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Streptococci and veillonellae occur in mixed-species colonies during formation of early dental plaque. One factor hypothesized to be important in assembly of these initial communities is coaggregation (cell-cell recognition by genetically distinct bacteria). Intrageneric coaggregation of streptococci occurs when a lectin-like adhesin on one streptococcal species recognizes a receptor polysaccharide (RPS) on the partner species. Veillonellae also coaggregate with streptococci. These genera interact metabolically; lactic acid produced by streptococci is a carbon source for veillonellae. To transpose these interactions from undisturbed dental plaque to an experimentally tractable in vitro biofilm model, a community consisting of RPS-bearing streptococci juxtaposed with veillonellae was targeted by quantum dot-based immunofluorescence and then micromanipulated of the enamel surface and cultured. Besides the expected antibody-reactive cell types, a non-antibody-reactive streptococcus invisible during micromanipulation was obtained. The streptococci were identified as Streptococcus oralis (RPS bearing) and Streptococcus gordonii (adhesin bearing). The veillonellae could not be cultivated; however, a veillonella 16S rRNA gene sequence was amplified from the original isolation mixture, and this sequence was identical to the sequence of the previously studied organism Veillonella sp. strain PK1910, an oral isolate in our culture collection. S. oralis coaggregated with S. gordonii by an RPS-dependent mechanism, and both streptococci coaggregated with PK1910, which was used as a surrogate during in vitro community reconstruction. The streptococci and strain PK1910 formed interdigitated three-species clusters when grown as a biofilm using saliva as the nutritional source. PK1910 grew only when streptococci were present. This study confirms that RPS-mediated intrageneric coaggregation occurs in the earliest stages of plaque formation by bringing bacteria together to create a functional community.

The comparison of primary immunofluorescence by using quantum dots (QD)-antibody conjugates with primary immunofluorescence by using typical antibody fluorescence conjugates, such as Alexa Fluor conjugates is presented. The advances in the application of QD-based immunofluorescence for studying biofilms in vitro and in will help in defining bacterial community architecture and also in detecting the interactions between bacterial species in these communities.

Oral health is often excluded from broad health policy discussions, addressed only in a policy silo. There is a paucity of research to guide policymaking as it relates to oral health. In response, AcademyHealth's Oral Health Interest Group organized a meeting during the 2019 AcademyHealth Annual Research Meeting to promote transdisciplinary dialog on the current state of oral health policy and the steps necessary to improve the oral health of Americans. This article summarizes the two main themes that emerged from the proceedings of the Oral Health Interest Group meeting: a) recommendations for advocating the inclusion of oral health in policy discussions and b) critical research topics and measures needed for effective oral health policies in the future. [ABSTRACT FROM AUTHOR]

The integration of Fusobacterium nucleatum into multispecies communities is examined by using two in vitro models with saliva as the sole nutritional source. The integration of Fusobacterium nucleatum into multispecies commensal communities is evident from the interdigitation of fusobacteria in coaggregates with Actinomyces naeslundii and Streptococcus oralis and from the improved growth of fusobacteria, which is dependent on the presence of Actinomyces naeslundii.

The 16S rRNA gene sequencing and a retrievable enamel chip model were used to characterize the microflora present at 4 h and 8 h of plaque development in three individuals. Fluorescence in situ hybridization (FISH) was used to visualize the biofilm architecture of the mixed-species communities while conforming the dominance in situ of streptococci in initial dental plaque bacterial populations.

Background. The objective of this study was to identify specific factors (sex, race or ethnicity, and health care provider type) associated with patient receipt of an opioid prescription after a dental diagnosis. Methods. The authors used Medicaid claims dated from January 1, 2013, through September 30, 2015, for 13 US states in this study. The authors identified oral health--related conditions by using International Classification of Diseases, Ninth Revision, Clinical Modification diagnosis codes 520.0 through 529.9. Results. During the 2013-2015 study period, among the more than 890,000 Medicaid patients with a dental diagnosis, 23% received an opioid within 14 days of diagnosis. Female patients were 50% more likely to receive an opioid for pain management of a dental condition than were men (odds ratio [OR], 1.53; 95% confidence interval [CI], 1.52 to 1.55). Non-Hispanic whites and African Americans were approximately twice as likely to receive opioids than were Hispanics (OR, 2.11; 95% CI, 2.05 to 2.17 and OR, 1.88; 95% CI, 1.83 to 1.93, respectively). Patients receiving oral health care in an emergency department were nearly 5 times more likely to receive an opioid prescription than were patients treated in a dental office (OR, 4.66; 95% CI, 4.59 to 4.74). Patients with a dental condition diagnosed were nearly 3 times as likely to receive an opioid from a nurse practitioner as from a dentist (OR, 2.64; 95% CI, 2.57 to 2.70). Opioid use was substantially higher among African American female patients (OR, 3.29; 95% CI, 3.18 to 3.40) and non-Hispanic white female patients (OR, 3.24; 95% CI, 3.14 to 3.35) than among Hispanic female patients. Conclusions. Opioid prescribing patterns differ depending on patient race or ethnicity, sex, and health care provider source in patients with a dental diagnosis in the United States. Practical Implications. Dentists are providing substantially less opioid prescriptions compared to their medical colleagues for pain treatment following a dental diagnosis in the Medicaid population. When considering pain management for dental and related conditions, dentists should continue with conservative prescribing practices as recommended. [ABSTRACT FROM AUTHOR]

