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Maduratna E, Sari DS, Rahayu RP, Masya RN, Adinar N. The Anti-Inflammatory Effect of Nigella sativa Toothpaste on Porphyromonas gingivalis Bacteria Through Decreased TNF-α, MMP-9, PGE-2 Expression in Wistar Rats. Eur J Dent 2024; 18:808-814. [PMID: 38744331 PMCID: PMC11290913 DOI: 10.1055/s-0043-1772700] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/16/2024] Open
Abstract
OBJECTIVE The main principle in preventing periodontal disease is to improve oral hygiene. The bacteria that cause the onset of periodontal disease, one of which is the Porphyromonas gingivalis bacterium, causes inflammation. Persistent inflammation causes tissue damage and alveolar bone resorption by secreting proinflammatory cytokines, matrix metalloproteinase-9 (MMP-9), prostaglandin E2 (PGE-2), and anti-inflammatory cytokines. In this case, preventive treatment is needed, such as using toothpaste that contains anti-inflammatories so that the progression of the disease does not get worse. The traditional ingredient currently being developed is Nigella sativa, which has anti-inflammatory properties. Therefore, this study analyzes the potential of toothpaste containing Nigella sativa on the expression of tumor necrosis factor-α (TNF-α), MMP-9, and PGE-2 in the Wistar rat model induced by Porphyromonas gingivalis bacteria. This study aims to prove the potential of Nigella sativa toothpaste to decrease the expression of PGE-2, TNF-α, and MMP-9 in the gingiva of rats induced by Porphyromonas gingivalis bacteria. MATERIALS AND METHODS Forty-five healthy male Wistar rats were used, consisting of the negative control group, which was only injected with Porphyromonas gingivalis bacteria ATCC3322. The positive control group was given enzyme toothpaste, and the treatment group was assigned 1 mg of Nigella sativa paste using a microbrush for 30 seconds on the gingiva incisors mandibular with a circular motion, given two times a day for a week. Immunohistochemical to see the expression of TNF-α, PGE-2, and MMP-9. Parametric comparative analysis using a one-way analysis of variance test was performed to analyze differences between groups. RESULTS AND DISCUSSION Nigella sativa toothpaste significantly reduced proinflammatory cytokines, as seen through the expression of TNF-α, PGE-2, and MMP-9 on days 3, 5, and 7 (p <0.05). CONCLUSION In the limit of studied animal model, this trial indicates that giving toothpaste with black seed extract (Nigella sativa) could inhibit inflammatory mediators, as seen from the decreased expression of MMP-9, TNF-α, and PGE-2 seen from the 3rd, 5th, and 7th days.
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Affiliation(s)
- Ernie Maduratna
- Department of Periodontics, Faculty of Dentistry Universitas Airlangga, Surabaya, Indonesia
| | - Desi Sandra Sari
- Department of Periodontics, Faculty of Dentistry, Universitas Jember, Jember, Indonesia
| | - Retno Puji Rahayu
- Department of Anatomical Pathology, Faculty of Dentistry Universitas Airlangga, Surabaya, Indonesia
| | - Resgita Nadila Masya
- Department of Periodontics, Faculty of Dentistry Universitas Airlangga, Surabaya, Indonesia
| | - Noor Adinar
- Department of Restorative Dentistry, Faculty of Dentistry, Universiti Malaya, Kuala Lumpur, Malaysia
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Jong FJX, Ooi DJ, Teoh SL. The effect of oil pulling in comparison with chlorhexidine and other mouthwash interventions in promoting oral health: A systematic review and meta-analysis. Int J Dent Hyg 2024; 22:78-94. [PMID: 37635453 DOI: 10.1111/idh.12725] [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: 11/07/2021] [Revised: 05/11/2023] [Accepted: 08/06/2023] [Indexed: 08/29/2023]
Abstract
