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Macherla S, Varghese J, Nayak UY, Velagacherla V, Lobo R, U V, Kamath V. Formulation and assessment of biological properties of garcinia indica fruit extract mouthrinse as an adjunct to oral hygiene regimen: an in vitro analysis. J Appl Oral Sci 2024; 32:e20230291. [PMID: 38865512 PMCID: PMC11189596 DOI: 10.1590/1678-7757-2023-0291] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2023] [Revised: 03/29/2024] [Accepted: 04/18/2024] [Indexed: 06/14/2024] Open
Abstract
The prevalence of gingivitis is substantial within the general population, necessitating rigorous oral hygiene maintenance. OBJECTIVE This study assessed a Garcinia indica (GI) fruit extract-based mouthrinse, comparing it to a 0.1% turmeric mouthrinse and a 0.2% Chlorhexidine (CHX) mouthrinse. The evaluation encompassed substantivity, staining potential, antimicrobial efficacy and cytocompatibility. METHODOLOGY The study employed 182 tooth sections. For antimicrobial analysis, 64 extracted human teeth coated with a polymicrobial biofilm were divided into four groups, each receiving an experimental mouthrinse or serving as a control group with distilled water. Microbial reduction was assessed through colony forming units (CFU). Substantivity was evaluated on 54 human tooth sections using a UV spectrophotometer, while staining potential was examined on 64 tooth sections. Cytocompatibility was tested using colorimetric assay to determine non-toxic levels of 0.2% GI fruit extract, 0.1% Turmeric, and 0.2% CHX. RESULTS Data were analysed with one-way ANOVA (α=0.05). Cell viability was highly significant (p<0.001) in the 0.2% GI group (64.1±0.29) compared to 0.1% Turmeric (40.2±0.34) and 0.2% CHX (10.95±1.40). For antimicrobial activity, both 0.2% GI (20.18±4.81) and 0.2% CHX (28.22±5.41) exhibited no significant difference (P>0.05) at end of 12 hours. However, 0.1% Turmeric showed minimal CFU reduction (P<0.001). Substantivity results at 360 minutes indicated statistically significant higher mean release rate in 0.1%Turmeric (12.47±5.84 ) when compared to 0.2% GI (5.02±3.04) and 0.2% CHX (4.13±2.25) (p<0.001). The overall discoloration changes (∆E) were more prominent in the 0.2% CHX group (18.65±8.3) compared to 0.2% GI (7.61±2.4) and 0.1% Turmeric (7.32±4.9) (P<0.001). CONCLUSION This study supports 0.2% GI and 0.1% Turmeric mouth rinses as potential natural alternatives to chemical mouth rinses. These findings highlight viability of these natural supplements in oral healthcare.
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Affiliation(s)
- Shravya Macherla
- Manipal Academy of Higher Education, Manipal College of Dental Sciences, Department of Periodontology, Manipal, Karnataka, India
| | - Jothi Varghese
- Manipal Academy of Higher Education, Manipal College of Dental Sciences, Department of Periodontology, Manipal, Karnataka, India
| | - Usha Y Nayak
- Manipal Academy of Higher Education, Manipal College of Pharmaceutical Sciences, Department of Pharmaceutics, Manipal, Karnataka, India
| | - Varalakshmi Velagacherla
- Manipal Academy of Higher Education, Manipal College of Pharmaceutical Sciences, Department of Pharmaceutics, Manipal, Karnataka, India
| | - Richard Lobo
- Manipal Academy of Higher Education, Manipal College of Pharmaceutical Sciences, Department of Pharmacognosy, Manipal, Karnataka, India
| | - Viswanatha U
- Sri Dharmasthala Manjunatheshwara Centre for Research in Ayurveda & Allied sciences, Department of Biotechnology and Microbiology, Kuthpady, Udupi, Karnataka, India
| | - Vinayak Kamath
- Goa Dental College and Hospital, Department of Public Health Dentistry, Bambolim, Goa, India
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Tang Y, Nie H, Zhang Y, Wei Y, Huang Y, Zhuang Y, Yang W, Zhu Y. Effects of Sjogren's syndrome and high sugar diet on oral microbiome in patients with rampant caries: a clinical study. BMC Oral Health 2024; 24:361. [PMID: 38515087 PMCID: PMC10956276 DOI: 10.1186/s12903-024-04150-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2023] [Accepted: 03/15/2024] [Indexed: 03/23/2024] Open
Abstract
OBJECTIVE The purpose of this study was to assess the composition of the oral microbial flora of adults with rampant caries in China to provide guidance for treatment. PATIENTS AND METHODS Sixty human salivary and supragingival plaque samples were collected. They were characterized into four groups: patients with rampant caries with Sjogren's syndrome (RC-SS) or high-sugar diet (RC-HD), common dental caries (DC), and healthy individuals (HP). The 16S rRNA V3-V4 region of the bacterial DNA was detected by Illumina sequencing. PCoA based on OTU with Bray-Curtis algorithm, the abundance of each level, LEfSe analysis, network analysis, and PICRUSt analysis were carried out between the four groups and two sample types. Clinical and demographic data were compared using analysis of variance (ANOVA) or the nonparametric Kruskal-Wallis rank-sum test, depending on the normality of the data, using GraphPad Prism 8 (P < 0.05). RESULTS OTU principal component analysis revealed a significant difference between healthy individuals and those with RC-SS. In the saliva of patients with rampant caries, the relative abundance of Firmicutes increased significantly at the phylum level. Further, Streptocpccus, Veillonella, Prevotella, and Dialister increased, while Neisseria and Haemophilus decreased at the genus level. Veillonella increased in the plaque samples of patients with rampant caries. CONCLUSION Both salivary and dental plaque composition were significantly different between healthy individuals and patients with rampant caries. This study provides a microbiological basis for exploring the etiology of rampant caries. CLINICAL RELEVANCE This study provides basic information on the flora of the oral cavity in adults with rampant caries in China. These findings could serve as a reference for the treatment of this disease.
