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Purpose: There is a burgeoning recognition and interest in the potential of probiotics in the treatment and prevention of oral candidiasis associated with the use of dentures. Our aim was to investigate if commercially available over-the-counter probiotics can influence the ability of Candida albicans to form biofilms, which is considered a hallmark of the initiation and progression of oral candidiasis. Methods: We conducted a 2x5 factorial in vitro study to culture C. albicans on denture strips and challenge with one of the following four commercially available probiotics in bacterial or cell-free supernatant form: Accuflora®, Align®, Culturelle® and Sustenex®. C. albicans biofilm formation was studied in triplicates in all factorial combinations of the study and assessed qualitatively with fluorescence microscopy and quantitatively with tetrazolium salt (XTT) reduction assay. Quality control measures included determination of coefficient of variation, Bland Altman plots and Pittman's test. Results were analyzed using two-way analysis of variance (ANOVA) with pairwise post-hoc Scheffe's tests. Results: Our experimental conditions passed the quality control checks. Two-way ANOVA results indicated that cell-free supernatants provided a stronger and significant inhibitory effect on biofilm formation than their bacterial counterparts (2-way ANOVA p=3.8x10-6). Further, Lactobacillus-containing probiotic formulations (Accuflora® and Culturelle®) significantly reduced biofilm formation especially in supernatant form. Conclusion: Commercially available probiotics that contain Lactobacilli species interfere with the in vitro ability of C. albicans to form biofilms on dentures. The mechanistic and clinical implications of our results need to be addressed by larger in vivo studies. Keywords: candidiasis, dentures, probiotics, biofilm, experimental studies, Introduction Candida albicans is a commensal saprophytic fungus that colonizes the oral cavity of humans. However, overgrowth of C. albicans can result in clinical presentation of candidiasis that includes a [...]

As more dental schools adopt a comprehensive care model focused on patients’ needs rather than a certain number of required procedures, clinic time utilization by students is coming under increasingly close scrutiny. This article presents an analysis of the influence of broken appointment rates on dental students’ clinical experience levels. The total percentage of broken appointments experienced by each student from the classes of 2010 and 2011 at Case Western Reserve University School of Dental Medicine during his or her clinical education in the junior and senior years was determined, and the impact of the broken appointment rate on students’ clinical experience levels was analyzed. The results show a statistically significant difference regarding the percentage of broken appointments between the classes of 2010 and 2011: 18.64 percent and 14.44 percent, respectively. When the rate of no‐shows was compared to the students’ clinical experience level, a weak but significant negative correlation was determined for the class of 2010 but not for the class of 2011. It is concluded that the rate of broken appointments accounts for a small part of the variability observed in the number of clinical procedures performed in the predoctoral clinic. When this rate is lowered below a threshold of 14.5 percent, broken appointments seem to have no influence on students’ clinical experience level.

An awareness of the various medications commonly prescribed for patients to self-administer will assist clinicians to anticipate the most commonly encountered medical diagnoses; will give clues to a patient’s physical and emotional ability to undergo and respond to dental care; will alert clinicians to potential drug-drug and drug-disease interactions, and to the presence of drug-induced illness; and provide invaluable information that will help the clinician identify high-risk patients who may experience a life-threatening medical emergency while in the dental office.