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PubMed2005

Factors influencing the incidence and severity of oral mucositis in patients undergoing autologous stem cell transplantation.

This retrospective descriptive study documented the frequency of oral mucositis and examined the impact of certain variables in the development of oral mucositis in autologous stem cell transplants. Oral mucositis occurred in 90% of the patients, but 53.57% developed ulcerations. On average, oral mucositis started on day seven, lasted for six days and resolved on day 13 after the initiation of chemotherapy. Sodium bicarbonate mouthwash and mucositis mouthwash were commonly used interventions; 72.92% of the interventions were used as secondary prevention. Oral mucositis was significantly associated with diagnosis (lymphoma), chemotherapy (etoposide and melphalan), and level of prevention (secondary). Diagnosis (lymphoma), chemotherapy (etoposide and melphalan), serum creatinine (peak level), and level of prevention (secondary) were independent predictors of oral mucositis.

Adult↗

PubMed2001

The impact of chlorhexidine gluconate on the relative cell surface hydrophobicity of oral Candida albicans.

OBJECTIVES: Adherence of Candida albicans has been implicated as the first step in the pathogenesis of oral candidosis, and its relative cell surface hydrophobicity (CSH) a contributory physical force. Chlorhexidine gluconate is by far the commonest antiseptic mouthwash prescribed in dentistry. The intra-oral concentrations of the retained chlorhexidine mouthwash fluctuate considerably due to the dilution effect of saliva and the cleansing action of the oral musculature. Hence the objective of the present study was to investigate the effect of brief exposure to sub-therapeutic concentrations of chlorhexidine gluconate on the relative CSH of C. albicans. DESIGN: The CSH of the isolates was assessed by a biphasic aqueous-hydrocarbon assay. RESULTS: A statistically significant reduction in CSH was observed following the exposure of Candida isolates to 0.005 and 0.0025% chlorhexidine gluconate. CONCLUSIONS: These results elucidate additional mechanisms by which chlorhexidine gluconate suppress candidal pathogenicity despite a brief period of transient exposure within the oral environment.

Adhesiveness↗

PubMedDate not supplied

[Genetic testing for cystic fibrosis: evaluation of the Elucigene CF20 kit in blood and buccal cells].

Routine determination of mutations in cystic fibrosis requires accurate, rapid, reliable and low-cost methods, permitting the simultaneous detection of multiple mutations. The Elucigene CF20 kit developped by Cellmark Diagnostics, uses multiplex ARMS, which allows the screening for 20 CFTR gene mutations (deltaF508, G542X, N1303K, 1717-1G>A, G551D, W1282X, R553X, deltaI507, 1078delT, 2183AA>G, 3849+10kbC>T, R1162X, 621+1G>T, R334W, R347P, 3659delC, R117H, S1251N, E60X, A455E ) in a work day without specific instrumentation. The kit distinguishes between homozygotes and heterozygotes for deltaF508, but not for rare mutations. The kit detects from 68 to 92% of defective alleles in Caucasians. We evaluate the kit in a blind study in two independent laboratories. Thirty blood samples and thirty mouthwash samples from CF patients, carriers and unaffected individuals were analysed by the Elucigene CF20 kit. All the samples were previously analysed by denaturing gradient gel electrophoresis and sequencing. The Elucigene CF20 kit consists of three multiplexes. Each mutiplex contains ARMS specific primers for six to eight mutations and two control reactions. The absence of the upper control fragment indicates that a repeat test is required. We demonstrated a first time amplification rate of 98.3%: of the 60 samples tested, one required a reamplification. Results compared with the reference method demonstrated that in all cases where one or more of the 20 mutations detected by the kit were present in the test set, the kit accurately identified them. Reproducibility was assessed by repeating the analysis of a blood and mouthwash sample five times. Cross reactivity between R117C and R117H, R117P and R117H, R347P and R347H, deltaI507 and deltaF508, G551D and R553X were evaluated. Only a cross reactivity between R347P and R347H was observed. The kit is specially useful for first line study of patients and carrier identification.

Amino Acid Substitution↗

PubMed1975

Gas-liquid chromatographic determination of vinyl chloride in vinyl chloride polymers, food-simulating solvents, and other samples.

