Are we well? A post-pandemic snapshot of dental educator wellness, well-being, and fulfillment.

INTRODUCTION: The COVID-19 pandemic brought unprecedented changes to oral care and dental education delivery. To date, the vast majority of studies focus on the impact COVID-19 had on the well-being and wellness of patients, practitioners, and students; however, limited literature addresses the pandemic's impact on dental educators. PURPOSE: The aim of this study was to investigate the wellness, well-being, and fulfillment of dental educators in the years following the onset of the COVID-19 pandemic. METHODS: Following Institutional Review Board approval, an anonymous electronic Qualtrics survey was emailed to full-time and adjunct faculty across five (5) dental education institutions in the US. Faculty self-reported on their wellness, general well-being, physical well-being, mental well-being, fulfillment, and work-life balance. Group differences were examined using analysis of variance and the Tukey-Kramer test for multiple comparisons at the p < 0.05 level. RESULTS: The results revealed females and younger dental faculty members reported statistically significantly lower levels of wellness (F2, 123  = 11.16, p < 0.001, F3, 121  = 8.53, p < 0.001), physical (F2, 123  = 11.53, p < 0.001, F3, 121  = 5.54, p = 0.001) and mental well-being (F2, 123  = 12.49, p < 0.001, F3, 121  = 8.63, p < 0.001), fulfillment (F3, 121  = 5.01, p < 0.003), and higher levels of burnout (F2, 123  = 5.53, p = 0.005, F3, 121  = 4.85, p < 0.003). Those who expressed higher levels of burnout also had statistically lower mean well-being scores (F4, 119  = 10.54, p < 0.001). Females also reported a significantly lower work-life balance score compared to male respondents (F2, 121  = 10.37, p < 0.002). CONCLUSION: Despite the social and environmental challenges faced over the last couple of years post-pandemic, dental educators demonstrate a quick ability to adapt, however, disproportional differences in gender and age groups were identified as being significantly correlated to dental educators' self-reports on wellness, well-being, and fulfillment. Insight into these variables can help inform strategies in the academic setting to help support and strengthen the academic workforce.

Development and Characterization of In Vitro Human Oral Mucosal Equivalents Derived from Immortalized Oral Keratinocytes.

Tissue-engineered oral mucosal equivalents (OME) are being increasingly used to measure toxicity, drug delivery, and to model oral diseases. Current OME mainly comprise normal oral keratinocytes (NOK) cultured on top of a normal oral fibroblasts-containing matrix. However, the commercial supply of NOK is limited, restricting widespread use of these mucosal models. In addition, NOK suffer from poor longevity and donor-to-donor variability. Therefore, we constructed, characterized, and tested the functionality of OME based on commercial TERT2-immortalized oral keratinocytes (FNB6) to produce a more readily available alternative to NOK-based OME. FNB6 OME cultured at an air-to-liquid interface for 14 days exhibited expression of differentiation markers cytokeratin 13 in the suprabasal layers and cytokeratin 14 in basal layer of the epithelium. Proliferating cells were restricted to the basal epithelium, and there was immuno-positive expression of E-cadherin confirming the presence of established cell-to-cell contacts. The histology and expression of these structural markers paralleled those observed in the normal oral mucosa and NOK-based models. On stimulation with TNFα and IL-1, FNB6 OME displayed a similar global gene expression profile to NOK-based OME, with increased expression of many common pro-inflammatory molecules such as chemokines (CXCL8), cytokines (IL-6), and adhesion molecules (ICAM-1) when analyzed by gene array and quantitative PCR. Similarly, pathway analysis showed that both FNB6 and NOK models initiated similar intracellular signaling on stimulation. Gene expression in FNB6 OME was more consistent than NOK-based OME that suffered from donor variation in response to stimuli. Mucosal equivalents based on immortalized FNB6 cells are accessible, reproducible and will provide an alternative animal experimental system for studying mucosal drug delivery systems, host-pathogen interactions, and drug-induced toxicity.