OBJECTIVES A meta-analytic review was performed to critically synthesize the evidence of oil pulling on improving the parameters of gingival health, plaque control and bacteria counts against chlorhexidine and other mouthwash or oral hygiene practices. METHODS Databases including Medline, Embase and bibliographies were searched from inception to 1 April 2023. Randomized controlled trials (RCTs) with 7 days or longer duration of oil pulling with edible oils in comparison to chlorhexidine or other mouthwashes or oral hygiene practice concerning the parameters of plaque index scores (PI), gingival index scores (GI), modified gingival index scores (MGI) and bacteria counts were included. Cochrane's Risk of Bias (ROB) tool and the Grading of Recommendations Assessment, Development and Evaluation (GRADE) framework were employed to determine the quality of evidence. Two authors independently conducted study selection and data extraction. Meta-analyses of the effect of oil pulling on the parameters were conducted using an inverse-variance random-effects model. RESULTS Twenty-five trials involving 1184 participants were included. Twenty-one trials comparing oil pulling (n = 535) to chlorhexidine (n = 286) and non-chlorhexidine intervention (n = 205) were pooled for meta-analysis. More than half of the trials (n = 17) involved participants with no reported oral health issues. The duration of intervention ranged from 7 to 45 days, with half of the trials using sesame oil. When compared to non-chlorhexidine mouthwash interventions, oil pulling clinically and significantly improved MGI scores (Standardized mean difference, SMD = -1.14; 95% confidence interval [CI]: -1.31, -0.97). Chlorhexidine was more effective in reducing the PI scores compared to oil pulling, with an SMD of 0.33 (95% CI: 0.17, 0.49). The overall quality of the body of evidence was very low. CONCLUSIONS There was a probable benefit of oil pulling in improving gingival health. Chlorhexidine remained superior in reducing the amount of plaque, compared to oil pulling. However, there was very low certainty in the evidence albeit the clinically beneficial effect of oil pulling intervention.
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Affiliation(s)
- Freda Jia Xin Jong
- Department of Psychology, School of Medical and Life Sciences, Sunway University, Bandar Sunway, Malaysia
| | - Der Jiun Ooi
- Department of Oral Biology and Biomedical Sciences, Faculty of Dentistry, MAHSA University, Selangor, Malaysia
| | - Siew Li Teoh
- School of Pharmacy, Monash University Malaysia, Bandar Sunway, Malaysia
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Shirazi M, Pirzeh A, Atashgaran M. Antimicrobial properties of glass-ionomer cement incorporated with nano-hydroxyapatite against mutans streptococci and lactobacilli under orthodontic bands: An in vivo split-mouth study. Dent Res J (Isfahan) 2024; 21:1. [PMID: 38425324 PMCID: PMC10899160] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2023] [Revised: 10/19/2023] [Accepted: 10/30/2023] [Indexed: 03/02/2024] Open
Abstract
Background Fixed orthodontic appliances enhance dental plaque accumulation. Glass ionomer (GI) is among the most popular orthodontic cement. It possesses antibacterial properties; however, its antibacterial activity may not be sufficient for caries prevention. Although evidence shows that the addition of 8wt% nano-hydroxyapatite (nHA) may enhance the antibacterial properties of GI, no clinical study has been conducted in this respect. Thus, this study aimed to assess the subgingival accumulation of Streptococcus mutans (S. mutans) and Lactobacillus acidophilus (L. acidophilus) around orthodontic bands cemented with conventional GI and GI reinforced with 8wt% nHA. Materials and Methods This split-mouth clinical trial was conducted on 20 patients requiring a lingual arch. The patients were randomly assigned to two groups. In group 1, the right molar band was cemented with pure Fuji I (GC), and the left was cemented with Fuji I containing 8wt% nHA. In group 2, the right molar band was cemented with Fuji I containing 8wt% nHA, and the left was cemented with Fuji I. After 3 months, subgingival sampling was performed by sterile paper points. S. mutans and L. acidophilus were cultured on MSB and MRS agar, and colonies were counted by a colony counter. Data were analyzed by independent samples t-test using SPSS 25 at a 0.05 level of significance. Results The mean counts of S. mutans, aerobic and anaerobic lactobacilli, and total bacterial around orthodontic bands cemented with Fuji I containing 8wt% nHA were significantly lower than those around orthodontic bands cemented with pure Fuji I (P < 0.05). Conclusion The addition of 8wt% nHA to GI cement can enhance its antibacterial properties for the cementation of orthodontic bands, decrease the accumulation of cariogenic bacteria, and probably decrease the incidence of caries in orthodontic patients.