The determination of vinyl chloride (VC) in polyvinyl chloride (PVC), vegetable oils, food-simulating solvents, mouthwashes, and blood anticoagulant solutions by gas-liquid chromatography is described. PVC polymers are disolved in either tetrahydrofuran or dimethyl acetamide. Vegetable oils are diluted with an equal volume of tetrahydrofuran. The resulting solutions are injected into a gas-liquid chromatograph equipped with a flame ionization detector. Mouthwashes, blood anticoagulant solutions, and 3 food-simulating solvents, 3% acetic acid, 50% ethanol, and heptane, are analyzed by direct injection into a chromatograph. Sensitivities are such that 0.05 ppm VC in solution or 1 ppm VC in PVC can be quantitated.

Anticoagulants↗

PubMed2002

Clinical and mycological responses to fluconazole and fluconazole MIC in oropharyngeal candidiasis in HIV-infected patients.

INTRODUCTION: OPC is a common opportunistic infection in HIV-infected patients. Although some patients are asymptomatic, progression of the disease may occur leading to esophageal candidiasis. Fluconazole resistant candidiasis has been reported in several international studies. OBJECTIVES: This study aimed to test the MICs (minimal inhibitory concentrations) to fluconazole of Candida species isolated from mouthwash specimens of 54 HIV positive patients with oral candidiasis. Clinical and mycological responses to fluconazole were also assessed in 16 patients. MATERIAL AND METHOD: This was a prospective study. Mouthwash specimens were cultured on sabouraud dextrose agar twice. Candida species identification was performed and MICs for fluconazole were obtained using NCCLS guidelines. Clinical and mycological responses were assessed on day 14 and 42 in 16 patients who received a 14-day course of fluconazole. RESULTS: 48/54 patients (88.89%) were found to carry pure C. albicans. The other 6 patients (11.11%) had mixed Candida species on cultures. Among these 6 patients, 5 patients had mixed C. albicans and C. glabrata, and 1 patient had C. albicans and C. krusei. Fluconazole MICs of C. albicans, C. glabrata, and C. krusei ranged from 0.125-32 (median=0.250), 4-64 (median=2), and 8 g/L respectively. This study showed that the MICs to fluconazole of oropharyngeal Candida was a good predictor of the therapeutic responses.

Adult↗

PubMed2005

[Determination of SARS-CoV by simplified nested fluorescent RT-PCR].

OBJECTIVE: To establish a simple rapid and sensitive nested RT-PCR method for detection of SARS coronavirus RNA by designing the specific primers for SARS and optimizing the parameters for PCR. METHODS: Primers and fluorescent probes were designed according to the sequences of SARS coronavirus genes available from GenBank. The optimization of the parameters for PCR was performed in PE 7700 thermal cycle. The 36 serum samples and 40 mouthwash of SARS patients and 80 samples of healthy people were tested. RESULTS: The positive rate of patient serum and mouthwash was 33.6%, (12/36) and 67.5%, (27/40), respectively, while the positive rate of healthy people was zero (0/160). CONCLUSION: The simple nested RT-PCR method was a rapid, efficient and sensitive one for SARS early diagnosis.

Bodily Secretions↗

PubMed1987

Effects of benzydamine on the oral mucositis during antineoplastic radiotherapy and/or intra-arterial chemotherapy.

In view of the good results obtained with benzydamine against oral radio-chemomucositis in a previous trial, a double-blind/placebo study was undertaken in order to ascertain the possible oral histoprotective effect of benzydamine mouthwash during the intra-arterial polychemotherapy and/or radiotherapy for neoplasms of the head and neck. Statistical comparison of the results obtained in these two groups, treated with benzydamine and placebo mouthwash, revealed a marked difference in the clinical evolution of iatrogenic tissue damage. The benzydamine topical application was more effective than placebo in the control of mucositis symptoms and signs produced by radiotherapy and/or intra-arterial antineoplastic chemotherapy.

Administration, Topical↗

PubMed1984

Alcohol and the young child.