Comparative Efficacy of a Soft Toothbrush with Tapered-tip Bristles and an ADA Reference Toothbrush on Established Gingivitis and Supragingival Plaque over a 12-Week Period.

OBJECTIVES: Evaluation of the efficacy of a soft toothbrush with tapered-tip bristles (Test Toothbrush) and an ADA reference soft toothbrush (ADA Toothbrush) on established gingivitis and supragingival plaque over a 12-week period. METHODS: This randomized, single-center, examiner-blind, two-cell, parallel clinical research study assessed plaque removal by the comparison of pre- to- post-brushing after a single use, and again after six- and 12-weeks' use, using the Quigley-Hein Plaque Index, Turesky Modification. The study also assessed gingivitis after six weeks and 12 weeks using the Löe & Silness Gingival Index. Adult male and female subjects from the Central New Jersey, USA area refrained from all oral hygiene procedures for 24 hours. They reported to the study site after refraining from eating, drinking, and smoking for four hours. Subjects had the study procedure explained to them both orally and by written instructions. Subjects then gave written consent to participate before entry into the study. Following an examination for plaque (pre-brushing) and gingivitis (baseline), the subjects were randomized into two balanced groups, each group assigned to one of the two study toothbrushes. Subjects were instructed to brush their teeth for one minute under supervision with their assigned toothbrush and a commercially available fluoride toothpaste (Colgate© Cavity Protection Toothpaste), after which they were again evaluated for plaque (post-brushing). Subjects were dismissed from the study site with their assigned toothbrush and toothpaste, and instructed to brush twice daily at home for the next 12 weeks. The subjects were instructed to brush for one minute during each tooth brushing. The subjects reported to the study site after six weeks and 12 weeks of product use, at which time they were evaluated for plaque and gingivitis. RESULTS: Seventy-one (71) subjects complied with the protocol and completed the clinical study. Compared to the ADA Toothbrush, the Test Toothbrush provided statistically significantly (p < 0.05) greater reductions of 71.1% in whole mouth plaque index scores, 43.8% in plaque severity index scores, and 81.3% in interproximal sites plaque scores after a single tooth brushing. After six weeks' use, the Test Toothbrush provided statistically significantly (p < 0.05) greater reductions of 700% in whole mouth gingival index scores, 700% in gingivitis severity index scores, and 400% in interproximal sites gingival scores compared to the ADA Toothbrush. Also after six weeks' use, the Test Toothbrush provided statistically significantly (p < 0.05) greater reductions of 188.9% in whole mouth plaque index scores, 165% in plaque severity index scores, and 203% in interproximal sites plaque scores compared to the ADA Toothbrush. After 12 weeks' use, the Test Toothbrush provided statistically significantly (p < 0.05) greater reductions of 266.7% in whole mouth gingival index scores, 300% in gingivitis severity index scores, and 250% in interproximal sites gingival scores compared to the ADA Toothbrush. Also after 12 weeks' use, the Test Toothbrush provided statistically significantly (p < 0.05) greater reductions of 158.1% in whole mouth plaque index scores, 143.5% in plaque severity index scores, and 145.4% in interproximal sites plaque scores compared to the ADA Toothbrush. CONCLUSIONS: This study demonstrated that a soft toothbrush with tapered-tip bristles provided a significantly greater reduction in supragingival plaque after a single tooth brushing, as well as after six and 12 weeks of twice-daily use, compared to the ADA Toothbrush. After six and 12 weeks of twice-daily use, it also provided a significantly greater reduction in gingivitis as compared to the ADA Toothbrush.

Comparative Efficacy of a Soft Toothbrush with Tapered-tip Bristles to an ADA Reference Toothbrush on Gingival Abrasion over a 12-Week Period.

