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PubMed2005

Sanguinarine activates polycyclic aromatic hydrocarbon associated metabolic pathways in human oral keratinocytes and tissues.

Sanguinarine's use in human clinical applications is currently controversial. While some studies have demonstrated sanguinarine's anti-inflammatory and anti-oxidant properties, other investigations reported sanguinarine's procarcinogenic effects. Like the tobacco-associated carcinogen, benzo(a)pyrene (B(a)P), sanguinarine is a polycyclic aromatic hydrocarbon (PAH). PAH exposure activates the aryl hydrocarbon transcription activating factor (AhR), resulting in nuclear translocation, binding to the aryl hydrocarbon nuclear translocator (ARNT), which thereby increases expression of a pool of carcinogen metabolizing enzymes. The goal of this study was to investigate whether sanguinarine activates this PAH-associated signaling cascade in human oral cells and tissues. Our results demonstrate that sanguinarine: (i) results in formation of the AhR-ARNT complex, (ii) induces AhR-associated gene expression, (iii) inhibits cytochrome P450 1A1 (CYP 1A1) microsomal oxidative activity and (iv) pretreatment upregulates CYP 1A1 function. Collectively, these data provide evidence that sanguinarine activates PAH-associated signaling and metabolic pathways. Notably, previous studies have demonstrated that mammalian hepatic microsomes metabolize sanguinarine to a mutagenic epoxide. Persons who respond to sanguinarine exposure with induction of primarily Phase I relative to Phase II enzymes are, therefore, at risk for sanguinarine bioactivation and its potential mutagenic effects.

Adult↗
PubMed2004

Efficacy of chlorhexidine gluconate rinse for treatment and prevention of oral candidiasis in HIV-infected children: a pilot study.

PURPOSE: We evaluated the effect of chlorhexidine (CHX) 0.12% rinses on the clinical and microbiologic manifestations of oral candidiasis in HIV-infected children. STUDY DESIGN: This was a cross-sectional, clinical intervention study of 38 HIV-positive children. Inclusion in the study was based on oral examination and positive oral culture for Candida. At baseline, subjects with no clinical lesions but who were culture-positive for Candida (N = 9) were placed on preventive therapy of CHX q.d. for 90 days. Subjects with clinical oral candidiasis (N = 9) were placed on therapeutic CHX b.i.d. All 38 subjects received oral exams at monthly intervals. At 90 days oral mucosal samples were again taken for Candida. Colony-forming units (CFU) were determined before and after CHX treatment. RESULTS: Of 18 culture-positive subjects, 12 were included in the CFU analyses. After 3 months of CHX oral rinse therapy, Candida was undetectable in 3 children; another 8 showed an average 2-fold reduction in CFU. In 1 child the number of CFU increased modestly. Overall, the average pre- and posttreatment mean CFU was 6.18 +/- 2.19 and 2.73 +/- 3.15, respectively (P = .009). Five patients with clinical oral candidiasis at baseline, including all 3 who had pseudomembranous candidiasis, were free of signs of disease at the end of the study. CONCLUSIONS: This study suggests that the topical disinfectant CHX may be a promising agent for treating and preventing oral candidiasis in HIV-infected children.

Adolescent↗
PubMed2005

Prevention of alveolar osteitis with chlorhexidine: a meta-analytic review.

OBJECTIVE: The objective of this study was to assess if chlorhexidine (CHX) rinse decreases the occurrence of alveolar osteitis (AO) following third molar removal. STUDY DESIGN: A literature search identified 7 randomized prospective clinical trials reporting incidence of AO following removal of mandibular third molars. Studies were combined into 2 groups and summary relative risks were calculated for each group. One group of studies evaluated rinsing on the day of surgery only and the second group of studies rinsed at least on the day of surgery and several days after surgery. RESULTS: The relative risk for the single rinse group was 1.36 (95% confidence interval [CI] 0.80, 2.33), P>.05, whereas for the multiple rinse group, the relative risk was 1.90 (95% CI 1.46, 2.47), P<.05. CONCLUSION: Rinsing with CHX on the day of surgery and several days after may reduce the incidence of AO.

Anti-Infective Agents, Local↗
PubMed2006

Oral pityriasis rubra pilaris.

Pityriasis rubra pilaris is a chronic, papulosquamous dermatosis of unknown etiology. Oral mucosal involvement of this condition is rare with only 3 previously reported cases in the English literature. A case of a 68-year-old man with pityriasis rubra pilaris with involvement of tongue and palate is presented. Clinical features, histopathologic features, and management of pityriasis rubra pilaris are discussed. We hereby present an additional case, the fourth worldwide, and review the literature.