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Affiliation(s)
- Yifei Tang
- Department of Endodontic, Nanjing Stomatological Hospital, Affiliated Hospital of Medical School, Research Institute of Stomatology, Nanjing University, Nanjing, China
| | - Hua Nie
- Department of Endodontic, Nanjing Stomatological Hospital, Affiliated Hospital of Medical School, Research Institute of Stomatology, Nanjing University, Nanjing, China
| | - Yu Zhang
- Department of Endodontic, Nanjing Stomatological Hospital, Affiliated Hospital of Medical School, Research Institute of Stomatology, Nanjing University, Nanjing, China
| | - Yuan Wei
- Department of Endodontic, Nanjing Stomatological Hospital, Affiliated Hospital of Medical School, Research Institute of Stomatology, Nanjing University, Nanjing, China
| | - Yequan Huang
- Department of Endodontic, Nanjing Stomatological Hospital, Affiliated Hospital of Medical School, Research Institute of Stomatology, Nanjing University, Nanjing, China
| | - Yuan Zhuang
- Department of Endodontic, Nanjing Stomatological Hospital, Affiliated Hospital of Medical School, Research Institute of Stomatology, Nanjing University, Nanjing, China
| | - Weidong Yang
- Department of Endodontic, Nanjing Stomatological Hospital, Affiliated Hospital of Medical School, Research Institute of Stomatology, Nanjing University, Nanjing, China.
| | - Yanan Zhu
- Department of Endodontic, Nanjing Stomatological Hospital, Affiliated Hospital of Medical School, Research Institute of Stomatology, Nanjing University, Nanjing, China.
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Brookes Z, Teoh L, Cieplik F, Kumar P. Mouthwash Effects on the Oral Microbiome: Are They Good, Bad, or Balanced? Int Dent J 2023; 73 Suppl 2:S74-S81. [PMID: 37867065 PMCID: PMC10690560 DOI: 10.1016/j.identj.2023.08.010] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2023] [Accepted: 08/21/2023] [Indexed: 10/24/2023] Open
Abstract
This narrative review describes the oral microbiome, and its role in oral health and disease, before considering the impact of commonly used over-the-counter (OTC) mouthwashes on oral bacteria, viruses, bacteriophages, and fungi that make up these microbial communities in different niches of the mouth. Whilst certain mouthwashes have proven antimicrobial actions and clinical effectiveness supported by robust evidence, this review reports more recent metagenomics evidence, suggesting that mouthwashes such as chlorhexidine may cause "dysbiosis," whereby certain species of bacteria are killed, leaving others, sometimes unwanted, to predominate. There is little known about the effects of mouthwashes on fungi and viruses in the context of the oral microbiome (virome) in vivo, despite evidence that they "kill" certain viral pathogens ex vivo. Evidence for mouthwashes, much like antibiotics, is also emerging with regards to antimicrobial resistance, and this should further be considered in the context of their widespread use by clinicians and patients. Therefore, considering the potential of currently available OTC mouthwashes to alter the oral microbiome, this article finally proposes that the ideal mouthwash, whilst combatting oral disease, should "balance" antimicrobial communities, especially those associated with health. Which antimicrobial mouthwash best fits this ideal remains uncertain.
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Affiliation(s)
- Zoë Brookes
- Peninsula Dental School, Plymouth University, Plymouth, UK.
| | - Leanne Teoh
- Melbourne Dental School, The University of Melbourne, Carlton, Victoria, Australia
| | - Fabian Cieplik
- Department of Conservative Dentistry and Periodontology, University Hospital Regensburg, Regensburg, Germany
| | - Purnima Kumar
- Department of Periodontics and Oral Medicine, School of Dentistry, University of Michigan, Ann Arbor, USA
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Kurek-Górecka A, Ramos P, Kłósek M, Bobela E, Czuba ZP, Balwierz R, Olczyk P. Propolis as a Cariostatic Agent in Lozenges and Impact of Storage Conditions on the Stability of Propolis. Pharmaceutics 2023; 15:1768. [PMID: 37376216 DOI: 10.3390/pharmaceutics15061768] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2023] [Revised: 06/16/2023] [Accepted: 06/17/2023] [Indexed: 06/29/2023] Open
Abstract
Propolis is known as a source of compounds with strong antibacterial activity. Due to the antibacterial effect against streptococci of the oral cavity, it seems to be a useful agent in decreasing the accumulation of dental plaque. It is rich in polyphenols which are responsible for a beneficial impact on the oral microbiota and antibacterial effect. The aim of the study was to evaluate the antibacterial effect of Polish propolis against cariogenic bacteria. The minimum inhibitory concentration (MIC) and minimum bactericidal concentration (MBC) were determined on cariogenic streptococci related to the occurrence of dental caries. Lozenges based on xylitol, glycerin, gelatin, water, and ethanol extract of propolis (EEP) were prepared. The effect of prepared lozenges on cariogenic bacteria was assessed. Propolis was compared to chlorhexidine which is used in dentistry as the gold standard. In addition, the prepared propolis formulation was stored under stress conditions to assess the influence of physical conditions (i.e., temperature, relative humidity, and UV radiation). In the experiment, thermal analyses were also performed to evaluate the compatibility of propolis with the substrate used to create the base of lozenges. The observed antibacterial effect of propolis and prepared lozenges with EEP may suggest directing subsequent research on prophylactic and therapeutic properties decreasing the accumulation of dental plaque. Therefore, it is worth highlighting that propolis may play an important role in the management of dental health and bring advantages in preventing periodontal diseases and caries as well as dental plaque. The colorimetric analyses carried out in the CIE L*a*b* system, microscopic examinations, and TGA/DTG/c-DTA measurements indicate the unfavorable effect of the tested storage conditions on the lozenges with propolis. This fact is particularly evident for lozenges stored under stress conditions, i.e., 40 °C/75% RH/14 days, and lozenges exposed to UVA radiation for 60 min. In addition, the obtained thermograms of the tested samples indicate the thermal compatibility of the ingredients used to create the formulation of lozenges.
