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Background: Infective endocarditis (IE) often is caused by bacteria that colonize teeth. The authors conducted a study to determine if poor oral hygiene or dental disease are risk factors for developing bacteremia after toothbrushing or single-tooth extraction., Methods: One hundred ninety-four participants in a study were in either a toothbrushing group or a single-tooth extraction with placebo group. The authors assessed the participants' oral hygiene, gingivitis and periodontitis statuses. They assayed blood samples obtained before, during and after the toothbrushing or extraction interventions for IE-associated bacteria., Results: The authors found that oral hygiene and gingival disease indexes were associated significantly with IE-related bacteremia after toothbrushing. Participants with mean plaque and calculus scores of 2 or greater were at a 3.78- and 4.43-fold increased risk of developing bacteremia, respectively. The presence of generalized bleeding after toothbrushing was associated with an almost eightfold increase in risk of developing bacteremia. There was no significant association between any of the measures of periodontal disease and the incidence of bacteremia after toothbrushing. The oral hygiene or disease status of a tooth was not significantly associated with bacteremia after its extraction., Conclusion: Bacteremia after toothbrushing is associated with poor oral hygiene and gingival bleeding after toothbrushing., Clinical Implications: Improvements in oral hygiene may reduce the risk of developing IE.

Biofilms are a complex community of microorganisms characterized by the excretion of an adhesive and protective extracellular matrix, microbe-to-microbe attachment, structural heterogeneity, genetic diversity, and complex community interactions. Bacteria growing in dental biofilms display an increased tolerance to antibiotics and antimicrobial agents, including those used in dentifrices and mouthrinses. The microbial challenge associated with the inflammatory periodontal diseases induces an immediate inflammatory and immune response in the host. The nature and magnitude of the response has an impact on the severity and rate of progression of the periodontal disease. It is this host inflammatory-immune response that ultimately leads to the clinical signs and symptoms of gingivitis and chronic periodontitis. The traditional treatment modality of scaling and root planing (SRP) remains the "gold standard" for the non-surgical management of chronic periodontitis. Even clinically successful treatment has a high probability of pocket reinfection. Re-infection of periodontal pockets results from residual biofilms, increased tolerance of microbes within a dense, mature biofilm to antibiotics, reservoirs of bacteria in calculus, and reservoirs of bacteria within the dentinal tubules of infected root surfaces. Thus, for maximum effect, a combination of scaling and root planing and locally delivered antimicrobials should be considered if non-surgical therapy is the treatment of choice.

The aim of this study was to investigate the possible association of a distinct combination of polymorphisms in the interleukin (IL)-1 gene cluster on gingival bleeding tendency in young adult Arabs with plaque-induced gingivitis. Fifty otherwise healthy, nonsmoking volunteers, 19-28 years of age, participated. Clinical examinations included periodontal probing depth, bleeding on probing, and plaque index. Probing was done with a pressure-controlled probe at about 1.27 MPa. Examinations were repeated after 2 and 4 weeks. Polymorphisms in the IL-1 gene cluster were assessed using a reverse hybridization assay. A subject carrying alleles 2 at IL-1A ( -889 ) and IL-1B ( +3954 ) was designated genotype-positive. Twenty-six subjects were genotype-positive (52%). A repeated measures two-level (occasion, subject) model of the proportion of sites bleeding on probing, which was adjusted for gender, average plaque index, probing depth, and calculus, revealed a significantly lower proportion of bleeding sites in genotype-positive subjects (estimate -0.050, standard error 0.025, p < 0.05). Biserial correlations of bleeding proportions were high (0.71-0.78), confirming the steady-state plaque environment. It was concluded that inflammatory responses to dental plaque were considerably dampened in genotype-positive, nonsmoking young adults of Arabic heritage.

An altered gingival inflammatory response to supragingival plaque in smokers had been claimed by several authors. Relatively limited information exists with regard to the consistency of naturally occurring plaque and bleeding upon probing within the oral cavity under usual oral hygiene measures. The aims of the present study were to describe the distribution of tooth surfaces covered by supragingival plaque and gingival units bleeding upon probing in a steady state environment of no dental intervention. In addition relative consistency of plaque and bleeding was investigated. 65 volunteers, 14 women and 51 men in the age range of 19 to 30 years, participated. 33 volunteers were heavy smokers and 32 non-smokers. Clinical examinations revealed mild, plaque-induced gingivitis with no overt destructive periodontitis. Within a 6-month period. presence and amount of plaque, calculus and gingival bleeding was site-specifically assessed four times, i.e., every 8 weeks. Well-defined, symmetric and consistent patterns of plaque and calculus distribution within the oral cavity were observed, which were rather identical in smokers and non-smokers. Smokers had evenly more plaque in all regions of the oral cavity. In contrast, there was no obvious pattern of bleeding upon probing. Consistency of observations was considerably lower than for plaque scores. This was particularly true for smokers, where the association between bleeding scores was generally smaller than in non-smokers. A large portion of the variation of gingival bleeding may be due to presently unknown factors other than plaque and calculus with considerable consequences for preventive programmes.

