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

Editorial 2022 : Inclusion of medical emergencies syllabus in our dental school curriculum

The prevention, diagnosis, and management of medical emergencies are of utmost importance in the practice of dentistry. Dental students and dental surgeons must be well trained and prepared to manage all possible medical emergencies in their daily professional practices. The team must be competent and confident in handling the initial basic emergency treatment with quality. Proper management of life-threatening medical emergencies may lead to the prevention of possible death and complications. This may also avert the psychological trauma that the healthcare professional may go through and the stigma attached to the hospital or clinic. Besides that, the ethical and legal implications of medical emergencies related to the obligations of the healthcare practitioner cannot be overlooked. The teaching of medical emergencies in our dental schools starts at the pre-clinical undergraduate level. However, the program is not well structured. Despite the consensus on the importance of training in medical emergencies, several international studies show unsatisfactory results by demonstrating low knowledge and confidence of professionals in managing medical emergencies and first aid. As a result of these international research findings, there has been aparadigm shift in teaching undergraduate students in most developed countries. The fundamental change in the approach now is emphasizing on a more competency-based curriculum and more hands-on teaching. Hence the need for a revision and inclusion of medical emergencies in our curricula in Ghana