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Affiliation(s)
- Anna Kurek-Górecka
- Department of Community Pharmacy, Faculty of Pharmaceutical Sciences in Sosnowiec, Medical University of Silesia in Katowice, Kasztanowa 3, 41-200 Sosnowiec, Poland
| | - Paweł Ramos
- Department of Biophysics, Faculty of Pharmaceutical Sciences in Sosnowiec, Medical University of Silesia in Katowice, Jedności 8, 41-200 Sosnowiec, Poland
| | - Małgorzata Kłósek
- Department of Microbiology and Immunology, Faculty of Medical Sciences in Zabrze, Medical University of Silesia in Katowice, Jordana 19, 41-808 Zabrze, Poland
| | - Elżbieta Bobela
- Department of Microbiology and Immunology, Faculty of Medical Sciences in Zabrze, Medical University of Silesia in Katowice, Jordana 19, 41-808 Zabrze, Poland
| | - Zenon P Czuba
- Department of Microbiology and Immunology, Faculty of Medical Sciences in Zabrze, Medical University of Silesia in Katowice, Jordana 19, 41-808 Zabrze, Poland
| | - Radosław Balwierz
- Institute of Chemistry, University of Opole, Oleska 48, 45-052 Opole, Poland
| | - Paweł Olczyk
- Department of Community Pharmacy, Faculty of Pharmaceutical Sciences in Sosnowiec, Medical University of Silesia in Katowice, Kasztanowa 3, 41-200 Sosnowiec, Poland
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Schönbächler N, Thurnheer T, Paqué PN, Attin T, Karygianni L. In vitro versus in situ biofilms for evaluating the antimicrobial effectiveness of herbal mouthrinses. Front Cell Infect Microbiol 2023; 13:1130255. [PMID: 36798085 PMCID: PMC9927218 DOI: 10.3389/fcimb.2023.1130255] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2022] [Accepted: 01/20/2023] [Indexed: 02/01/2023] Open
Abstract
For centuries, diverse mouthrinses have been applied for medicinal purposes in the oral cavity. In view of the growing resistance of oral microorganisms against conventional antimicrobial agents e.g. chlorhexidine, the implementation of alternative treatments inspired by nature has lately gained increasing interest. The aim of the present study was to compare in vitro biofilm models with in situ biofilms in order to evaluate the antimicrobial potential of different natural mouthrinses. For the in vitro study a six-species supragingival biofilm model containing A. oris, V. dispar, C. albicans, F. nucleatum, S. mutans and S. oralis was used. Biofilms were grown anaerobically on hydroxyapatite discs and treated with natural mouthrinses Ratanhia, Trybol and Tebodont. 0.9% NaCl and 10% ethanol served as negative controls, while 0.2% CHX served as positive control. After 64h hours, biofilms were harvested and quantified by cultural analysis CFU. For the in situ study, individual test splints were manufactured for the participants. After 2h and 72h the biofilm-covered samples were removed and treated with the mouthrinses and controls mentioned above. The biofilms were quantified by CFU and stained for vitality under the confocal laser scanning microscope. In the in vitro study, 0.2% CHX yielded the highest antimicrobial effect. Among all mouthrinses, Tebodont (4.708 ± 1.294 log10 CFU, median 5.279, p<0.0001) compared with 0.9% NaCl showed the highest antimicrobial potential. After 72h there was no significant reduction in CFU after 0.2% CHX treatment. Only Trybol showed a statistically significant reduction of aerobic growth of microorganisms in situ (5.331 ± 0.7350 log10 CFU, median 5.579, p<0.0209). After treatment with the positive control 0.2% CHX, a significant percentage of non-vital bacteria (42.006 ± 12.173 log10 CFU, median 42.150) was detected. To sum up, a less pronounced effect of all mouthrinses was shown for the in situ biofilms compared to the in vitro biofilms.
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Affiliation(s)
- Nicole Schönbächler
- Clinic of Conservative and Preventive Dentistry, Center of Dental Medicine, University of Zurich, Zurich, Switzerland
| | - Thomas Thurnheer
- Clinic of Conservative and Preventive Dentistry, Center of Dental Medicine, University of Zurich, Zurich, Switzerland
| | - Pune Nina Paqué
- Clinic of Conservative and Preventive Dentistry, Center of Dental Medicine, University of Zurich, Zurich, Switzerland
- Clinic of Reconstructive Dentistry, Center of Dental Medicine, University of Zurich, Zurich, Switzerland
| | - Thomas Attin
- Clinic of Conservative and Preventive Dentistry, Center of Dental Medicine, University of Zurich, Zurich, Switzerland
| | - Lamprini Karygianni
- Clinic of Conservative and Preventive Dentistry, Center of Dental Medicine, University of Zurich, Zurich, Switzerland
- *Correspondence: Lamprini Karygianni,
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Aguilera FR, Viñas M, Sierra JM, Vinuesa T, R. Fernandez de Henestrosa A, Furmanczyk M, Trullàs C, Jourdan E, López-López J, Jorba M. Substantivity of mouth-rinse formulations containing cetylpyridinium chloride and O-cymen-5-ol: a randomized-crossover trial. BMC Oral Health 2022; 22:646. [PMID: 36575444 PMCID: PMC9793821 DOI: 10.1186/s12903-022-02688-z] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2022] [Accepted: 12/22/2022] [Indexed: 12/28/2022] Open
Abstract
BACKGROUND The efficacy of mouth-rinses strongly depends upon their substantivity. The use of natural and non-toxic products that avoid secondary effects is gaining interest in preventive dentistry. The purpose of this study was to evaluate the substantivity of two formulations of mouth-washing solutions based on cetylpyridinium (CPC) and O-cymen-5-ol. METHODS This was a randomized, double-blind, crossover trial conducted at the Faculty of Medicine and Health Sciences of the University of Barcelona. Bacterial re-colonization was followed by live/dead (SYTOTM9 + propidium iodide) bacterial staining and measured by confocal laser scanning microscopy and fluorometry. Unstimulated saliva samples were collected from 16 healthy individuals at baseline saliva and then, at 15 min, 30 min and 1, 2, 3, and 4 h after the following mouth-rinses: (i) a single, 1-min mouth-rinse with 15 ml of placebo (negative control); (ii) a single, 