Aged↗
PubMed1988

Xylitol chewing gum in caries prevention: a field study in children.

As the prevalence of dental caries decreases in industrialized nations like the United States, it simultaneously increases in developing nations and Third World countries. The decrease in the West is attributed to increased use of fluorides, but the increase in developing countries has been explained by an increase in the consumption of sugar. As this information continues to propel researchers to find sucrose substitutes, xylitol has been singled out as a proposed sucrose replacement. The question tackled by this study was: Can the daily use of chewing gum containing xylitol increase the efficacy of the existing caries-preventive measures now regularly used for 11- to 15-year-old children in most industrialized western countries?

Adolescent↗
PubMed1994

Antimicrobial mouthrinses: overview and update.

The Seal of Acceptance of the American Dental Association's Council on Dental Therapeutics has been awarded to Listerine and chlorhexidine gluconate (Peridex). The mechanism of action of Listerine involves bacterial cell wall destruction, bacterial enzymatic inhibition, and extraction of bacterial lipopolysaccharides. Chlorhexidine has the property of substantivity, i.e. the ability to bind to hard and soft tissue with slow release. Antibacterial mouthrinses/dentifrices containing triclosan hold promise for the reduction of plaque and gingivitis but are not yet available in the United States. The quaternary ammonium compounds and sanguinarine compounds (Viadent) have some merit, but studies of their efficacy in plaque and gingivitis reduction are mixed. New products containing various fluorides and oxygenating agents may have potential for the future as antiplaque and antigingivitis agents.

Alkaloids↗
PubMed1994

Evaluation of antimicrobial mouthrinses and their bactericidal effectiveness.

The mechanisms of action of antimicrobials have been based in the past on in vitro data obtained from laboratory experiments performed on pure cultures of bacteria. A more complete understanding of oral antimicrobials and their mechanisms of action will results from testing of agents in systems that more closely resemble environmental areas existing in the oral cavity. It is proposed that mechanisms of drug action be studied with a drug held at suboptimal (sublethal) concentrations for short periods and in a dynamic environment that resembles the mouth. Adequate guidelines provided by the American Dental Association Council on Dental Therapeutics are available and have helped to determine the efficacy of these agents over long periods in appropriate populations.

Anti-Infective Agents, Local↗
PubMed1994

A clinician's perspective on antimicrobial mouthrinses.

Today's dental professional must advise patients as to the antimicrobial mouthrinse appropriate for their periodontal condition. Considerations such as chemical nature, mechanism of action, efficacy, and safety of mouthrinses are important to the clinician. Taste and cost are equally important considerations to the patient. No ideal antimicrobial mouthrinse exists; yet, chlorhexidine gluconate (Peridex), Listerine, and two of its generic equivalents have the American Dental Association's Seal of Acceptance. An expanded role of antimicrobial mouthrinses that holds promise is that of preprocedural rinsing. This protocol can decrease the number of microorganisms aerosolized during numerous dental procedures.

Aerosols↗
PubMed1994

Antimicrobial mouthrinses: impact on dental hygiene.

Within the assessment, planning, implementation, and evaluation phases of the dental hygiene process of care model, the hygienist can decide which antimicrobial mouthrinse is best suited for a patient's given periodontal condition. First, the initial periodontal condition and the home care of the patient is assessed. Next, the hygienist can plan which protocol, in-office and/or at-home, will best meet the needs of the patient. Implementation of a program can include antimicrobial mouthrinses as an adjunct to scaling and root planing in the office, and the mechanical removal of plaque at home. Finally, the hygienist can evaluate the concerted efforts of both patient and clinician. Patients with extensive crowns and bridges, implants, and orthodontics can also benefit from the use of antimicrobial mouthrinses.

Aerosols↗
PubMed1994

Expanded and future uses of mouthrinses.

The use of antimicrobial mouthrinses is important to dental professionals and their patients. Listerine Antiseptic was found to greatly decrease the anaerobic and aerobic bacteria associated with bacteremia, when used as a subgingival irrigant prior to scaling. Furthermore, preprocedural rinsing with either Listerine or chlorhexidine gluconate (Peridex) can greatly decrease the number of bacteria aerosolized during many dental procedures. Studies have shown that both Listerine and chlorhexidine have anti-Candida properties and therefore are helpful to patients who are immunosuppressed and subject to the opportunistic infection of candidiasis. Chlorhexidine has also been shown to decrease the incidence and severity of mucositis during cancer chemotherapy. Healing of the wounds and aiding in plaque control following periodontal surgery are further benefits of chlorhexidine and Listerine. Finally, each of these antimicrobials can be adjuncts to implant maintenance.