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Fujimoto A, Fujii K, Suido H, Fukuike H, Miyake N, Suzuki H, Eguchi T, Tobata H. Changes in oral microflora following 0.3% cetylpyridinium chloride-containing mouth spray intervention in adult volunteers after professional oral care: Randomized clinical study. Clin Exp Dent Res 2023; 9:1034-1043. [PMID: 38041504 PMCID: PMC10728501 DOI: 10.1002/cre2.810] [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: 06/13/2023] [Revised: 10/12/2023] [Accepted: 10/24/2023] [Indexed: 12/03/2023] Open
Abstract
OBJECTIVES This study explored the changes in bacterial flora composition and total bacterial count in the saliva and tongue coating, along with the change in the tongue coating index (TCI) following an intervention with 0.3% cetylpyridinium chloride (CPC) mouth spray after professional oral care. MATERIALS AND METHODS Fifty-two adult volunteers aged 30-60 years were equally divided into CPC spray (n = 26) and control (n = 26) groups. All subjects underwent scaling and polishing. The CPC spray group was administered four puffs of CPC spray to the tongue dorsum four times a day for 3 weeks. The control group performed only routine daily oral care (brushing) and did not use any other spray. Bacteriological evaluation of saliva and tongue coating was performed using 16S ribosomal RNA gene sequencing and quantitative polymerase chain reaction. The tongue coating was evaluated to calculate the TCI. A per-protocol analysis was conducted for 44 subjects (CPC spray group, n = 23; control group, n = 21). RESULTS At 1 and 3 weeks after CPC spray use, the flora of the saliva and tongue coating changed; the genus Haemophilus was dominant in the CPC spray group, whereas the genus Saccharibacteria was dominant in the control group. The sampling time differed among individual participants, which may have affected the bacterial counts. There was no significant intragroup change in TCI in either group. CONCLUSIONS CPC spray affected the bacterial flora in the saliva and tongue coating, particularly with respect to an increase in the abundance of Haemophilus. However, CPC spray did not change the TCI. These results suggest that it may be optimal to combine CPC spray with a physical cleaning method such as using a tongue brush or scraper. Clinical Trial Registration: University Hospital Medical Information Network UMIN000041140.
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Affiliation(s)
- Ai Fujimoto
- Research and Development, Sunstar Inc.OsakaJapan
| | - Kana Fujii
- Research and Development, Sunstar Inc.OsakaJapan
| | - Hirohisa Suido
- Department of Health and Nutrition, Faculty of Health ScienceKyoto Koka Women's UniversityKyotoJapan
| | - Hisae Fukuike
- Oral Health Promotion, Affiliated with the Sunstar FoundationOsakaJapan
| | - Naoko Miyake
- Sunstar Senri Dental Clinic, Affiliated with the Sunstar FoundationOsakaJapan
| | - Hidenori Suzuki
- Sunstar Senri Dental Clinic, Affiliated with the Sunstar FoundationOsakaJapan
| | - Toru Eguchi
- Research and Development, Sunstar Inc.OsakaJapan
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Oo MMT, Oo PH, Saddki N. Efficacy of 0.05% cetylpyridinium chloride mouthwash as an adjunct to toothbrushing compared with 0.12% chlorhexidine gluconate mouthwash in reducing dental plaque and gingival inflammation: A randomized control trial. Int J Dent Hyg 2023; 21:195-202. [PMID: 35946123 DOI: 10.1111/idh.12614] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2021] [Revised: 02/12/2022] [Accepted: 08/06/2022] [Indexed: 01/12/2023]
Abstract
OBJECTIVES This study determined the efficacy of alcohol-free 0.05% cetylpyridinium chloride (CPC) mouthwash as an adjunct to twice-daily toothbrushing in comparison with 0.12% chlorhexidine gluconate (CHX) mouthwash and a placebo in reducing plaque accumulation and gingival inflammation. The side effects of the mouthwashes were also determined. MATERIALS AND METHODS A double-blind, parallel, randomized control trial was conducted with 219 university students who were divided into three trial groups using block randomization: CPC, CHX and placebo groups. Clinical oral examinations to assess dental plaque accumulation (modified Quigley-Hein Plaque Index), gingival health (Löe and Silness Gingival Index) and tooth staining (modified Lobene Stain Index) were performed at baseline and at 6 weeks. RESULTS Plaque and gingivitis scores were not significantly different among participants at baseline. After 6 weeks, plaque and gingivitis scores between the CPC and placebo groups and between the CHX and placebo groups were found to be significantly different. However, there was no significant difference between the CPC and CHX groups. The staining scores of participants in the CPC group were lower than those in the CHX group, but the difference was not significant. Taste alteration and numbness were more common among participants in the CHX group than in the CPC group. No significant difference in the perception of a burning sensation was observed. CONCLUSIONS The 0.05% CPC mouthwash was as efficient as 0.12% CHX mouthwash in reducing dental plaque accumulation and gingival inflammation with fewer side effects, supporting its use as an adjunct to toothbrushing.