1-min mouth-rinse with 15 ml of CPC (0.05%) ; (iii) a single, 1-min mouth-rinse with 15 ml of O-cymen-5-ol (0.09%); (iv) a single, 1-min mouth-rinse with 15 ml of CPC (0.05%) + O-cymen-5-ol (0.09%). RESULTS Proportion of dead bacteria was significantly higher for all mouthrinses during the first 15 min compared to baseline (CPC = 48.0 ± 13.9; 95% CI 40.98-56.99; p < 0.001, O-cymen-5-ol = 79.8 ± 21.0; 95% CI 67.71-91.90; p < 0.05, CPC + O-cymen-5-ol = 49.4 ± 14; 95% CI 40.98-56.99; p < 0.001 by fluorometry and 54.8 ± 23.0; 95% CI 41.50-68.06; p < 0.001, 76.3 ± 17.1; 95% CI 66.36-86.14; p < 0.001, 47.4 ± 11.9; 95% CI 40.49-54.30; p < 0.001 by confocal laser scanning microscopy, respectively). Nevertheless, after 4 h, CPC + O-cymen-5-ol was the only one that obtained significant values as measured by the two quantification methods used (80.3 ± 22.8; 95% CI 67.15-93.50; p < 0.05 and 81.4 ± 13.8; 95% CI 73.45-89.43; p < 0.05). The combined use of CPC + O-cymen-5-ol increased the substantivity of the mouthrinse with respect to mouthrinses prepared with either of the two active products alone. CONCLUSION The synergistic interaction of CPC and O-cymen-5-ol prolongs their substantivity. The resulting formulation may be as effective as other antimicrobials, such as triclosan or chlorhexidine, but without their undesirable secondary effects. Thus, mouthrinsing products based on Combinations of CPC and O-cymen-5-ol may replace in the near future Triclosan and Chlorhexidine-based mouthrinses.
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Affiliation(s)
- Felipe-Rodrigo Aguilera
- grid.5841.80000 0004 1937 0247Laboratory of Molecular Microbiology and Antimicrobials, Department of Pathology and Experimental Therapeutics, Faculty of Medicine, University of Barcelona & IDIBELL, 08907 L’Hospitalet de Llobregat, Barcelona, Spain ,grid.7119.e0000 0004 0487 459XDental School, Faculty of Medicine, Universidad Austral de Chile, Valdivia, Chile
| | - Miguel Viñas
- grid.5841.80000 0004 1937 0247Laboratory of Molecular Microbiology and Antimicrobials, Department of Pathology and Experimental Therapeutics, Faculty of Medicine, University of Barcelona & IDIBELL, 08907 L’Hospitalet de Llobregat, Barcelona, Spain
| | - Josep M. Sierra
- grid.5841.80000 0004 1937 0247Laboratory of Molecular Microbiology and Antimicrobials, Department of Pathology and Experimental Therapeutics, Faculty of Medicine, University of Barcelona & IDIBELL, 08907 L’Hospitalet de Llobregat, Barcelona, Spain
| | - Teresa Vinuesa
- grid.5841.80000 0004 1937 0247Laboratory of Molecular Microbiology and Antimicrobials, Department of Pathology and Experimental Therapeutics, Faculty of Medicine, University of Barcelona & IDIBELL, 08907 L’Hospitalet de Llobregat, Barcelona, Spain
| | | | - Marta Furmanczyk
- grid.487221.a0000 0004 1795 1224Innovation and Development, ISDIN, Barcelona, Spain
| | - Carles Trullàs
- grid.487221.a0000 0004 1795 1224Innovation and Development, ISDIN, Barcelona, Spain
| | - Eric Jourdan
- grid.487221.a0000 0004 1795 1224Innovation and Development, ISDIN, Barcelona, Spain
| | - José López-López
- grid.5841.80000 0004 1937 0247Department of Dentistry, Faculty of Medicine, University of Barcelona & IDIBELL, Barcelona, Spain
| | - Marta Jorba
- grid.5841.80000 0004 1937 0247Laboratory of Molecular Microbiology and Antimicrobials, Department of Pathology and Experimental Therapeutics, Faculty of Medicine, University of Barcelona & IDIBELL, 08907 L’Hospitalet de Llobregat, Barcelona, Spain
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Hassan S, Dhadse P, Bajaj P, Sethiya K, Subhadarsanee C. Pre-procedural Antimicrobial Mouth Rinse: A Concise Review. Cureus 2022; 14:e30629. [DOI: 10.7759/cureus.30629] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2022] [Accepted: 10/24/2022] [Indexed: 11/07/2022] Open
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Perelli M, Abundo R, Semenza M, Centracchio M, Chiara SD, Monaco A, Arduino PG. Preliminary Evaluation of a NitrAdine-Based Brushing Solution for Patients Suffering from Gingivitis: A Prospective Clinical Case-Control Study. Eur J Dent 2022; 16:612-618. [PMID: 34875712 PMCID: PMC9507566 DOI: 10.1055/s-0041-1741120] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
OBJECTIVES This article aimed to evaluate the clinical efficacy of a nonantibiotic biofilm-removal formulation based on NitrAdine (PerioTabs), combined with a regular home oral hygiene regimen, in Caucasian patients with gingivitis. MATERIALS AND METHODS A sample of 60 patients were included in this clinical prospective study. All selected subjects underwent regular prophylaxis and professional oral hygiene at baseline; 30 days later, they were recalled for the measurements of the reference parameters about bleeding on probing (full-mouth bleeding upon probing score [FMBS]) and plaque index (full-mouth plaque score [FMPS]); no other clinical procedure was performed. Consequently, half of the patients (n = 30) were instructed to use PerioTabs for 10 days. The remaining patients (n = 30) were used as the negative control, only instructed to continue with their usual oral hygiene regimen. Fifteen days after, the clinical parameters of FMBS and FMPS were re-evaluated in both groups. RESULTS Changes in the scores of clinical indices FMBS and FMPS were calculated and compared. A significant difference between pre- and post-values, for both FMBS and FMPS, was noticed in the test group; in particular, the bleeding index value demonstrated the more significant changes: 22 participants showed a clinically meaningful improvement, and 5 had a small improvement. Only three patients had no evidence of change. In addition, 50% of patients had a reduction in plaque levels. No side effects were reported. CONCLUSIONS The adjunctive use of 10-day PerioTabs treatment in the daily oral hygiene routine seemed to be efficient in reducing gingival bleeding and plaque accumulation, with absence of adverse effects. These results should be confirmed in studies with a larger number of participants following a controlled-blinded design.