OBJECTIVES: Evaluation of the impact of a soft toothbrush with tapered-tip (Test Toothbrush) bristles and an ADA reference toothbrush (ADA Toothbrush) on gingival abrasion over a 12-week period. METHODS: This was a randomized, single-center, examiner-blind, two-cell, parallel clinical research study and used the Danser Gingival Abrasion Index to assess the level of gingival abrasion after a single brushing, as well as after six weeks and 12 weeks of twice-daily brushing. Adult male and female subjects from the Central New Jersey, USA area refrained from all oral hygiene procedures for 24 hours. They reported to the study site after refraining from eating, drinking, and smoking for four hours. Following a qualifying examination using plaque and gingivitis scores along with a baseline gingival abrasion examination, subjects were randomized into two balanced groups, each group using one of the two study toothbrushes. Subjects were instructed to brush their teeth for one minute, under supervision, with their assigned toothbrush and a commercially available fluoride toothpaste (Colgate© Cavity Protection Toothpaste), after which they were again evaluated for gingival abrasion. Subjects were dismissed from the study site with their assigned toothbrush and toothpaste, and instructed to brush twice daily at home for the next 12 weeks. The subjects were instructed to brush for one minute during each tooth brushing. The subjects reported to the study site after six weeks and 12 weeks of product use, at which time they were evaluated for gingival abrasion. RESULTS: Seventy-one (71) subjects complied with the protocol and completed the clinical study. The results of this study showed that the Test Toothbrush provided statistically significantly (p < 0.05) greater reductions in gingival abrasion scores as compared to the gingival abrasion scores of the ADA Toothbrush after a single tooth brushing, after six weeks, and after 12 weeks of product use (75.0%, 85.5%, 73.9%, respectively). CONCLUSIONS: The soft toothbrush with tapered-tip bristles produced significantly less gingival abrasion after 12 weeks of product use as compared to the ADA reference toothbrush.

The efficacy of two oral hygiene regimens in reducing oral malodour: a randomised clinical trial.

OBJECTIVES: This study compared the efficacy of two oral hygiene regimens in reducing oral malodour and the proportions of bacterial species involved in the production of volatile sulphur compounds. MATERIAL AND METHODS: Seventy subjects who participated in a halitosis-induction phase and achieved an organoleptic score of ≥ 3.0 [time point 0 (T0)] randomised into two groups: brushing with regular fluoride toothpaste alone (control group) or brushing with regular fluoride toothpaste followed by rinsing with a 0.075% cetylpyridinium chloride (CPC) mouthwash (CPC group). Subjects followed their assigned oral hygiene regimen for 21 days. Then, they underwent an organoleptic examination and measurement of volatile sulphur compounds (VSCs) using a portable gas chromatograph, 12 hours after their last oral hygiene procedure (T1) and 4 hours after an on-site oral hygiene (T2). Microbiological samples (supragingival biofilm, tongue coating and saliva) were analysed using checkerboard DNA-DNA hybridisation. RESULTS: Both therapies statistically significantly improved the organoleptic scores (P < 0.05), but the VSC levels and/or concentrations were reduced only in the CPC group (P < 0.05). In subjects rinsing with CPC, oral malodour scores were reduced by 49% at the 4-hour assessment (T2) compared with those not rinsing (P < 0.05). Red-complex pathogens were reduced more effectively in the CPC group than in the control group. CONCLUSIONS: Brushing followed by rinsing with a 0.075% CPC mouthwash provided statistically significantly greater reductions in oral malodour, measured organoleptically and instrumentally, and in the proportions of red-complex species when compared with brushing alone.

Efficacy of a mouthwash containing 0.8% arginine, PVM/MA copolymer, pyrophosphates, and 0.05% sodium fluoride compared to a negative control mouthwash on dentin hypersensitivity reduction. A randomized clinical trial.