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Affiliation(s)
- Mon Mon Tin Oo
- School of Dental Sciences, Universiti Sains Malaysia, Health Campus, Kota Bharu, Malaysia
| | - Phyoe Htut Oo
- School of Dental Sciences, Universiti Sains Malaysia, Health Campus, Kota Bharu, Malaysia
| | - Norkhafizah Saddki
- School of Dental Sciences, Universiti Sains Malaysia, Health Campus, Kota Bharu, Malaysia
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Witkowska E, Łasica AM, Niciński K, Potempa J, Kamińska A. In Search of Spectroscopic Signatures of Periodontitis: A SERS-Based Magnetomicrofluidic Sensor for Detection of Porphyromonas gingivalis and Aggregatibacter actinomycetemcomitans. ACS Sens 2021; 6:1621-1635. [PMID: 33792284 PMCID: PMC8155661 DOI: 10.1021/acssensors.1c00166] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
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Recently, Porphyromonas gingivalis, the keystone pathogen implicated
in the development of gum disease
(periodontitis), was detected in the brains of Alzheimer’s
disease patients, opening up a fascinating possibility that it is
also involved in the pathobiology of this neurodegenerative illness.
To verify this hypothesis, an unbiased, specific, and sensitive method
to detect this pathogen in biological specimens is needed. To this end, our interdisciplinary
studies demonstrate that P. gingivalis can be easily identified by surface-enhanced Raman scattering (SERS).
Moreover, based on SERS measurements, P. gingivalis can be distinguished from another common periodontal pathogen, Aggregatibacter actinomycetemcomitans, and also from
ubiquitous oral Streptococcus spp.
The results were confirmed by principal component analysis (PCA).
Furthermore, we have shown that different P. gingivalis and A. actinomycetemcomitans strains
can easily adsorb to silver-coated magnetic nanoparticles (Fe2O3@AgNPs). Thus, it is possible to magnetically
separate investigated bacteria from other components of a specimen
using the microfluidic chip. To obtain additional enhancement of the
Raman signal, the NPs adsorbed to bacterial cells were magnetically
attracted to the Si/Ag SERS platform. Afterward, the SERS spectra
could be recorded. Such a time-saving procedure can be very helpful
in rapid medical diagnostics and thus in starting the appropriate
pharmacological therapy to prevent the development of periodontitis
and associated comorbidities, e.g., Alzheimerʼs disease.
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Affiliation(s)
- Evelin Witkowska
- Institute of Physical Chemistry, Polish Academy of Sciences, Kasprzaka 44/52, 01-224 Warsaw, Poland
| | - Anna M. Łasica
- Department of Bacterial Genetics, Institute of Microbiology, Faculty of Biology, University of Warsaw, Miecznikowa 1, 02-096 Warsaw, Poland
| | - Krzysztof Niciński
- Institute of Physical Chemistry, Polish Academy of Sciences, Kasprzaka 44/52, 01-224 Warsaw, Poland
| | - Jan Potempa
- Department of Microbiology, Faculty of Biochemistry, Biophysics, and Biotechnology, Jagiellonian University, Gronostajowa 7, 30-387 Krakow, Poland
- Oral Immunology and Infectious Diseases, University of Louisville School of Dentistry, 501 S. Preston Street, Louisville, Kentucky 40202, United States
| | - Agnieszka Kamińska
- Institute of Physical Chemistry, Polish Academy of Sciences, Kasprzaka 44/52, 01-224 Warsaw, Poland
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Antimicrobial effects in oral microenvironments by a novel herbal toothpaste. Contemp Clin Trials Commun 2021; 21:100680. [PMID: 33511298 PMCID: PMC7815994 DOI: 10.1016/j.conctc.2020.100680] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2020] [Revised: 11/07/2020] [Accepted: 11/22/2020] [Indexed: 11/22/2022] Open
