The prevalence of pathogenic periodontal microflora in healthy young adult smokers.

BACKGROUND: Smoking is a major risk factor in periodontitis, although the mechanisms of its effects are not well understood. The overall goal of this clinical study was to determine if smoking enhances the colonization of the oral cavity by pathogenic bacteria in a periodontitis-free population. The prevalence of Actinobacillus actinomycetemcomitans, Porphyromonas gingivalis, Prevotella intermedia, Fusobacterium nucleatum, Campylobacter rectus, Eikenella corrodens, Bacteroides forsythus, and Treponema denticola was investigated in 25 smokers and 25 non-smokers by using DNA probes. METHODS: The subjects were 21 to 35 years of age with a healthy periodontium or slight gingivitis and were systemically healthy. The test group included subjects who had a minimum of a 1.5 pack-year history of smoking, while the control subjects never smoked. Subgingival plaque samples were taken by paper point following the assessment of multiple clinical parameters. RESULTS: This investigation showed: 1) no statistically significant differences were noted in any clinical parameter measured between the groups; 2) of the 8 subjects who were infected by at least 1 tested pathogen, seven were smokers (P= 0.02); 3) infected smokers had a 15.7+/-3.5 pack-year history and smoked a mean of 27+/-5 cigarettes/day versus 4.4+/-0.8 pack years and 15+/-1 cigarettes/day for the non-infected smokers (P = 0.0001 and P = 0.004); and 4) smokers were 18 times more likely to exhibit the presence of pathogens than non-smokers. CONCLUSIONS: These data indicate that the prevalence of colonization of the sulcus by pathogenic bacterial species in periodontitis-free individuals is related to the quantity and duration of cigarette smoking.

Salaries and benefits of dental hygienists in Tennessee.

Salaries and benefits are a major concern for dental hygienists and their employers. In 1998, the University of Tennessee Dental Hygiene Department conducted a survey of dental hygienists licensed to practice in Tennessee. Objectives included (1) to determine the current salary range and benefits of practicing dental hygienists, (2) to determine the factors which influence salaries and benefits, and (3) to compare the salaries and benefits of dental hygienists across the state. Results revealed an average compensation of $175.00 per day. While most full-time dental hygienists receive paid vacation, only 33 percent receive health care benefits. There were various factors influencing salaries and benefits, including the method of compensation, region of the state in which one practices, years of experience, and ethnic background.

Inhibition of neutrophil and monocyte defensive functions by nicotine.

To learn more about the effects of smokeless tobacco on the defensive functions of neutrophils, we studied the influence of nicotine on these cells in vitro, looking at their bactericidal activity against oral pathogens, and at their ability to produce microbicidal reactive oxygen species (oxygen radicals). Exposure of human blood neutrophils to nicotine (0.01% to 0.1%) inhibited their ability to kill Actinomyces naeslundii, Actinobacillus actinomycetemcomitans, and Fusobacterium nucleatum. Although these concentrations of nicotine are high, such concentrations are relevant to phagocytes in the gingival sulcus, because smokeless tobacco contains 0.5% to 3.5% nicotine by dry weight. Nicotine had no such inhibitory effect when the killing assay was performed in an anaerobic environment, implying that nicotine preferentially affected oxygen-dependent killing mechanisms. To further investigate the effects of nicotine on production of oxygen radicals, neutrophils were primed with lipopolysaccharide and triggered with f-met-leu-phe or phorbol ester in the presence of nicotine. Nicotine inhibited production of superoxide anion (measured by reduction of cytochrome c) and hydrogen peroxide (measured by oxidation of phenol red). Nicotine inhibition of superoxide production was reversible by washing away the nicotine. By observing that nicotine inhibited the reduction of cytochrome c by reagent potassium superoxide, we determined that nicotine directly absorbed superoxide. In addition, by examining nicotine inhibition of the uptake of oxygen by neutrophils, we determined that nicotine also interfered with the production of oxygen radicals by these cells. Nicotine also inhibited production of superoxide and interleukin-1 beta by monocytes. Nicotine did not affect the viability of neutrophils and monocytes, as determined by their ability to exclude trypan blue dye. Inhibition of the aerobic antimicrobial functions of neutrophils and monocytes by nicotine may alter the microbial ecology of the oral cavity, and this might be one mechanism by which nicotine compromises the oral health of users of tobacco products.

Factors affecting participation in external degree completion programs.

Although many dental hygienists have considered pursuing a baccalaureate degree, many barriers intervene to prevent accomplishment of this goal. The external degree is one option that could be available to overcome some of the barriers to accessibility. An external program is one that makes education accessible to students in nontraditional ways. A characteristic of these programs is that students can usually pursue academic credit toward a degree without being physically present on the degree-granting campus for the majority of the program. This paper reports the results of a 1988 survey of certificate and associate degree dental hygienists' interest in an external baccalaureate degree completion program. A questionnaire was mailed to 213 certificate and associate degree dental hygienists in Tennessee who had expressed an interest in degree completion. Two hundred six questionnaires were returned for a response rate of 96.7%. In order to determine the potential success of such programs, the following factors were explored: the motivations or reasons for participating; program design factors that might encourage or deter participation; degree of employer support; and individual characteristics relevant to participation, such as personal commitment and demographic information. Geographic location, flexibility in scheduling, and accessibility to course work were the program design factors most important to the likely participants. Likely participants indicated that they wanted to return to complete their baccalaureate degrees for personal satisfaction, for the status of the degree, and to increase their knowledge and skill in dental hygiene. They indicated that they did not want to change the focus of their careers. The area of study rated as most important was advanced clinical dental hygiene. The likely participants were found to resemble other nontraditional students. They averaged 34 years of age, were married with children living at home, and were able to study on a part-time basis only. The analysis of the data obtained from the questionnaire led to the conclusion that external program design factors would be essential for most certificate and associate degree dental hygienists to participate in a baccalaureate degree completion program.

Survey of ethical issues in dental hygiene.

The purpose of this study was to determine the types and frequency of ethical problems encountered by dental hygienists, and to determine the type of instruction they have received in ethical theory and problem solving. A 40-item questionnaire mailed to 2,251 American Dental Hygienists' Association members resulted in a stratified random sample of 1,523 (68% response rate). The three ethical dilemmas most frequently encountered in dental hygiene practice are (1) observation of behavior in conflict with standard infection control procedures (66%); (2) failure to refer patients to a specialist such as a periodontist (60%); and (3) nondiagnosis of dental disease (58%). While almost 86% of the respondents received formal instruction in ethical theory, only 51% received formal instruction in methods for solving ethical problems. More hygienists (74%) felt their ethical principles were influenced by role models rather than by formal instruction (63%). This study indicates that serious ethical dilemmas are encountered by the majority of dental hygienists and that some modification of current entry-level education, as well as of continuing professional education, should be considered to prepare dental hygienists to recognize and resolve ethical problems.