OBJECTIVE: The objective of this eight week, single-center, two-cell, double-blind, and randomized clinical study was to evaluate the dentin hypersensitivity reduction efficacy of a mouthwash using Pro-Argin™ Mouthwash Technology containing 0.8% arginine, PVM/MA copolymer, pyrophosphates, and 0.05% sodium fluoride in an alcohol-free base ("Arginine Mouthwash") compared to an ordinary mouthwash without any active ingredients ("Negative Control"). METHODS: Qualifying subjects who presented two hypersensitive teeth with a tactile hypersensitivity score between 10 and 50 g of force, and an air blast hypersensitivity score of 2 or 3 participated in this study and were randomized into one of two treatment groups. Subjects brushed with the toothbrush and fluoride toothpaste provided and then rinsed with 20 mL of their assigned mouthwash for 30s twice daily. Subjects refrained from eating or drinking for 30 min after rinsing. Dentin hypersensitivity assessments, as well as examinations of oral hard and soft tissues, were conducted at the baseline visit and again after two weeks, four weeks and eight weeks of product use. RESULTS: Ninety (90) subjects entered and completed the eight week study. After two weeks, four weeks and eight weeks of product use, subjects in the Arginine Mouthwash group exhibited statistically significant (p<0.05) improvements in mean tactile and air blast hypersensitivity scores as compared to the Negative Control Mouthwash. CONCLUSION: The results of this study support the conclusion that the Arginine Mouthwash provides a significant reduction in dentin hypersensitivity after eight weeks of product use as compared to a Negative Control mouthwash.

Efficacy of a mouthwash containing 0.8% arginine, PVM/MA copolymer, pyrophosphates, and 0.05% sodium fluoride compared to a commercial mouthwash containing 2.4% potassium nitrate and 0.022% sodium fluoride and a control mouthwash containing 0.05% sodium fluoride on dentine hypersensitivity: a six-week randomized clinical study.

OBJECTIVE: Evaluate the efficacy of 0.8% arginine, potassium nitrate and sodium fluoride mouthwashes on dentine hypersensitivity reduction. METHODS: Six week randomized, double blinded, two cell, parallel single centre clinical study in the Dominican Republic; subjects were randomized into three treatment groups: mouthwash containing 0.8% arginine, PVM/MA copolymer, pyrophosphates, and 0.05% sodium fluoride in an alcohol-free base (arginine); mouthwash containing 2.4% potassium nitrate and 0.022% sodium fluoride (potassium nitrate); a control mouthwash containing 0.05% sodium fluoride (negative control). Tactile and air-blast dentine hypersensitivity assessments were conducted at baseline, thirty minutes post rinsing and two, four, and six weeks of twice-daily product use. For treatment group comparisons, ANCOVA and post hoc Tukey's pair-wise comparisons (α=0.05) were done. RESULTS: Seventy-five subjects were enrolled; 69 subjects completed the study. There were no differences after thirty minutes of a single use, among the three groups with respect to mean tactile and air blast hypersensitivity scores compared to potassium nitrate and negative control mouthwashes (p<0.05). The arginine group presented a statistically significant improvement in the mean tactile scores compared to potassium nitrate and negative control groups after two, four, and six weeks (p<0.001) of product use; the arginine group showed a statistically significant enhancement in air blast hypersensitivity mean scores compared to potassium nitrate and negative control groups after two (p=0.001), four (p<0.001), and six weeks (p<0.001) of product use. CONCLUSION: A mouthwash containing arginine provides a significant and superior reduction in dentine hypersensitivity compared to potassium nitrate and a negative control mouthwash after two weeks.

A clinical study comparing the supragingival plaque and gingivitis efficacy of a specially engineered sonic powered toothbrush with unique sensing and control technologies to a commercially available manual flat-trim toothbrush.