Abstract
Objective This clinical study compared the antibacterial effects after brushing with a novel herbal toothpaste incorporating zinc [test] to a control fluoride toothpaste on anaerobic organisms, gram-negative bacteria and malodor bacteria of dental plaque, tongue scrapings and cheek surfaces. Methods This double-blind, two-cell study enrolled 44 adults [age range 19–63 years]. Subjects completed a 1-week washout and provided baseline oral samples i.e. dental plaque, tongue and cheek scrapings for microbiological analysis. Diluted samples for microbiological analyses were plated on agar to enumerate anaerobic organisms, gram-negative bacteria and malodor bacteria representing functional groups of organisms. Subjects were randomized to brush their teeth with either the test or control with the first brushing conducted under supervision in the dental clinic. Post-treatment samples were collected 12 h after 21 day hygiene with assigned toothpaste. After providing these samples, subjects brushed in the dental clinic with additional samples collected 4 h after brushing. Statistical analyses were conducted separately for each organism collected from each oral niche by t-test for within-treatment assessments and analysis of covariance (ANCOVA) for between-treatment comparisons. Results Treatment groups demonstrated no significant differences at baseline for anaerobic organisms, gram-negative bacteria and malodor bacteria in any oral niche (p > 0.05). The test demonstrated reductions between 42 and 68% for anaerobic bacteria in oral niches, 12 h after brushing with reductions increasing to 46–80%, 4 h after brushing. Similarly, the test demonstrated reductions between 49 and 61% for gram-negative bacteria of oral niches that increased to 54–69% at the 4 h post-brushing evaluation. Reductions in malodor organisms of 22–42% were noted 12 h after brushing that increased to 60–72%, 4 h after brushing. Conclusions In comparison to control, brushing with a novel herbal toothpaste demonstrated significant reductions in functional bacterial groups from distinct oral niches 12 h after brushing with additional microbial reductions 4 h after brushing.
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Burgette JM, Vujicic M, Booth M, Meltzer D, Best TJ, Neill J, Conicella ML, Joskow RW, Chalmers NI. Advancing oral health policy through persuasive messaging and effective research measures. J Public Health Dent 2020; 81:77-83. [PMID: 33135181 DOI: 10.1111/jphd.12422] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2019] [Revised: 09/13/2020] [Accepted: 10/16/2020] [Indexed: 12/23/2022]
Abstract
Oral health is often excluded from broad health policy discussions, addressed only in a policy silo. There is a paucity of research to guide policymaking as it relates to oral health. In response, AcademyHealth's Oral Health Interest Group organized a meeting during the 2019 AcademyHealth Annual Research Meeting to promote transdisciplinary dialog on the current state of oral health policy and the steps necessary to improve the oral health of Americans. This article summarizes the two main themes that emerged from the proceedings of the Oral Health Interest Group meeting: a) recommendations for advocating the inclusion of oral health in policy discussions and b) critical research topics and measures needed for effective oral health policies in the future.
