Effectiveness of an Antigen-Specific Streptococcus mutans Chairside Test as Compared to a Culture-Based S. mutans Test.

Purpose: To compare the effectiveness of an antigen-specific Streptococcus mutans (S. mutans) chairside test to a culture based S. mutans test.Methods: Fifty-three patients receiving dental hygiene care at the University of Missouri-Kansas City, School of Dentistry were enrolled in the study. Stimulated saliva was collected from the patients and utilized for both bacteria tests. The antigen-specific test was compared to the culture-based bacteria test and to a caries risk assessment measuring sensitivity and specificity.Results: The majority of participants were male (53%) with high caries risk (60%). The culture based test results were primarily negative (62%); while the antigen-specific test had more positives (76%). The sensitivity and specificity comparing the antigen-specific test to the culture based test was high (88%, 95% CI = (78%, 97%) and low (25%, 95% CI = (13%, 37%), respectively. The sensitivity and specificity comparing the antigen-specific test to caries risk was high (83%, 95% CI = (72%, 93%) and low (38%, 95% CI = (24%, 51%) respectively.Conclusions: While the sensitivity of the antigen-specific test was high for both the culture-based test and caries risk, the specificity was low for both. These results suggest that the antigen-specific test tends to give a higher proportion of false positive results.

Improving periodontal outcomes: merging clinical and behavioral science.

New data indicate that periodontal diseases are much more prevalent than previously thought, which means that there are large numbers of patients who will need to be diagnosed and treated for periodontal disease in a general dental practice. Oral hygiene procedures performed by patients between office visits are important for gingival health. No particular type of toothbrush has consistently been shown to have superior plaque-removal ability over another. Although studies on powered brushes have shown evidence for efficacy of biofilm removal and increased patient compliance, they are of short duration, making evaluation of long-term effects difficult to achieve. Interdental cleaning with dental floss can be effective but it is technique-sensitive. Interdental brushes have been shown to be superior to floss in plaque index scores, but not in gingival inflammation reduction. A systematic review of oral irrigation reported a beneficial adjunctive effect on bleeding and gingival indices and pocket depth. Antimicrobials in mouthrinses and toothpastes have shown significant reductions in plaque and gingivitis when used correctly. Even though it is considered essential for patients to utilize biofilm-removal techniques on a frequent basis, studies on adherence show that approximately 30-60% of health information is forgotten within 1 h, and 50% of health recommendations are not followed. Incorporating psychosocial aspects of behavioral change, including well-established counseling strategies, such as motivational interviewing, may elicit improved patient outcomes.

Providing advanced degrees in dental hygiene via computer mediated distance learning: a model program.

A chief concern regarding distance education for the health professions is quality of the experience. Distance education has the potential for expanding student access, providing individualized instruction, and promoting active learning among geographically separated members of learning groups. Students and professors who have participated in distance learning platforms have expressed concerns about technical problems, inability to interact in real time with each other, and other frustrations related to this type of delivery. The Dental Hygiene program at the University of Missouri-Kansas City (UMKC) has addressed these issues and enhanced an already successful program by putting the professor, a technologist, and the student in the same space, at the same time, in real time. This enhancement has substantiated the ability of distance education to provide instruction among geographically separated members of learning groups, making it a plausible solution to the shortage of educators in healthcare professions.

Relationship between prereferral periodontal care and periodontal status at time of referral.

BACKGROUND: According to a recent study, the severity of periodontal disease of individuals referred for periodontal care is greater now than in 1980. Variability in the standard of periodontal care in general dental practices may result in less than desirable outcomes and consequences of poorer periodontal health. METHODS: A sample of 100 newly referred dental patients from three separate periodontal practices in the greater Kansas City, Missouri area participated in this study. Data were collected from three sources: 1) a clinical chart audit, 2) current periodontal disease status as determined by clinical examination, and 3) a patient response questionnaire on past professional care and personal oral care habits. Bivariate analyses were performed using a statistical package. RESULTS: Of the 100 subjects, 74 were diagnosed as periodontal case type IV at the point of referral, of which 29.8% were treatment planned by the periodontist for two or more extractions. Teeth treatment planned for extraction were significant as a function of disease severity (P = 0.0001). Periodontal treatment provided in general dental practices did not vary because of disease severity. The incidence of deep cleanings (scaling and root planing) was reported slightly higher (32.4%) for case type IV than for case type III (26.9%), but this difference was not statistically significant. The average number of cleanings received in the general dental office was less than the standard of care according to the severity of the disease. CONCLUSION: If one assumes that the data obtained in the Kansas City practices are representative of a larger geographic area, it indicates that dentistry may be failing to address issues of the timely diagnosis of periodontal disease, appropriate treatment, and/or timely referral for treatment.