With the increasing availability of alcohol in modern times, the child neglect and abuse portrayed in Hogarth's engraving Gin Lane may once again be witnessed. Reports occur occasionally of alcohol being given deliberately to infants to quieten them, but alcohol poisoning in the slightly older child is not uncommon. The introduction of child-proof containers has altered poisoning figures recently. However, alcohol poisoning tends to occur at ages 3 and 4, that is, about 2 years after the peak of all poisonings in children. This difference may be an indication that alcohol is taken in imitation of parents' drinking, a suggestion which has some support from reported cases of mouthwash poisoning. Holidays and high days where children and alcohol mix, are potentially dangerous periods. Since alcohol poisoning can be fatal, yet if recognised is relatively easily managed, every child with the slightest degree of drowsiness should be suspect until proven or not by blood alcohol. The prevention of alcohol poisoning in the young child consists in protecting the alcohol by lock and key, not setting an example by drinking or gargling in front of children. Many substances such as mouthwash and perfume should also be under supervision. Once actual poisoning has occurred blood sugar is probably more important than the level of blood ethanol and blood sugar levels should be monitored frequently and the child treated with glucose, preferably intravenously.

Age Factors↗

PubMed1994

Shedding oral mucosa.

Four patients presented with asymptomatic gray-white oral mucosal tissues that sloughed and peeled away leaving a normal tissue base. This peeling phenomenon appeared unlike any known oral mucosal disease, although it somewhat resembled leukoedema and chemically irritated oral mucosa due to certain dentifrices and mouthwashes. Examination of biopsy tissue from three of the four cases along with stripped tissue from the fourth case revealed an intraepithelial cleft near the surface of each specimen. The linear cleft ran parallel to the epithelial surface. Foci of adjacent cells displayed intracellular edema, a feature commonly noted in leukoedema. There was evidence of neither acantholysis nor inflammation. The microscopic pattern was unlike the mucosal entities pemphigus vulgaris, mucosal pemphigoid, lichen planus, candidiasis, and mucosal biting. Although the authors questioned the patients in detail regarding all forms of mechanical and chemical trauma, including those from certain dentifrices and mouthwashes, they could not detect causative factors for these lesions.

Adult↗

PubMedDate not supplied

[The prevalence of caries and associated factors in 12-year-old schoolchildren of Barcelona].

OBJECTIVE: To find the prevalence of caries in the 12-year-old school population of the city of Barcelona. DESIGN: An epidemiological crossover survey of dental caries in a representative sample of children in Barcelona. PARTICIPANTS: 739 children in the 7th year of basic education, who were twelve years old at the moment of the examination and came from 35 schools in the city of Barcelona, were examined. MEASUREMENTS AND MAIN RESULTS: Prevalence of caries was 52% (60% in girls and 45% in boys) and the CAOD index (teeth with caries, absent because of caries or permanent teeth with fillings) was 1.37 (1.70 for girls and 1.12 for boys). 51% of the permanent teeth affected by caries had been filled. The distribution of the CAOD index showed that 23% (almost a quarter of the population studied) of 12-year old schoolchildren in Barcelona had 3 teeth or more affected by caries. In the logistical regression analysis, gender (being a girl, OR = 1.69) and the absence of a regular programme of fluoride mouthwashes (OR = 1.69) were associated with having a higher caries index (CAOD equal to or above 3). CONCLUSIONS: The results show caries indices which are generally low and a tendency to stability. The programmes of fluoride mouthwashes seem to be effective in decreasing the incidence of caries.

Child↗

PubMed1996

Smoking and drinking in relation to oral epithelial dysplasia.