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Affiliation(s)
- Jacqueline M Burgette
- Departments of Dental Public Health and Pediatric Dentistry, School of Dental Medicine, University of Pittsburgh, Pittsburgh, PA, USA.,Cecil G. Sheps Center for Health Services Research, University of North Carolina, Chapel Hill, NC, USA
| | - Marko Vujicic
- Health Policy Institute, American Dental Association, Chicago, IL, USA
| | - Meg Booth
- Children's Dental Health Project, USA
| | - David Meltzer
- Department of Medicine, University of Chicago, Chicago, IL, USA.,Center for Health and the Social Sciences, University of Chicago, Chicago, IL, USA
| | - Thomas J Best
- Center for Health and the Social Sciences, University of Chicago, Chicago, IL, USA
| | - James Neill
- Congressman Mike Simpson (ID-02), U.S. House of Representatives, USA
| | | | - Renée W Joskow
- Health Resources and Services Administration, U.S. Department of Health and Human Services, USA
| | - Natalia I Chalmers
- Center for Drug Evaluation and Research, U.S. Food and Drug Administration, USA
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Joshipura K, Muñoz-Torres F, Fernández-Santiago J, Patel RP, Lopez-Candales A. Over-the-counter mouthwash use, nitric oxide and hypertension risk. Blood Press 2020; 29:103-112. [PMID: 31709856 PMCID: PMC7125030 DOI: 10.1080/08037051.2019.1680270] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2019] [Revised: 10/07/2019] [Accepted: 10/09/2019] [Indexed: 12/20/2022]
Abstract
Purpose: Mouthwash is used by a large population. Short-term clinical trials have shown that antibacterial mouthwash deplete oral nitrate-reducing bacteria, and decrease systemic nitric oxide bioavailability. Our previous publication from the San Juan Overweight Adults Longitudinal Study (SOALS) was the first to show frequent over-the-counter mouthwash use was independently associated with increased risk of prediabetes/diabetes. This manuscript evaluates whether over-the-counter mouthwash was associated with increased risk of hypertension.Materials and methods: SOALS recruited 40-65 year old overweight/obese individuals; baseline evaluations started in 2011 and the 3-year follow-up exam was completed by 2016. From the 1028 participants (76%) who completed follow-up, we excluded people with reported physician diagnosis of hypertension or systolic or diastolic BP at or above the hypertension cut-offs (n = 481), missing smoking (n = 1), missing physical activity (n = 1) and missing alcohol intake (n = 5) at baseline; 540 participants were included. The primary exposure was mouthwash use twice daily or more. The primary outcome for this manuscript is self-reported physician-diagnosed hypertension over the follow-up. We used Poisson regression controlling for age, sex, smoking, physical activity, waist circumference, alcohol intake, systolic blood pressure, pre-diabetes/diabetes status and cardiac medication use. We additionally evaluated other mouthwash use categorizations.Results: Twelve percent (66/540) developed hypertension over follow-up. People who used mouthwash twice/day or more had higher incidence of hypertension compared to less frequent users (Incidence Rate Ratio = 1.85; 95% Confidence Interval: 1.17, 2.94), and compared to non-users (IRR = 2.17; 95% CI: 1.27, 3.71). Several additional potential confounders evaluated did not impact these associations. Associations persisted among never smokers. Additional outcomes including BP assessed at a single study visit did not show associations.Conclusion: In this study, frequent regular use of over-the-counter mouthwash was associated with increased risk of hypertension, independent of major risk factors for hypertension and several other potential confounders.
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Affiliation(s)
- Kaumudi Joshipura
- Center for Clinical Research and Health Promotion, University of Puerto Rico Medical Sciences Campus, San Juan, Puerto Rico
- Department of Epidemiology, Harvard T. H. Chan School of Public Health, Boston, MA, USA
| | - Francisco Muñoz-Torres
- Center for Clinical Research and Health Promotion, University of Puerto Rico Medical Sciences Campus, San Juan, Puerto Rico
| | - Jeanpaul Fernández-Santiago
- Center for Clinical Research and Health Promotion, University of Puerto Rico Medical Sciences Campus, San Juan, Puerto Rico
| | - Rakesh P Patel
- Department of Pathology and Center for Free Radical Biology, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Angel Lopez-Candales
- Cardiology Division, Department of Medicine, University of Puerto Rico Medical Sciences Campus, San Juan, Puerto Rico
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Haraszthy VI, Raylae CC, Sreenivasan PK. Antimicrobial effects of a stannous fluoride toothpaste in distinct oral microenvironments. J Am Dent Assoc 2019; 150:S14-S24. [PMID: 30797255 DOI: 10.1016/j.adaj.2019.01.007] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2018] [Revised: 01/02/2019] [Accepted: 01/05/2019] [Indexed: 12/13/2022]
Abstract
BACKGROUND Clinical research has shown a relationship between microbial accumulations and oral diseases such as gingivitis and caries. The mouth harbors large densities of bacteria in distinct oral microenvironments, that is, dental plaque on teeth, saliva, and soft tissues such as the tongue, cheek, and gingiva. In this home-use study, the authors compared the effects of brushing with a newly formulated stannous fluoride toothpaste and a sodium monofluorophosphate dentifrice on bacteria of distinct oral microenvironments. METHODS Adult participants completed a washout phase before baseline sampling of dental plaque, saliva, and scrapings from tongue, cheek, and gingiva, which were used for microbiological analysis. Treatments were randomly assigned: test (62 participants) and control (67 participants) for twice-daily toothbrushing over 8 weeks. After 4 weeks and 8 weeks, posttreatment samples 12 hours after brushing were collected for analysis. At these posttreatment visits, participants brushed in the dental clinic, and an additional sample was collected 4 hours later for microbiological analysis. RESULTS Relative to the control, 12 hours after brushing, the test toothpaste showed greater reductions of bacteria (ranging from 14% to 27%) at the 4-week evaluation, which increased to 27% to 41% after 8 weeks of brushing. Correspondingly, 4 hours after brushing with the test toothpaste at the 4-week evaluation, there were greater reductions of bacteria in the range of 22% to 59%, which increased to a range of 33% to 61% at the 8-week assessment for participants completing the study. CONCLUSIONS The stannous fluoride toothpaste provided bacterial reductions in all oral microenvironments 12 hours after brushing. In addition, the authors observed microbial reductions 4 hours after brushing, which increased after extended use. PRACTICAL IMPLICATIONS The results are appropriate for oral hygiene recommendations by dental professionals.