Aerosols↗
PubMed2000

Oral glucose retention, saliva viscosity and flow rate in 5-year-old children.

There are significant differences of glucose retention in site-specificity and individuals. Sixty-two 5-year-old nursery schoolchildren participated in this study on the relation between the viscosity of saliva and flow rate and glucose retention. Each child was instructed to rinse his/her mouth with a glucose solution (0.5 M, 5 ml) and then to spit out. Three minutes after rinsing, glucose retention was determined. Resting saliva was collected by a natural outflow method, then the flow rate was determined. A rotational viscometer was used to determine the viscosity. Glucose retention and flow rate were correlated at the left maxillary primary molars, and glucose retention and viscosity were correlated at the maxillary central primary incisors. It was concluded that glucose retention after glucose mouth rinsing was site-specific, and that glucose retention and the index of decayed, missing and filled primary teeth (dmft) were slightly correlated with the salivary viscosity and flow rate.

Analysis of Variance↗
PubMed2003

Modelling oral malodour in a longitudinal study.

The aim of this study was to develop an in vitro model of the tongue microflora in order to assess anti-malodour compounds before clinical evaluation. Biofilms, derived from the tongue microflora, were grown in a constant depth film fermentor (CDFF) with nutrients supplied in the form of mucin- and serum-containing artificial saliva. Differential agars and a halimeter were used to determine the bacterial microflora and production of volatile sulphur compounds (VSCs), respectively. The resulting biofilms had a bacterial population which contained, on average, 29% streptococci, 48% Gram-negative anaerobes and 2.5% with an H2S-producing phenotype. When the biofilms were pulsed with either chlorhexidine or zinc acetate there was a reduction in the number of H2S-producing bacteria, however these counts subsequently recovered as pulsing continued. The generation of VSCs was correlated to the viable counts of the H2S-producing bacteria. By pulsing with anti-malodour compounds over time we observed a reduction in the quantity of VSCs produced and a change in the composition of the plaque to one which contained fewer H2S-producing bacteria.

Anti-Infective Agents, Local↗
PubMed1997

The effect of fluoride on Streptococcus sanguis 7863 IgA1 protease production and activity.

Fluoride was found to affect the production of the bacterial IgA1 protease but to have no effect on IgA1 protease activity. The concentrations of fluoride that do affect Streptococcus sanguis growth and IgA1 protease production are higher than those normally seen in vivo under normal circumstances. The concentrations of fluoride in dental plaque following use of a fluoride rinse or dentifrice would be sufficient to reduce Strep. sanguis IgA1 protease production.

Cariostatic Agents↗
PubMed1998

An approach to differentiate between antibacterial and antiadhesive effects of mouthrinses in vivo.

An experimental set-up allowing differentiation in vivo between antibacterial and antiadhesive properties of mouthrinses is described. The percentage of vital bacteria (= microbial vitality) and the bacterial counts were microscopically evaluated in saliva and in supragingival dental plaque both collected simultaneously at various times during de novo plaque formation. In a cross-over design, 12 healthy participants refrained from all oral hygiene for four separate periods of 2 x 4 h and 2 x 72 h after having rinsed with either an amine fluoride/stannous fluoride solution (Meridol) or 0.9% NaCl (placebo). Stimulated whole saliva was collected before and after the rinse. Together with whole-saliva samples, representative 4, 24 and 72-h-old plaque samples were separately taken from defined vestibular tooth surfaces that had been either exposed to the mouthrinse (unprotected sites) or temporarily covered with inert plastic films (protected sites) during rinsing. The pooled plaque and saliva were stained with fluorescent dyes to differentiate vital from dead micro-organisms which permitted the estimation of the percentages of vital bacteria. The total bacterial counts were quantified under the darkfield microscope. The Wilcoxon test was used for selected pairwise comparisons (alpha = 0.05). The percentage of vital bacteria in saliva fell significantly from 80-95% to about 50-60% as a result of the antibacterial activity of the test solution. These baseline values and those found in the presence of 4 and 24-h-old plaque were frequently lower than those recorded after the placebo rinse. In comparison to the placebo, microbial vitality was significantly reduced in early supragingival plaque formed on unprotected sites after applying the test solution. The similar total bacterial counts in 4-h-old plaque recorded after the use of the test solution on the unprotected and the protected areas did not point to an antiadhesive effect of the agent. It is concluded that this new experimental set-up allows decoding of the mode of action of a mouthrinse.

Adult↗