Objective: To measure production of volatile sulfur compounds (VSC) responsible for halitosis on the crown surface of the maxillary fourth premolar of dogs with gingivitis., Animals: 28 dogs owned by veterinary students who complained that their dogs had halitosis., Procedure: Clinical dental indices (plaque index, calculus index, and gingival index) were measured on the most diseased maxillary fourth premolar tooth. Production of VSC from the crown surface of the tooth was recorded by use of a portable sulfide monitor. Measurements were performed several times on each dog over a 2-month period, resulting in 98 series of measurements., Results: Dogs with heavy amounts of plaque or calculus (plaque and calculus indices of 2 or 3) had significantly higher VSC readings than did dogs with no visible plaque and calculus accumulation. Significant (P = 0.0008) correlation was found between VSC measurements and plaque index, and significant correlations were found between VSC measurements and calculus index (P = 0.00118) and gingival index (P = 0.00475)., Conclusion: VSC production recorded on the crown of maxillary fourth premolar teeth of dogs with gingivitis is significantly correlated with the amount of plaque and calculus accumulation and with severity of gingivitis., Clinical Relevance: VSC measurements on tooth surfaces could be used as a site-specific method to assess, in conjunction with clinical dental variables, effectiveness of dental hygiene products.

To analyze the occurrence of root caries in relation to the periodontal state, we examined clinically a representative sample (n = 4,777) of Finish adults, aged 30 years and older. Our definition of root caries included primary decay on root surfaces, and a subject's periodontal state was described according to the presence or absence of gingival inflammation or periodontal pockets and subgingival calculus and/or overhangings. Subjects with a healthy periodontium seldom (4%) had any caries on root surfaces, whereas 15% had caries in conjunction with gingival inflammation, and 17% in conjunction with deepened pockets. The deeper the pockets, the greater the frequency of root caries for men, but not for women. Subgingival plaque retention showed a strong association with root caries. As the study population represented Finnish adults, the results can be generalized with reasonable confidence.

Weanling specific pathogen-free Osborne-Mendel rats were fed a high-calcium, high-phosphorus diet with various levels of sucrose and inoculated with Streptococcus sobrinus strain 6715-13WT and Actinomyces viscosus strain OMZ-105 in order to determine whether calculus and caries could develop simultaneously. Rats consumed diets designated RC-16-5, RC-16-25, or RC-16-50 which partially replaced the corn starch component with progressively higher levels of sucrose, thus, to 5, 25, or 50% sucrose. In general, bacterial recoveries of A. viscosus declined with higher sucrose content of the diet, but a pattern of recovery for S. sobrinus was less clear with respect to dietary sucrose. S. sobrinus, however, was recovered at higher percentages from the tooth surface flora at the later two of three sampling dates. Most calculus--identified by the brittle quality, staining characteristics, and apatitic x-ray diffraction patterns of tooth surface deposits--was formed on the maxillary molars, and most carious lesions occurred on mandibular molars. While there was minimal association of the calculus score with the amount of sucrose in the diet, calculus scores increased greatly from 23 to 43 days after infectious challenge. Caries scores, of both fissure and smooth surfaces, by contrast, increased in a dose-response fashion with increasing dietary sucrose and with time. It is thus possible to induce calculus formation and caries simultaneously in specific pathogen-free Osborne-Mendel rats consuming a high-calcium and -phosphorus diet conducive to calculus formation and containing sucrose.(ABSTRACT TRUNCATED AT 250 WORDS)

Feline periodontal disease has many elements in common with human and canine disease. Anatomic, physiologic, microbiologic, and immunologic differences between the three species make it impossible to predict with certainty whether successful approaches to controlling and treating canine oral disease will also prove successful in cats. We have developed methods for reproducible, quantitative evaluation of feline dental plaque and calculus. Our studies demonstrated that feline plaque accumulation peaks at 1 week after prophylaxis and that calculus peaks at 4 weeks after prophylaxis. These methods should be adequately sensitive to document control of plaque and calculus accumulation by efficacious chemical or antimicrobial agents.

The influence of plaque and calculus deposition on the prevalence of pocket formation was studied using cross-sectional data from 615 Japanese manual workers aged 18-49. A periodontal pocket with a depth of 4 mm or more from gingival margin to bottom of the pocket was coded as presence of pockets. The oral hygiene status at the specified site was classified into four hygiene patterns as no deposition, deposition of plaque only, deposition of calculus only and deposition of both plaque and calculus. The percentages of six specified tooth types with pocket formation were analyzed according to the local hygiene condition. The results indicate that local oral hygiene produces significant differences in the proportion of teeth with pocket formation in the examined tooth types. The frequency of site-specific hygiene condition were no deposition, deposition of plaque only and deposition of both plaque and calculus, except for the lower central incisors. The teeth without plaque and calculus show no pocket formation in most of the examined tooth types in the subjects aged 18-39, while teeth with plaque and/or calculus indicate high prevalence of pocket formation. It is also revealed that the teeth with both plaque and calculus tend to show higher percentages of pocket formation than those with plaque only. These findings suggest that promotion of a plaque free state would reduce risk for pocket formation to negligible level, and that calculus deposition increase the risk for pocket formation around the teeth with plaque.