Oral epithelial dysplasia (OED) is a histopathological diagnosis that is associated with an increased risk of oral cancer. The purpose of this case-control study was to measure the association between OED and the use of smoking tobacco and alcoholic beverages. Incident cases of OED (n = 127) were identified through two oral pathology laboratories. Controls, pair-matched 1:1 to cases on age (+/- 5 years), gender, appointment date (+/- 1 year), and surgeon, were identified through the office in which the respective case had been biopsied. Exposure information regarding smoking, drinking, and other potential risk factors was obtained through a standardized telephone interview. Conditional logistic regression was used to calculate measures of association and statistical significance. The odds ratio (OR) for current smoking adjusted for drinking, mouthwash use, denture status, and education was 4.1 (95% confidence interval, 2.1-7.9) relative to never/ex-smokers. The risk of OED increased with increasing levels of smoking and declined following smoking cessation, with ex-smokers of 15+ years demonstrating no excess risk relative to never smokers. Individuals drinking 7+ drinks/week, relative to less than that amount, had over twice the risk of OED (OR, 2.4; 95% confidence interval, 1.2-4.8) after controlling for smoking, mouthwash use, denture status, and education. Adjusted ORs tended to increase with increasing levels of alcohol intake. An exploratory analysis suggests that the joint effect of smoking and drinking may be more than additive as regards the risk of OED. The findings of this case-control study implicate smoking and drinking as important risk factors for OED.

Adult↗

PubMed2026

Cross-kingdom dynamics of the subgingival bacteriome and mycobiome: A pilot study on the effects of a novel HA-H₂O₂-Glycine formulation to treat periodontitis.

OBJECTIVES: Traditional periodontal therapy primarily focuses on bacterial biofilm control; however, recent evidence also suggests a critical role for the oral mycobiome. This study evaluated the clinical and ecological impact of a novel mouthwash formulation containing hyaluronic acid (HA), hydrogen peroxide (H2O2), and glycine on periodontal patients METHODS: This prospective, randomized split-mouth trial included 13 adult participants with periodontitis treated with HA-H2O2-glycine formula (BMG0703A) used twice a day for seven days. Subgingival plaque samples were collected from periodontal pocket and healthy control sites at baseline (T0) and one-week post-treatment (T1). Microbial and fungal communities were characterized using Next-Generation Sequencing (NGS) of the 16S rRNA and ITS2 regions. Linear Mixed Models (LMM) and Spearman correlation were used to assess taxonomic shifts and cross-kingdom relationships. RESULTS: Sequencing revealed a promising ecological shift: the bacteriome shifted from anaerobic dominance (Olsenella, Peptostreptococcus) toward a health-associated aerobic profile, with Rothia near-doubling (11.91% to 22.68%). The mycobiome underwent a "normalization" effect: Candida abundance decreased significantly (22.8% to 9.1%), while fungal Shannon diversity in pockets returned to healthy-site levels. Inter-kingdom analysis identified antagonistic relationships between expanding commensal bacteria and opportunistic fungi, suggesting that the intervention may help re-establish a protective bacterial niche. CONCLUSIONS: The HA-H2O2-glycine formulation seems to facilitate a rapid, cross-kingdom modulation of the subgingival niche. By reducing anaerobic pathogens and normalizing the mycobiome it appear to induce short-term changes, suggesting potential as adjunctive strategy in periodontal management. CLINICAL SIGNIFICANCE: The present work underlines the possible cross-Kingdom effects of a novel compound.

Humans↗

PubMed2000

Interventions for treating oral lichen planus.

BACKGROUND: Oral lichen planus is a chronic autoimmune disease of unknown aetiology that affects the inner surface of the mouth. The symptomatic forms are painful,tend to worsen with age and with remissions being rare. Current treatment is palliative and not curative, many topical and systemic agents have been tried with little hard evidence for efficacy. OBJECTIVES: To assess the effectiveness and safety of any form of palliative therapy against placebo for the treatment of symptomatic oral lichen planus. SEARCH STRATEGY: Electronic databases, handsearching of conference proceedings and specific journals, researchers in the field, drug manufacturers. SELECTION CRITERIA: Any placebo-controlled trial of palliative therapy for symptomatic oral lichen planus, using a randomised or quasi-randomised design that measured changes in symptoms and/or clinical signs. DATA COLLECTION AND ANALYSIS: Change in symptoms (pain, discomfort) and clinical signs (visual impression, lesion measurements) at the end of therapy. Odds ratio of improvement vs no improvement for each trial outcome and pooling where appropriate. MAIN RESULTS: A total of nine RCTs were identified. The nine interventions were grouped into four separate classes (cyclosporines, retinoids, steroids and phototherapy) for comparison. No therapy was replicated exactly, the closest replication involved two trials using high and low dose cyclosporine mouthwash. Only trials recording the same outcomes in each therapeutic class were pooled. The largest number of pooled trials was three. Large odds ratios with very wide confidence intervals indicating a statistically significant treatment benefit were seen in all trials. However this has to be tempered by considerations of the small study sizes, the lack of replication, the difficulty in measuring outcome changes and the very high likelihood of publication bias. Only systemic agents were associated with treatment toxicities, all other side-effects were mild and mainly limited to local mucosal reactions. REVIEWER'S CONCLUSIONS: The review provides only weak evidence for the superiority of the assessed interventions over placebo for palliation of symptomatic OLP. The results highlight the need for larger placebo-controlled RCTs with more carefully selected and standardised outcome measures before between-treatment comparisons can be properly interpreted.

