Conceptualization of Dental Caries by Undergraduate Dental Students from the First to the Last Year

Keyes triad in type 2 diabetes mellitus: A microbiological study

Background:

With the increasing prevalence of type 2 diabetes mellitus (DM), there is a need to assess if the elevated salivary glucose levels provide an environment conducive to the growth of cariogenic microorganisms specifically Streptocooccus mutans and Lactobacillus acidophilus.

Materials and Methods:

Forty-five patients were divided into three groups consisting of patients with type 2 DM with caries, patients with type 2 DM without caries and age-matched healthy nondiabetic individuals (control). Saliva samples were subjected to semiautomatic salivary glucose estimation by the glucose oxidase-peroxidase method, using the Tulip glucose estimation kit. Swabs were immediately inoculated onto Mitis Salivarius Bacitracin agar and Man Rogosa Sharpe agar.

Results:

In Group A, statistically significant positive correlation was found between S. mutans and salivary glucose (r = 0.858) as well as L. acidophilus and salivary glucose (r = 0.853). In Group B, a statistically significant positive correlation was found only between S. mutans and salivary glucose (r = 0.705) and not between L. acidophilus and salivary glucose (r = 0.387). The control group did not show a statistically significant correlation.

Conclusion:

It is established that salivary glucose levels reflect the diabetic state of an individual. The salivary glucose level predicted a 1.7 times higher caries susceptibility in a diabetic, as shown by results in this study. Salivary glucose causes an increase in the cariogenic load in diabetic patients, thus warranting a modification of the Keyes triad.

Conceptualization of dental caries by dental students is related to their preventive oral care routine

OBJECTIVE

Whether the understanding of dental caries influences how future dentists manage the disease themselves has not been previously studied. Thus, this study evaluated whether the conceptualization (understanding) of dental caries by dental students is related to their own preventive oral care routine.

METHODS

Dental students at a U.S. dental school (n = 517) were invited to voluntarily respond to an anonymous electronic survey in spring 2018. Demographic characteristics, caries conceptualization (CC), dental care habits, and self-caries risk determination were asked. Discursive responses to CC were analyzed by content analysis technique, and categories [c] were created. Chi-square and Fisher's exact tests were used for analysis.

RESULTS

Overall response rate was 54.5% (n = 282, 48.2% female). Three researchers independently analyzed discursive answers and classified them into 1 of 6 caries concept categories [c]: [c1] only signs of the disease (10.3%), [c2] bacterial disease-not specifying bacterial metabolism (38.3%), [c3] bacterial byproducts-not specifying substrate (13.8%), [c4] biological or multifactorial concept (24.8%), [c5] comprehensive multifactorial disease (8.2%), or [c6] other (4.6%). Only 33% completely defined dental caries according to the modern understanding of the disease (c4-c5). Statistical differences were found between: CC and diet modification, CC and rinsing after brushing, year of school (YS) and self-determined caries-risk, YS and brushing at school, and YS and rinsing after brushing (P < 0.05).

CONCLUSION

Our data suggest that the students' understanding of the disease can influence how they will manage the disease in terms of diet modification and behavior after brushing. Moreover, self-caries risk determination influenced students' brushing behavior.

Cariology education for undergraduate Brazilian dental students

ABSTRACT This study sought to provide an overview of current cariology education for undergraduate Brazilian dental students. Data collection was via a Portuguese version of a 12-item questionnaire (Schulte et al., 2011) that was sent to all Brazilian dental schools (n = 219). The response rate was 57.0% (n = 125). Of the schools that returned the questionnaire, 84.8% supported the development of a Brazilian cariology curriculum. The units responsible for teaching cariology were predominantly operative dentistry (49.6%), pediatric dentistry (49.6%), dental public health (44.8%), and cariology (32%). Theoretical teaching of cariology (74.4%) and pre-clinical exercises (63.2%) were cited to occur mainly during the second year of the course, while clinical activities were placed in the third (71.2%) and fourth (64.8%) years. Among respondents, 76.8% of the schools included dental erosion and 86.4% included defects of dental hard tissues, such as abrasion, in teaching cariology. This survey was able to determine the panorama of cariology education in Brazil and to detect some differences among Brazilian geographic areas. The promotion of a workshop to discuss the topics that should be taught to undergraduate dental students and the development of a Brazilian core curriculum in cariology would be likely to reduce the differences in teaching cariology in Brazil.

In situ Multispecies Colonization of An Acrylic Resin: Comparison to Oral Microbiome and Potential for Inflammatory Response

Background:

Conventional acrylic resin is prone to microbial colonization and may cause inflammatory and allergic response.

Aims:

This study aims to research the initial microbial adhesion in situ and tissue response to an acrylic resin used in prosthodontics.

Materials and Methods:

Disks of a commercial acrylic resin were prepared and included on the surface of individual intraoral splints fabricated for 50 participants. The splints were used for 4 h, under clinical conditions. Beforehand, each participant was swabbed to provide a control for microbiological comparison. A cytological control sample was also taken from the palate. After the time elapsed, each splint was removed and growth of anaerobes, aerobes, Pseudomonas, oral streptococci, staphylococci, yeasts, and Streptococcus mutans was determined by plate counts and compared to the oral microbiome. A cytological sample was taken from the contact zone, stained using the Papanicolaou technique, analyzed in light microscopy, and classified accordingly. Means and standard deviations were calculated, and a nonparametric Wilcoxon test was employed to compare experimental groups. The significance level was set at 0.05 (95% confidence interval, and statistical analysis was performed using Statistical Package for the Social Sciences (SPSS) version 20.0.

Results:

Nuclear-cytoplasm ratio increase was found in 84% of the smears retrieved from the contact zone. Over 60% showed nuclear alterations. With exception to yeasts and Pseudomonas, all microbial groups colonized the resin. No statistically significant differences were found between the oral microbiome and the acrylic resin's colonization except regarding yeasts (P > 0.05).

Conclusions:

Cellular alterations were found but a diagnosis of inflammation is inconclusive. Microbial adhesion to the acrylic resin was substantial, with multiple species adhering.

Knowledge of dental caries and salivary factors related to the disease: influence of the teaching-learning process

Knowledge of factors related to caries and the possible consequences in controlling the disease may show the use of education as a relevant tool for achieving success in terms of dental health maintenance. Therefore, the aim of the present study was to investigate the relationship between acquired knowledge and salivary factors related to dental caries for freshmen students (n = 44) and trainees (n = 32) of the Piracicaba Dental School. Knowledge about dental caries was evaluated by a discursive questionnaire analyzed by the content analysis technique. Salivary flow and pH, buffer capacity, salivary sucrase activity, microbiological counts (total microorganisms, mutans, and lactobacilli) and inorganic concentration of calcium, phosphorus, and fluoride in saliva were evaluated and compared between groups using the Mann-Whitney test, with a significance of 5%. Trainees demonstrated knowledge of the disease, whereas freshmen showed unspecific and confusing concepts. Among the factors analyzed, statistically significant differences were observed for pH, buffer capacity, sucrase activity, total microorganisms, and calcium and fluoride concentrations in saliva. Knowledge about the disease increases and improves over time during the undergraduate program (highest among trainees); although the students from the final year of the program consume more sugar than those from the previous one, they try to balance this activity with greater exposure to fluorides.