The article focuses on the need for the use of quality improvement (QI) methods in dentistry. It states the goal of QI is to improve population health status, reduce per capita cost of care, and better patient experiences. It comments on the development of a disease management approach in reducing early childhood dental caries through caries risk assessment, engaging caregivers and patients in managing oral health, fluoride use, and more.

Purpose: The purpose of this study was to investigate the trends of pediatric dental rehabilitation in hospital outpatient departments (HOPDs) and ambulatory surgery centers (ASCs) during the COVID-19 public health emergency (PHE) from 2019 to 2021 across states and demographic groups. Methods: This cross-sectional study utilized the 2019 to 2021 Transformed Medicaid Statistical Information System Analytical Files to examine trends in dental rehabilitation for children ages 12 years and younger enrolled in Medicaid or the Children's Health Insurance Program. The final analytic sample included 20,508,093 beneficiaries from 2019, 19,436,957 beneficiaries from 2020, and 20,416,440 beneficiaries from 2021. Chi-square tests were used to compare dental rehabilitation usage across groups (age, sex, race/ethnicity, and place of service). Results: Rehabilitation of Medicaid beneficiaries performed in HOPDs showed a decrease year over year (51 to 34 to 30; P<0.001), while the usage in ASCs increased (1,307 to 1,310 to 1,367; P<0.001). For all three years, the highest usage was seen in Non-Hispanic (NH) American Indian/Alaskan Native children (154, 66, 74; P<0.001), while the lowest usage was seen in NH Black children (21, 16, 17; P<0.001). Rehabilitation for Hispanic children had the greatest relative recovery over the three years (39 to 34 to 38; P<0.001). Conclusions: Dental rehabilitation usage in ambulatory surgery centers showed continued growth through the public health emergency. There was significant variation in rates across states and demographics. [ABSTRACT FROM AUTHOR]

Purpose: To evaluate 1) if glass ionomer interim temporary restorations (ITR) placed for 1-3 months prior to vital pulp therapy (VPT) improved accuracy of diagnosing the pulp's clinical status and subsequent VPT success, and 2) the effect of the location of the carious lesion on VPT. Methods: Primary molars (N=117) receiving pulp therapy with or without ITR were evaluated retrospectively. All teeth had caries extending >50 percent into dentin; caries lesion location was identified (proximal or non-proximal). Two examiners rated pulp status assessment, caries location, and pulp treatment, and correlated treatment outcomes after a mean of 34.7 months to these factors. Results: VPT failed more often in first primary molars (Pk.001) than in second primary molars. Using ITR improved diagnosis of the pulp status, clinical success of VPT, (P=.013) and first molar VPT success (P=.02). First primary molars had more proximal lesions than second molars (P<.001). Failure of VPT was greater for teeth with proximal lesions (P=.03). Use of ITR significantly improved VPT in teeth with proximal lesions (P=.007) but not non-proximal lesions (P=38). Conclusions: ITR placed prior to VPT improved pulpal diagnosis and VPT outcomes. Vital pulp therapy was less successful in primary molars with proximol lesions, and ITR significantly improved the success. [ABSTRACT FROM AUTHOR]

El artículo presenta un estudio sobre las interacciones y sucesiones bacterianas durante el desarrollo de la placa. En los últimos años, se han encontrado aproximadamente 700 especies bacterianas o filotipos que contribuyen al desarrollo de la inflamación gingival y de la enfermedad periodontal. Se discuten los principios básicos sobre la coagregación que es integral en la interacción entre células genéticamente distintas.