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Affiliation(s)
- Michele Perelli
- Departemnt of Periodontology, Private Practice, Torino, Italy
| | - Roberto Abundo
- Departemnt of Periodontology, Private Practice, Torino, Italy
| | - Mario Semenza
- Departemnt of Prosthodontist, Private Practice, Sant'Angelo Lodigiano, Italy
| | | | | | - Andrea Monaco
- Departemnt of Dental Hygiene, Private Practice, San Remo, Italy
| | - Paolo Giacomo Arduino
- Department of Surgical Sciences, CIR-Dental School, University of Torino, Torino, Italy
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Pragman AA, Fieberg AM, Reilly CS, Wendt C. Chlorhexidine oral rinses for symptomatic COPD: a randomised, blind, placebo-controlled preliminary study. BMJ Open 2021; 11:e050271. [PMID: 34903538 PMCID: PMC8672026 DOI: 10.1136/bmjopen-2021-050271] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/16/2021] [Accepted: 10/29/2021] [Indexed: 12/26/2022] Open
Abstract
OBJECTIVES Determine the effect of twice-daily chlorhexidine oral rinses on oral and lung microbiota biomass and respiratory symptoms. SETTING Single centre. PARTICIPANTS Participants were aged 40-85 with chronic obstructive pulmonary disease (COPD) and chronic productive cough or COPD exacerbation within the last year. Exclusions included antibiotics in the previous 2 months and/or those with less than four teeth. Forty-four participants were recruited and 40 completed the study. INTERVENTION Participants were randomised 1:1 to twice-daily 0.12% chlorhexidine oral rinses versus placebo for 2 months along with daily diaries. St. George's Respiratory Questionnaire (SGRQ), blood tests, oral rinse and induced sputum were collected at randomisation and the final visit. PRIMARY AND SECONDARY OUTCOMES Primary outcome was a change in oral and sputum microbiota biomass. Secondary outcomes included: sputum and oral microbiota Shannon and Simpson diversity and taxonomy; inflammatory markers; Breathlessness, Cough and Sputum Scale and SGRQ scores. RESULTS Neither the oral microbiota nor the sputum microbiota biomass decreased significantly in those using chlorhexidine compared with placebo (oral microbiota mean log10 difference (SE)=-0.103 (0.23), 95% CI -0.59 to 0.38, p=0.665; sputum microbiota 0.80 (0.46), 95% CI -0.15 to 1.75, p=0.096). Chlorhexidine decreased both oral and sputum microbiota alpha (Shannon) diversity (linear regression estimate (SE) oral: -0.349 (0.091), p=0.001; sputum -0.622 (0.169), p=0.001). Chlorhexidine use did not decrease systemic inflammatory markers compared with placebo (C reactive protein (chlorhexidine 1.8±7.5 vs placebo 0.4±6.8, p=0.467), fibrinogen (22.5±77.8 vs 10.0±77.0, p=0.406) or leucocytes (0.2±1.8 vs 0.5±1.8, p=0.560)). Chlorhexidine use decreased SGRQ scores compared with placebo (chlorhexidine -4.7±8.0 vs placebo 1.7±8.9, p=0.032). CONCLUSIONS We did not detect a significant difference in microbiota biomass due to chlorhexidine use. Chlorhexidine decreased oral and sputum microbiota alpha diversity and improved respiratory health-related quality of life compared with placebo. TRIAL REGISTRATION NCT02252588.
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Affiliation(s)
- Alexa A Pragman
- Department of Medicine, Minneapolis VA Health Care System, Minneapolis, Minnesota, USA
- Department of Medicine, University of Minnesota Medical School, Minneapolis, Minnesota, USA
| | - Ann M Fieberg
- Coordinating Center for Biometric Research, University of Minnesota, Minneapolis, Minnesota, USA
| | - Cavan S Reilly
- Division of Biostatistics, University of Minnesota, Minneapolis, Minnesota, USA
| | - Christine Wendt
- Department of Medicine, Minneapolis VA Health Care System, Minneapolis, Minnesota, USA
- Department of Medicine, University of Minnesota Medical School, Minneapolis, Minnesota, USA
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Cosola S, Oldoini G, Giammarinaro E, Covani U, Genovesi A, Marconcini S. The effectiveness of the information-motivation model and domestic brushing with a hypochlorite-based formula on peri-implant mucositis: A randomized clinical study. Clin Exp Dent Res 2021; 8:350-358. [PMID: 34677005 PMCID: PMC8874111 DOI: 10.1002/cre2.487] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2021] [Revised: 08/17/2021] [Accepted: 08/24/2021] [Indexed: 11/06/2022] Open
Abstract
Objective Management of mucositis is essential for the long‐term maintenance of dental implants. This study determined the efficacy, in terms of clinical parameters, of an adjunctive domiciliary agent paired with non‐surgical periodontal therapy (NSPT) for patients with peri‐implant mucositis. Materials and methods Patients involved in a periodontal maintenance program were randomly distributed to the domestic use of a chlorhexidine toothpaste and mouthwash (control) or a hypochlorite‐based formula brushing solution (test) after diagnosis of peri‐implant mucositis. A modified approach towards NSPTwas performed after 10 days of domestic use of the assigned maintenance product in both groups. Clinical and patient‐related outcomes were recorded during a 90‐day follow‐up period. Results Forty patients completed the three‐month study (20 patients per group). Both groups showed relevant clinical and patient outcome improvements after the NSPT (T2) and between T1 and T2 (p < 0 0.01), except for PPD. For the test group, the clinical improvement was significantly greater than that for the control group at the seventh‐day evaluation (T1) in the gingival index (0–3) and FMBS (%). Favorable outcomes were maintained during the entire follow‐up period. Conclusion The present study showed that the modified NSPT paired with the domestic use of nitradine‐based formula helps resolve peri‐implant mucositis and that nitradine might represent an alternative to chlorhexidine in these cases. Clinical relevance The gold standard for nonsurgical maintenance is full‐mouth disinfection. A previous decontamination of the oral cavity with chlorhexidine or nitradine domiciliary for 10 days could reduce plaque and inflammation, resulting in a painless operative session. This protocol may help reduce airborne contamination and the risk of cross‐infection, and during the pandemic, the protocol is safer for clinicians. In the same clinical cases, nitradine may be more efficient than chlorhexidine, and the former has no side effects such as discolouration.
