The Effect of Chlorhexidine on Bacterial Contamination of Hall Technique Elastomeric Orthodontic Separators and Gingival Health: A Pilot Study

ABSTRACT Objective: To study the effect of chlorhexidine on elastomeric orthodontic separators (EOS) bacterial-colonisation and gingival-health in Hall technique (HT) patients. Material and Methods: Prospective in-vivo pilot clinical study of EOS bacterial colonisation and primary-molar gingival health assessment in 20 patients (mean age 5.45±1.27 years) requiring bilateral HT crowns (40 teeth). One side received 1-minute 0.12% chlorhexidine-soaked-EOSs (Chx-EOSs), and the other side dry-EOSs (NoChx-EOSs). The EOSs were removed five-days later and underwent a bacterial enumeration technique. Plaque (PI) and Gingival (GI) indices were assessed pre-, five-days and three-months post-treatment. Wilcoxon-Signed-Rank/McNemar-Chi-square statistics were used (p<0.05). Results: Baseline unused/packaged EOSs' sterility check yielded zero colony-forming-units (CFU) per millilitre, but 100% of the used EOSs became colonised by oral-microorganisms. An overall trend of lower mean CFU count in Chx-EOSs (3.415± 0.78 x105 CFU/ml) compared to NoChx-EOSs (6.157±1.48 x105 CFU/ml) was observed (p=0.009). Both NoChx-EOSs and Chx-EOSs insertion sites showed evidence of gingivitis with no difference between PI and GI indices by site over time. Conclusion: There was a lower trend of bacterial colonization in chlorhexidine treated EOSs and an occurrence of gingivitis pre/post HT-treatment regardless of EOS type. The lack of difference in the gingival health may be inconclusive due to this pilot's low power suggesting the need for robust large scale studies.

The Knowledge and Attitude of Practicing Dentists towards the Antibiotic Prescription: A Regional Study.

Aims: To assess dentist’s knowledge and practice in relation antibiotic prescription and to investigate if they follow the current international guidelines. Methodology: In this cross sectional study a structured and pretested questionnaire was sent to 202 licensed dental practitioners in UAE, Iran and Jordan took place in period between December 2011 and January 2012 by e-mail and physical delivery. Results: Of 160 responding dentists 93.1% would prescribe antibiotics for dentofacial infections with systemic signs but many prescribe antibiotics for conditions where antibiotic therapy is not required according to good practice. Amoxicillin was the most frequently prescribed antibiotics. The non-clinical factor that may affect decision of the majority of dentists to prescribe antibiotics was perception of the effectiveness of those antibiotics in previous cases they treated with same agent (61.25%). Most of the respondents (84%) prescribe prophylactic antibiotics for patients at risk of infective endocarditis. Conclusion: This study reveals that antibiotics were still being prescribed by dental practitioners where recent guidelines suggest there is no indication.