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Sreenivasan PK, Prasad KVV. Effects of a chlorhexidine mouthwash on clinical parameters of gingivitis, dental plaque and oral polymorphonuclear leukocytes [PMN]. Contemp Clin Trials Commun 2019; 19:100473. [PMID: 32760847 PMCID: PMC7393452 DOI: 10.1016/j.conctc.2019.100473] [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: 07/22/2019] [Revised: 09/18/2019] [Accepted: 10/14/2019] [Indexed: 11/28/2022] Open
Abstract
Histological features of oral inflammation include infiltration of polymorphonuclear leukocytes [PMN], however studies have not examined the effects of interventions mitigating inflammation on oral PMN. Methods: This double-blind clinical study examined the effects of rinsing with mouthwashes formulated with chlorhexidine [CHX], an ingredient widely utilized in the dental clinic in comparison to a control on oral PMN representing a novel measure of inflammation. A concurrent evaluation of dental plaque and gingival inflammation using widely accepted clinical indices was included in the study. The study enrolled adult subjects providing informed consent, met study criteria and registered gingival index scores of 1.0 or more at the screening visit. Subjects [n = 90; age range 19–58 years] completed a washout phase prior to baseline evaluations for PMN and clinical assessments for dental plaque and gingivitis. Treatments [CHX or a control mouthwash] were randomly assigned to subjects for twice-daily use for the next two weeks. Post-treatment evaluations similar to baseline were conducted after one and two week use of assigned treatment. Results: At baseline, no statistically significant differences between treatment groups for PMN or clinical indices for dental plaque or gingivitis were noted. Rinsing with CHX demonstrated significant reductions for PMN and dental plaque, gingivitis in comparison to the control group. After one and two week use of CHX, PMN demonstrated a 35.9% and 54.9% reduction respectively in comparison to the control group representing significant differences [p < 0.05]. At the one and two week post-treatment evaluations, rinsing with CHX demonstrated 15% and 25% reductions in gingivitis respectively and were significantly different from the control [p < 0.05]. Rinsing with CHX also demonstrated significant reductions in dental plaque of 15% and 19% at the one and two-week post-treatment evaluations respectively in comparison to the control [p < 0.05]. The CHX group also demonstrated reductions in interproximal scores and registered the lowest frequency of gingival index or dental plaque scores on all oral surfaces. Conclusions: Results outline an objective approach to evaluate oral inflammation demonstrating a large and sustained reduction in oral PMN by CHX with these outcomes numerically higher than a clinical index evaluating gingivitis. Enumeration of oral polymorphonuclear leukocytes [PMN] estimates the oral inflammatory burden. Rinsing with chlorhexidine demonstrated progressive PMN reductions corroborating gingivitis and dental plaque evaluations. Rapid PMN assessment provides objective assessment of treatment effects applicable for dental chair-side setting.
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Affiliation(s)
- Prem K Sreenivasan
- Department of Oral Biology, Rutgers School of Dental Medicine, Colgate-Palmolive, Piscataway, NJ, USA.,Department of Oral Biology, Rutgers School of Dental Medicine, Rutgers University, Newark, NJ, USA
| | - Kakarla V V Prasad
- Department of Public Health Dentistry, SDM Dental College and Hospital, Dharwad, India
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