Cyclosporins↗

PubMed1991

Pharmacokinetics of benzydamine after intravenous, oral, and topical doses to human subjects.

The pharmacokinetics of the anti-inflammatory drug benzydamine were determined after intravenous infusion of 5 mg to six healthy male subjects. Benzydamine was characterized as a drug of relatively low systemic clearance (ca. 160 ml min-1) but high volume of distribution (ca. 1101); the apparent terminal half-life in plasma was ca. 8 h. Benzydamine was well absorbed after oral administration, as indicated by a mean systemic availability of 87 per cent. However, absorption of the drug was low (less than 10 per cent of the dose) after its use by male subjects as a mouthwash, or after its application to female subjects as dermal cream and vaginal douche preparations. The data suggest that benzydamine is generally not well absorbed through the skin and non-specialized mucosae, thereby limiting unrequired systemic exposure to this drug when it is used by these routes.

Administration, Cutaneous↗

PubMed2006

Growth factors and cytokines in the prevention and treatment of oral and gastrointestinal mucositis.

GOALS OF WORK: Growth factors and cytokines may be useful in preventing chemotherapy (CT)- and radiotherapy (RT)-induced oral and gastrointestinal mucositis. Two systematic reviews of the medical literature on growth factors and cytokines for the amelioration of CT- and RT-induced mucositis throughout the alimentary tract were performed by the Mucositis Study Group of the Multinational Association of Supportive Care in Cancer/International Society for Oral Oncology. The aim of these evidence-based scientific reviews was to critically evaluate the literature and create evidence-based guidelines for the use of growth factors and cytokines in the prevention or treatment of CT- and RT-induced mucositis. METHOD: The two reviews covered articles on clinical trials from January 1966 through May 2002 and preclinical studies from June 2002 through May 2005, respectively. The systematic review process was based on a well-established method for evaluating scientific literature. MAIN RESULTS: The number of articles in the first review was 29. In the second review, 23 articles were evaluated, 14 preclinical and 9 clinical studies. It was concluded from the first review that there was no sufficient evidence to provide any recommendations for clinical practice guidelines regarding growth factors and cytokines. From the second review, a guideline could be presented recommending the use of recombinant human keratinocyte growth factor-1 (palifermin) to prevent oral mucositis in patients receiving high-dose CT and total body irradiation followed by stem cell transplantation for haematological malignancies. A guideline could also be provided suggesting that granulocyte macrophage colony-stimulating factor mouthwash not be used for the prevention of oral mucositis in the transplant setting with high-dose CT and autologous or allogeneic stem cell transplantation. CONCLUSIONS: These systematic reviews have provided clarity and shown exciting new results. Further studies will provide new options for this debilitating side-effect of cancer therapy.

Animals↗

PubMed2001

Effect of saliva substitutes on mineral content of demineralized and sound dental enamel.