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Affiliation(s)
- Saverio Cosola
- Department of Stomatology, Tuscan Stomatologic Institute, Foundation for Continuing Education and Dental Research, Camaiore (LU), Italy.,Department of Stomatology, Faculty of Medicine and Dentistry, University of Valencia, Valencia, Spain
| | - Giacomo Oldoini
- Department of Stomatology, Tuscan Stomatologic Institute, Foundation for Continuing Education and Dental Research, Camaiore (LU), Italy
| | - Enrica Giammarinaro
- Department of Stomatology, Tuscan Stomatologic Institute, Foundation for Continuing Education and Dental Research, Camaiore (LU), Italy
| | - Ugo Covani
- Department of Stomatology, Tuscan Stomatologic Institute, Foundation for Continuing Education and Dental Research, Camaiore (LU), Italy.,Department of Stomatology, Saint Camillus International University of Health Sciences (UniCamillus), Rome, Italy
| | - Annamaria Genovesi
- Department of Stomatology, Tuscan Stomatologic Institute, Foundation for Continuing Education and Dental Research, Camaiore (LU), Italy
| | - Simone Marconcini
- Department of Stomatology, Tuscan Stomatologic Institute, Foundation for Continuing Education and Dental Research, Camaiore (LU), Italy.,Department of Stomatology, Saint Camillus International University of Health Sciences (UniCamillus), Rome, Italy
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11
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Chatzigiannidou I, Teughels W, Van de Wiele T, Boon N. Oral biofilms exposure to chlorhexidine results in altered microbial composition and metabolic profile. NPJ Biofilms Microbiomes 2020; 6:13. [PMID: 32198347 PMCID: PMC7083908 DOI: 10.1038/s41522-020-0124-3] [Citation(s) in RCA: 36] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2019] [Accepted: 02/27/2020] [Indexed: 01/31/2023] Open
Abstract
Oral diseases (e.g., dental caries, periodontitis) are developed when the healthy oral microbiome is imbalanced allowing the increase of pathobiont strains. Common practice to prevent or treat such diseases is the use of antiseptics, like chlorhexidine. However, the impact of these antiseptics on the composition and metabolic activity of the oral microbiome is poorly addressed. Using two types of oral biofilms—a 14-species community (more controllable) and human tongue microbiota (more representative)—the impact of short-term chlorhexidine exposure was explored in-depth. In both models, oral biofilms treated with chlorhexidine exhibited a pattern of inactivation (>3 log units) and fast regrowth to the initial bacterial concentrations. Moreover, the chlorhexidine treatment induced profound shifts in microbiota composition and metabolic activity. In some cases, disease associated traits were increased (such as higher abundance of pathobiont strains or shift in high lactate production). Our results highlight the need for alternative treatments that selectively target the disease-associated bacteria in the biofilm without targeting the commensal microorganisms.
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Affiliation(s)
| | - Wim Teughels
- Department of Oral Health Sciences, KU Leuven, Kapucijnenvoer 33, 3000, Leuven, Belgium
| | - Tom Van de Wiele
- Center for Microbial Ecology and Technology, Coupure Links 653, 9000, Gent, Belgium
| | - Nico Boon
- Center for Microbial Ecology and Technology, Coupure Links 653, 9000, Gent, Belgium.
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12
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Marconcini S, Goulding M, Oldoini G, Attanasio C, Giammarinaro E, Genovesi A. Clinical and patient-centered outcomes post non-surgical periodontal therapy with the use of a non-injectable anesthetic product: A randomized clinical study. ACTA ACUST UNITED AC 2019; 10:e12446. [PMID: 31353819 PMCID: PMC6899940 DOI: 10.1111/jicd.12446] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2019] [Revised: 07/08/2019] [Accepted: 07/09/2019] [Indexed: 01/01/2023]
Abstract
Aim The aim of this study was to determine the impact of different full‐mouth decontamination (FMD) protocols on the effectiveness of an intrapocket anesthetic gel in periodontal maintenance patients. Methods Patients undergoing the periodontal maintenance program and with the need for FMD participated in this study. Patients were randomly allocated to non‐surgical periodontal therapy (NSPT) with either a preparatory 15‐day decontamination phase, including chlorhexidine mouth rinse and domiciliary hygiene instructions (modified FMD: test group), or without it (FMD: control group). In both groups, NSPT was performed with the aid of a non‐injectable anesthetic gel. Clinical and patient‐related outcomes were recorded during a 6‐month follow‐up period. Results Sixty patients completed the 6‐month study. Both groups experienced relevant clinical improvements after NSPT, but the test group showed a significant change in periodontal parameters already after the initial 15‐day preparatory period, and overall significantly better results in periodontal outcomes when compared with the control group at the last 6‐month follow up: the gingival index was 2.07 ± 1.25 in the control group and 1.13 ± 0.51 in the test group. Less pain and dental‐related anxiety were perceived by patients in the test group showing a 6‐month mean visual analog scale of 2.13 ± 1.25 in the control group and 1.13 ± 0.83 in the test group. Conclusion The present study suggested that the modification of the standard FMD could improve the clinical efficacy of non‐injectable anesthetic, along with patients’ short‐ and mid‐term appreciation and compliance.
