Denture Biofilm Models for Halitosis Related Bacteria and Their Application in Testing the Efficacy of Antimicrobial Agents

Objective: Since dentures can serve as a reservoir for halitosis-causing oral bacteria, halitosis development is a concern for denture wearers. In this study, we surveyed the prevalence of four selected halitosis-related species (Fusobacterium nucleatum, Tannerella forsythia, Veillonella atypica and Klebsiella pneumoniae) in clinical denture plaque samples, and developed denture biofilm models for these species in vitro to facilitate assessment of antimicrobial treatment efficacy. Design: Denture plaque from ten healthy and ten denture stomatitis patients was screened for the presence of aforementioned four species by PCR. Biofilm formation by these halitosis-associated species on the surfaces of denture base resin (DBR) discs was evaluated by crystal violet staining and confocal laser scanning microscopy. The efficacy of denture cleanser treatment on these mono-species biofilms was evaluated by colony counting. Results: 80% of the subjects in the denture stomatitis group and 60% in the healthy group contained at least one of the targeted halitosis-related species in their denture plaque. All halitosis species tested were able to form biofilms on DBR disc surfaces to varying degrees. These in vitro mono-species resin biofilm models were used to evaluate the efficacy of denture cleansers, which exhibited differential efficacies. When forming biofilms on resin surfaces, the halitosis-related species displayed enhanced resistance to denture cleansers compared with their planktonic counterparts. Conclusion: The four selected halitosis-related bacterial species examined in this study are present on the majority of dentures. The mono-species biofilm models established on DBR discs for these species are an efficient screening tool for dental product evaluation

Obstructive airway disease and edentulism in the atherosclerosis risk in communities (ARIC) study

ObjectivesWe examined the potential association between prior chronic obstructive pulmonary disease (COPD) and edentulism, and whether the association varied by COPD severity using data from the Dental Atherosclerosis Risk in Communities Study.DesignCross-sectional.SettingCommunity dwelling subjects from four US communities.Participants and measurementsCases were identified as edentulous (without teeth) and subjects with one or more natural teeth were identified as dentate. COPD cases were defined by spirometry measurements that showed the ratio of forced expiratory volume (1 s) to vital capacity to be less than 0.7. The severity of COPD cases was also determined using a modified Global Initiative for Chronic Obstructive Lung Disease classification criteria (GOLD stage I–IV). Multiple logistic regression was used to examine the association between COPD and edentulism, while adjusting for age, gender, centre/race, ethnicity, education level, income, diabetes, hypertension, coronary heart disease and congestive heart failure, body mass index, smoking, smokeless tobacco use and alcohol consumption.Results13 465 participants were included in this analysis (2087 edentulous; 11 378 dentate). Approximately 28.3% of edentulous participants had prior COPD compared with 19.6% among dentate participants (p<0.0001). After adjustment for potential confounders, we observed a 1.3 (1.08 to 1.62) and 2.5 (1.68 to 3.63) fold increased risk of edentulism among GOLD II and GOLD III/IV COPD, respectively, as compared with the non-COPD/dentate referent. Given the short period of time between the measurements of COPD (visit 2) and dentate status (visit 4) relative to the natural history of both diseases, neither temporality nor insight as to the directionality of the association can be ascertained.ConclusionsWe found a statistically significant association between prior COPD and edentulism, with evidence of a positive incremental effect seen with increasing GOLD classification

Clinical and Histological Findings of Denture Stomatitis as Related to Intraoral Colonization Patterns of Candida albicans , Salivary Flow, and Dry Mouth: Role ofC. albicansin Saliva, Mucosal and Denture Surfaces in DS

Multifactorial etiological factors contribute to denture stomatitis (DS), a type of oral candidiasis; however, unlike other oral candidiasis, DS can occur in a healthy person wearing a denture. In this study, we therefore attempt to explore the association between candida, denture, and mucosal tissue using 1) exfoliative cytology, 2) the candidal levels present in saliva, on mucosal tissues and on denture surfaces, and 3) the salivary flow rate and xerostomic symptoms