The aim of this in vitro study was to evaluate the effects of commercially available saliva substitutes on the mineral content of pre-demineralized and sound enamel. From 56 bovine incisors 224 enamel specimens were prepared and hand-polished. The specimens were partially covered with nail varnish (control of sound enamel). In group 1, 112 samples were demineralized (18 days; 37 degrees C; pH 5.0) and a portion of the demineralized area was likewise covered with nail varnish. Subsequently, 16 specimens were exposed (14 days; 37 degrees C) to 10 ml of each of several different saliva substitutes (Artisial; Glandosane; Oralube; Saliva medac), or mouthwash solutions (Biotène; Meridol), respectively. Non-carbonated, fluoride-containing mineral water (Eptinger) was used as control. In group 2, the 112 sound enamel specimens were immersed directly in the solutions (without a demineralization period). After immersion, the specimens were cut perpendicular to the surface, and slabs (110 microns) were ground. Contact microradiographs were obtained and studied with a digital image-analyzing system. A dedicated software (TMR 1.24) was used to calculate the mineral content. Sound enamel (group 2) was significantly demineralized after immersion in Biotène and Glandosane (P < 0.001; Kruskal-Wallis). In group 1, mineral loss after storage in Biotène and Glandosane was significantly increased (P < 0.001), compared with the mineral content after demineralization. All other solutions revealed a significant mineral gain (P < 0.01; Wilcoxon), with the most pronounced effects after use of Oralube and mineral water (both containing calcium, phosphates, and fluorides). Therefore, administration of products similar to the last named can be recommended for dentate patients with salivary gland hypofunction.

Animals↗

PubMed2000

Clinical and antibacterial effect of tea tree oil--a pilot study.

The aim of this clinical pilot study was to compare the effect of tea tree oil with the effect of water and chlorhexidine on supragingival plaque formation and vitality. Eight subjects were asked to refrain from any kind of mechanical oral hygiene for 4 days after professional tooth cleaning (day 0), and to rinse with water instead for 1 week, with chlorhexidine in a second and tea tree oil in a third test week. The plaque index (PI), which was evaluated daily (days 1-4), served as a clinical control parameter. On the last day of the study (day 4), the plaque covering the front teeth was stained, photographed, and therefrom the plaque area (PA; %) was estimated using a digital measuring system. Each day of the study (days 1-4), the sampled plaque was examined using a vital fluorescence technique. Tea tree oil reduced neither the clinical parameters (PI and PA) nor the vitality of the plaque flora significantly. Within the limitations of the study design, it was determined that a solution with tea tree oil--utilized as ordinary mouthwash--has no positive effect on the quantity or quality of supragingival plaque.

Adult↗

PubMed2005

[Bone collected with a bone collector during dental implant surgery].

BACKGROUND: Simultaneous implantation and augmentation using autogenous bone collected during implant surgery is a well-established procedure in oral implantology. The aims of this study were (1) to identify any bacterial contamination of bone obtained with a bone collector, and (2) to verify the antimicrobial effect of rinsing the bone collector with a 0.1% chlorhexidine solution prior to augmentation. MATERIAL AND METHODS: A total of 39 patients undergoing a simultaneous implantation and augmentation procedure were examined. All patients rinsed their mouths with a 0.1% chlorhexidine solution for 2 min prior to surgery. Bone was collected with the Osseous Coagulum Trap, while saliva was collected with a separate suction tip. Once bone collection was complete a microbiological swab was taken from the bone collector (sample 1); before the bone was taken from it 200 ml of a 0.1% chlorhexidine solution was aspirated into the collector, after which the bone was removed and the collector sieve was (sample 2) sent for microbiological analysis which included aerobic and anaerobic cultivation of microorganisms and their identification and semiquantitative assessment of microbial growth. RESULTS: Before the collector was rinsed with chlorhexidine microbial contamination was found in 34 (82.7%) of the 39 samples, and 37 different microbial species were identified in cultures. When the collector had been rinsed with 200 ml 0.1% chlorhexidine a significantly lower rate of microbial contamination was found: 66.7% of the samples were sterile. CONCLUSIONS: Despite separate suction techniques for bone dust and saliva and preoperative use of a chlorhexidine mouthwash, bacterial contamination of bone obtained from the mouth with a bone collector has to be anticipated. Not only the physiological bacteria of the oral flora, but also the microorganisms frequently associated with implant failure can be found. Rinsing the bone collector with 200 ml of a 0.1% chlorhexidine solution significantly reduces microbial contamination. The effects on bone vitality must be studied before routine rinsing with chlorhexidine can be recommended.

Adult↗