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13
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Effectiveness of Different Commercial Chlorhexidine-Based Mouthwashes After Periodontal and Implant Surgery: A Systematic Review. IMPLANT DENT 2019; 28:74-85. [PMID: 30648980 DOI: 10.1097/id.0000000000000854] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVES The aim of the present study was to review the effectiveness, side effects, and patient acceptance of different concentrations and formulation of chlorhexidine-based mouthwashes used after periodontal and implant surgery. MATERIALS AND METHODS The PRISMA guideline was adopted in the search strategy using electronic databases PubMed and MEDLINE to identify randomized and case-control prospective studies on humans written in English language and published up to September 2017. RESULTS A total of 10 articles were selected for a total of 344 patients. Because of the significant heterogeneity of the outcome measures, meta-analysis was not performed, and the data were summarized in a table. A positive relationship between the use of chlorhexidine and reduction of plaque was found, demonstrating the effectiveness of the substance in terms of antisepsis and decrease of inflammation after periodontal and implant surgery. CONCLUSION Chlorhexidine is recognized as the primary agent for plaque control and the gold standard in preventing infection, although the presence of largely known side effects would affect patient compliance. Future research should be directed at finding chlorhexidine formulation with negligible adverse effects, without compromising or even increasing its effectiveness as the antiseptics and antiplaque agent.
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14
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Effect of an Experimental Formulation Containing Chlorhexidine on Pathogenic Biofilms and Drug Release Behavior in the Presence or Absence of Bacteria. Pharmaceutics 2019; 11:pharmaceutics11020088. [PMID: 30791400 PMCID: PMC6410057 DOI: 10.3390/pharmaceutics11020088] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2019] [Revised: 02/12/2019] [Accepted: 02/18/2019] [Indexed: 01/09/2023] Open
Abstract
(1) Background: For any antibacterial oral formulation to be successful, it must present effects in the presence of biofilms. Therefore, our aim is to analyze the drug release and the antibiofilm effects of a semi-solid formulation containing chlorhexidine (CHX) in the presence of pathogenic biofilms. (2) Methods: The biofilms of Streptococcus mutans (n = 6) or Porphyromonas gingivalis (n = 3) were formed for 6 and 4 days, respectively, being exposed to: 1) a CHX system or 2) vehicle control without CHX. A group without treatment was included as negative control. The acidogenicity, CHX quantification and bacterial viability were determined. A dissolution assay in a buffer and culture medium in the absence of bacteria was also performed. (3) Results: Although the CHX quantification in the culture medium of both biofilms was lower compared to the buffer (p < 0.05) and the culture medium in the absence of bacteria, the CHX system was able to display antibiofilm effects until 96 h for the S. mutans biofilms (p < 0.05) and 72 h for the P. gingivalis biofilms (p < 0.05). (4) Conclusions: The experimental formulation is able to extend chlorhexidine effects, even in challenging conditions such as in the presence of bacteria, allowing the in vitro control of cariogenic biofilms for 4 days and periodontopathogenic biofilms for 3 days.
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15
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Biofilm Removal and Bacterial Re-Colonization Inhibition of a Novel Erythritol/Chlorhexidine Air-Polishing Powder on Titanium Disks. MATERIALS 2018; 11:ma11091510. [PMID: 30142888 PMCID: PMC6164901 DOI: 10.3390/ma11091510] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/23/2018] [Revised: 08/15/2018] [Accepted: 08/18/2018] [Indexed: 01/10/2023]
Abstract
Air-polishing with low abrasiveness powders is fast arising as a valid and mini-invasive instrument for the management of biofilm colonizing dental implants. In general, the reported advantage is the efficient removal of plaque with respect to the titanium integrity. In the present study, we evaluated the in situ plaque removal and the preventive efficacy in forestalling further infection of an innovative erythritol/chlorhexidine air-polishing powder and compared it with sodium bicarbonate. Accordingly, two peri-implantitis-linked biofilm formers, strains Staphylococcus aureus and Aggregatibacter actinomycetemcomitans, were selected and used to infect titanium disks before and after the air-polishing treatment to test its ability in biofilm removal and re-colonization inhibition, respectively. Biofilm cell numbers and viability were assayed by colony-forming unit (CFU) count and metabolic-colorimetric (2,3-Bis-(2-Methoxy-4-Nitro-5-Sulfophenyl)-2H-Tetrazolium-5-Carboxanilide) (XTT) assay. Results demonstrated that air-polishing performed with either sodium bicarbonate or erythritol/chlorhexidine was effective in reducing bacteria biofilm viability and number on pre-infected specimens, thus showing a similar ability in counteracting existing infection in situ; on the other hand, when air-polished pre-treated disks were infected, only erythritol/chlorhexidine powder showed higher post-treatment biofilm re-growth inhibition. Finally, surface analysis via mechanical profilometry failed to show an increase in titanium roughness, regardless of the powder selected, thus excluding any possible surface damage due to the use of either sodium bicarbonate or erythritol/chlorhexidine.
