Dental care for drug users in Norway: dental professionals' attitudes to treatment and experiences with interprofessional collaboration.

BACKGROUND: The present study aimed to assess dental professionals' attitudes and experiences related to the dental treatment of drug users and to interprofessional collaboration with the rehabilitation institutions (RIs). METHODS: The study population comprised 141 dentists and dental hygienists (response rate 73%) working in the Public Dental Service (PDS) in three counties in Norway. All of the participants completed an electronically distributed questionnaire on existing practices and experiences regarding dental treatment for drug users and interprofessional collaboration with RIs. The Norwegian Centre for Research Data (NSD) approved the study. RESULTS: Thirty-five percent of the dentists and 10% of the dental hygienists had treated five or more drug users per month (p <  0.05). The majority of dentists and dental hygienists used more time for examination and treatment of drug users compared to other patient groups. Over 70% of dental clinicians considered drug users as demanding patients due to fear, missing appointments, and poor compliance with oral hygiene advice. Multivariable logistic regression analyses showed that attitudes and experiences with dental treatment of drug users were significantly associated with background characteristics of professionals. The overall perception was that drug users often had higher expectations of dental treatment than what could be defined as necessary care and provided by the PDS. One-third of dental professionals reported that they were satisfied with the collaboration they had with RIs. Most of the respondents agreed that personnel from RIs could positively influence interprofessional collaboration by having sufficient knowledge of drug users statutory rights to free of charge dental treatment, as well as by close follow-up and motivation of patients before dental treatment. CONCLUSIONS: Dental professionals perceived the management of drug users as demanding due to dental fear, difficulties in coping with appointments, poor compliance to preventive measures, and disagreement between dental treatment defined as necessary and drug users' expectations. Attitudes and experiences related to dental treatment of drug users were significantly associated with background characteristics of clinicians. Organizational barriers regarding leadership, accessibility, and collaborative routines, as well as lack of interprofessional communication, suggest current models of health care delivery to drug users need reviewing.

DNA damage and DNA damage responses in THP-1 monocytes after exposure to spores of either Stachybotrys chartarum or Aspergillus versicolor or to T-2 toxin.

We have characterized cell death in THP-1 cells after exposure to heat-treated spores from satratoxin G-producing Stachybotrys chartarum isolate IBT 9631, atranone-producing S. chartarum isolate IBT 9634, and sterigmatocystin-producing Aspergillus versicolor isolate IBT 3781, as well as the trichothecenes T-2 and satratoxin G. Spores induced cell death within 3-6 h, with Stachybotrys appearing most potent. IBT 9631 induced both apoptosis and necrosis, while IBT 9634 and IBT 3781 induced mostly necrosis. T-2 toxin and satratoxin G caused mainly apoptosis. Comet assay +/- formamidopyrimidine DNA glycosylase showed that only the spore exposures induced early (3h) oxidative DNA damage. Likewise, only the spores increased the formation of reactive oxygen species (ROS), suggesting that spores as particles may induce ROS formation and oxidative DNA damage. Increased Ataxia Telangiectasia Mutated (ATM) phosphorylation, indicating DNA damage, was observed after all exposures. The DNA damage response induced by IBT 9631 as well as satratoxin G was characterized by rapid (15 min) activation of p38 and H2AX. The p38 inhibitor SB 202190 reduced IBT 9631-induced H2AX activation. Both IBT 9631 and T-2 induced activation of Chk2 and H2AX after 3 h. The ATM inhibitor KU 55933, as well as transfection of cells with ATM siRNA, reduced this activation, suggesting a partial role for ATM as upstream activator for Chk2 and H2AX. In conclusion, activation of Chk2 and H2AX correlated with spore- and toxin-induced apoptosis. For IBT 9631 and satratoxin G, additional factors may be involved in triggering apoptosis, most notably p38 activation.

Filler particles used in dental biomaterials induce production and release of inflammatory mediators in vitro.

Although dental composites are in extensive use today, little is known about the biological effects of the filler particles. As composite materials are gradually broken down in the aggressive environment of the oral cavity, the filler particles may leak and induce toxic effects on the surrounding tissue and cells. The aim of this study was to elucidate possible adverse biological effects of commonly used dental filler particles; bariumaluminiumsilica (BaAlSi) and bariumaluminiumfluorosilica (BaAlFSi) with mean size of 1 microm. BEAS-2B cells were used as a model system. Particle morphology, mean particle size in solution, and particle surface charge were determined by scanning electron microscopy and Malvern zetasizer technology, respectively. Enzyme-linked immunosorbent assay was used to detect secretion of cytokine and chemokine (IL-8 and IL-6) and quantitative PCR for detection of gene activity. Both types of particle increased the release of IL-6 and IL-8 in a dose-dependent manner. BaAlFSi particles induced a more marked IL-8 response compared to BaAlSi particles, whereas no significant difference was observed for the IL-6 response. Mechanistic studies using specific inhibitors and activators indicated that cyclic AMP-dependent protein kinase A is partly involved in the observed IL-8 response. In conclusion, we consider dental filler particles to have potential to induce adverse biological response in cell cultures.