OBJECTIVE: This study was designed to evaluate the efficacy of a new specially engineered sonic powered toothbrush with unique sensing and control technologies, as compared to a manual flat-trim toothbrush on supragingival plaque and established gingivitis. METHODS: This examiner-blind, two-treatment, parallel clinical research study assessed plaque removal via the comparison of pre- to post-brushing after a single use, and again after four- and 12-weeks' use using the Rustogi Modification of the Modified Navy Plaque Index. This study also assessed gingivitis at four and 12 weeks using the Löe and Silness Gingival Index. Qualifying adult male and female subjects from the southern Florida area reported to the study site after refraining from any oral hygiene procedures for 24 hours, and from eating, drinking, and smoking for four hours. Following an examination for plaque (pre-brushing) and gingivitis, they were randomized (for both plaque and gingivitis) into two balanced groups, each group using one of the two study toothbrushes. Subjects were instructed to brush their teeth for two minutes under supervision with their assigned toothbrush according to the manufacturer's instructions, and commercially available toothpaste (Colgate Cavity Protection Toothpaste), after which they were again evaluated for plaque (post-brushing). Subjects were then dismissed from the study site with the toothpaste and their assigned toothbrush to use at home twice daily for the next 12 weeks. They again reported to the study site after four and 12 weeks of product use, at which time they were evaluated for plaque and gingivitis. RESULTS: Seventy-six out of 82 enrolled subjects complied with the protocol and completed the clinical study. The new specially engineered sonic powered toothbrush with unique sensing and control technologies provided statistically significant reductions in gingival and gingivitis severity index scores after four and 12 weeks of product use. The manual toothbrush provided a statistically significant reduction in gingival index score only at the 12-week time point. Relative to the manual toothbrush group, after a single tooth brushing and after four and 12 weeks, the new sonic powered toothbrush provided statistically significantly greater reductions in whole mouth plaque index scores (1.6, 2.05, and 1.9 times, respectively), gingival margin plaque index scores (12.0, 90.0, and 8.2 times, respectively), and interproximal plaque index scores (2.0, 3.2, and 2.1 times, respectively). Relative to the manual toothbrush group after four and 12 weeks, the new sonic powered toothbrush provided statistically significant reductions in gingival index scores of 11.0 and 7.0 times, respectively, and in gingivitis severity index scores of 3.0 and 3.5 times, respectively. All statistically significant reductions were at the p < or = 0.05 level. CONCLUSION: The new specially engineered sonic powered toothbrush unique sensing and control technologies provides statistically significant and clinically relevant levels of efficacy in the removal of supragingival dental plaque after a single tooth brushing, and after four and 12 weeks' use. The new sonic powered toothbrush also provides statistically significantly greater levels of efficacy in the reduction of supragingival plaque, gingivitis, and gingival bleeding when compared to a manual flat-trim toothbrush.

Severity and prevalence of plaque-induced gingivitis in the Chinese population.

UNLABELLED: This study investigated the prevalence and severity of gingivitis and plaque in a representative Chinese population of adults. METHODS: Using the Loe-Silness gingivitis index (GI) and the modified Quigley-Hein plaque index (PULI), researchers examined 1143 patients from Guangzhou, Shenyang, and Nanjing for the presence of gingivitis and plaque. A two-tailed t-test was used to determine significant differences in the GI and PLI scores between gender and urban/rural areas. The data pertaining to study sites and age groups were compared using the Kruskal-Wallis one-way analysis of variances (ANOVA) by ranks. The correlation between GI/PLI and age was examined using the Pearson correlation coefficient. Age differences among three sites were analyzed with the one-way ANOVA. RESULTS: The age and urban/rural compositions (mean age 42.2 years) paralleled the 2008 China census. The overall average and standard deviation of GI and PLI were 1.101 +/- 0.239 and 3.394 +/- 0.578, respectively. Age significantly correlated with GI and PLI (P < .0001). The PLI in males was significantly higher (P < .0001) than in females; however, no significant difference was noted between GI in males compared to females. Patients in rural areas showed a significantly higher GI and PLI (t = 7.723, P < .0001; t = 7.072, P < .0001) than those in urban ones. CONCLUSIONS: Clinical trials evaluating a product's antigingivitis efficacy should recruit participants from a population that represents accurately the intended product users. Variables should include gender, race, age, and geography.