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16
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Activity of taurolidine gels on ex vivo periodontal biofilm. Clin Oral Investig 2017; 22:2031-2037. [DOI: 10.1007/s00784-017-2297-6] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2016] [Accepted: 12/06/2017] [Indexed: 12/27/2022]
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17
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A cytometric approach to follow variation and dynamics of the salivary microbiota. Methods 2017; 134-135:67-79. [PMID: 28842259 DOI: 10.1016/j.ymeth.2017.08.009] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2017] [Revised: 07/07/2017] [Accepted: 08/16/2017] [Indexed: 01/16/2023] Open
Abstract
Microbial flow cytometry is an established fast and economic technique for complex ecosystem studies and enables visualization of rapidly changing community structures by measuring characteristics of single microbial cells. Cytometric evaluation routines are available such as flowCyBar which are useful for automatic data processing. Here, a cytometric workflow was established which allows to routinely analyze salivary microbiomes on the example of ten oral healthy subjects. First, saliva was collected within a 3-month period, cytometrically analyzed and the evolution of the microbiomes followed as well as the calculation of their intra- and inter-subject similarity. Second, the respective microbiomes were stressed by exposition to high sugar or acid concentrations and immediate changes were recorded. Third, bactericide solutions were tested on their impact on the microbiomes. In all three set ups huge intra-individual variations in cytometric community structures were found to be largely absent, even under stress, while inter-individual diversity was obvious. The bacterial cell counts of saliva samples were found to vary between 3.0×107 and 6.2×108 cells per sample and subject in undisturbed environments. The application of the two bactericides did not cause noteworthy diversity changes but the loss in cell numbers by about 50% was high after treatment. Illumina® sequencing of whole microbiomes or sorted sub-microbiomes revealed typical phyla such as Firmicutes, Proteobacteria, Actinobacteria, Bacteroidetes and Fusobacteria. This approach is useful for fast monitoring of individual salivary microbiomes and automatic calculation of intra- and inter-individual dynamic changes and variability and opens insight into ecological principles leading to their sustainment in their individual environment.
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18
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Efficacy of a mouthrinse based on hydroxyapatite to reduce initial bacterial colonisation in situ. Arch Oral Biol 2017; 80:18-26. [DOI: 10.1016/j.archoralbio.2017.03.013] [Citation(s) in RCA: 45] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2016] [Revised: 02/15/2017] [Accepted: 03/17/2017] [Indexed: 12/30/2022]
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19
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Rodriguez Herrero E, Boon N, Pauwels M, Bernaerts K, Slomka V, Quirynen M, Teughels W. Necrotrophic growth of periodontopathogens is a novel virulence factor in oral biofilms. Sci Rep 2017; 7:1107. [PMID: 28439126 PMCID: PMC5430626 DOI: 10.1038/s41598-017-01239-9] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2017] [Accepted: 03/28/2017] [Indexed: 01/05/2023] Open
Abstract
The oral use of antimicrobial agents embedded in toothpastes and mouth rinses results in an oral microbial massacre with high amounts of dead bacteria in close proximity to few surviving bacteria. It was hypothesized that this provides the surviving pathogenic bacteria a large amount of dead microbial biomass as a nutritional source for growth (necrotrophy). This study demonstrated the necrotrophic growth of periodontal pathogens in the presence of different dead oral species. In addition, the presence of dead bacteria resulted in an outgrowth of several periodontal pathogens in complex multi-species biofilms. Additionally, upon contact with dead oral bacteria, virulence genes of P. intermedia and P. gingivalis were up-regulated (necrovirulence). This resulted in a more pronounced epithelial cytotoxicity (necrotoxicity). These findings indicate that presence of dead bacteria induce necrotrophy, necrovirulence and necrotoxicity in several oral pathogens.
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Affiliation(s)
| | - Nico Boon
- Center for Microbial Ecology and Technology (CMET), Ghent University, Coupure links 653, 9000, Gent, Belgium
| | - Martine Pauwels
- Department of Oral Health Sciences, KU Leuven, Kapucijnenvoer 33, 3000, Leuven, Belgium
| | - Kristel Bernaerts
- Bio- and Chemical Systems Technology, Reactor Engineering and Safety, Department of Chemical Engineering, KU Leuven (University of Leuven), Leuven Chem&Tech, Celestijnenlaan 200F (bus 2424), 3001, Leuven, Belgium
| | - Vera Slomka
- Department of Oral Health Sciences, KU Leuven, Kapucijnenvoer 33, 3000, Leuven, Belgium
| | - Marc Quirynen
- Department of Oral Health Sciences, KU Leuven, Kapucijnenvoer 33, 3000, Leuven, Belgium.,Dentistry, University Hospitals Leuven, Kapucijnenvoer 33, 3000, Leuven, Belgium
| | - Wim Teughels
- Department of Oral Health Sciences, KU Leuven, Kapucijnenvoer 33, 3000, Leuven, Belgium. .,Dentistry, University Hospitals Leuven, Kapucijnenvoer 33, 3000, Leuven, Belgium.
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20
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Shunsheng Han C. A specific hygiene hypothesis. Med Hypotheses 2016; 93:146-9. [PMID: 27372876 DOI: 10.1016/j.mehy.2016.05.029] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2015] [Accepted: 05/24/2016] [Indexed: 10/21/2022]
Abstract
Allergic diseases have reached epidemic proportions in Western populations in the last several decades. The hygiene hypothesis proposed more than twenty years ago has helped us to understand the epidemic and has been verified with numerous studies. However, translational measures deduced from these studies to prevent allergic diseases have not proven effective. Recent studies on immigrants' allergies and any potential association between oral infection and allergic diseases prompt me to propose a specific hygiene hypothesis to explain how oral hygiene practices might have contributed to the uprising of hay fever, the most common allergic disease. The historic oral hygiene level in US is closely associated with the emerging allergic epidemic. Future studies to test the hypothesis are needed and verification of the hypothesis can potentially yield highly effective measures to prevent allergic diseases.
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Affiliation(s)
- Cliff Shunsheng Han
- Los Alamos National Laboratory, Bioscience Division and Quality Performance Assurance Division, MS, M888, Los Alamos, NM 87545, USA
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