Higher prevalence of meticillin-resistant Staphylococcus aureus among dental students.

In order to test the hypothesis that more dental students are meticillin-resistant Staphylococcus aureus (MRSA) carriers than non-dental students, 100 dental students with five to six years of exposure to patients and 81 non-dental students were tested for nasal and pharyngeal MRSA carriage by polymerase chain reaction. All 181 students were clinically healthy and none had taken antibiotics. Significantly more dental students (20/100) carried MRSA than non-dental students (5/81) (odds ratio: 4.04; 95% confidence interval: 1.6-12.6; P = 0.0033). Also, more dental students' mobile phones (8/100) carried MRSA. All MRSA isolates were distinguished by pulsed-field gel electrophoresis from epidemiologically significant strains. The results suggest that dental students are occupationally exposed to MRSA.

Dental school deans' and dentists' perceptions of infection control and HIV/AIDS patient care: a challenge for dental education in Mexico.

HIV/AIDS patients face unique oral diagnostic and treatment challenges. The aim of this investigation among dental school deans (DSD) and graduate school applicants (GSA) who had qualified from 30 different dental schools was to assess their perceptions on dental education relevant to infection control (IC) and HIV/AIDS patient care. The questionnaire included Likert-type scale evaluations of agreement with statements. Of 158 questionnaires, 23 DSD (68% response rate), and 123 GSA (100% response rate) returned valid questionnaires. Fifteen (65%) DSD and 89 (72%) GSA ranked as "very strong" their perception that infection control prevents the transmission of blood borne viruses. However, the perception prevailed, among DSD and GSA, that HIV infection was a "very strong" to "strong" occupational hazard. Special reprocessing of instruments used on HIV patients was frequently reported. Many considered "very strong" to "strong" that HIV/AIDS patients must be treated in specialized clinics, and nearly half (48%) of the DSD and one third (35%) of the GSA stated that their school does refer HIV/AIDS patients to dental treatment in specialized clinics. These results indicate that many dental schools in Mexico must provide better education on IC and HIV/AIDS patient care to enhance attitudes toward HIV/AIDS patients.

Mexican dental school deans' opinions and practices regarding oral cancer, 2007.

Dentists must be trained in oral cancer (OC) screening and counseling. However, educational gaps exist in OC prevention worldwide. The objective of this investigation was to assess self-reported perceptions and practices relevant to OC education among Mexican dental school deans. At a leadership meeting in 2007, deans were given a questionnaire containing Likert-type scale evaluations of agreement with statements. Associations between variables were analyzed with Pearson's chi-square test. Of thirty-four deans attending, twenty-three (68 percent response rate) answered the questionnaire in full. Among the respondents, 83 percent believed "very strongly" that dentists must look for OC, but only 52 percent believed "very strongly" that OC screening must be adopted as a standard practice. Fifty-two percent ranked dentists' responsibility in looking after their patients' overall health as "very strong." The deans indicated less support for dentists' roles to intervene in tobacco and alcohol cessation. Participant deans lead institutions that provide education for over 12,000 dental students; their low awareness on OC screening and counseling may hinder the establishment of routine standardized screening and health promotion that help save human lives.

Infection control attitudes and perceptions among dental students in Latin America: implications for dental education.

UNLABELLED: Latin American dental schools are at diverse stages in the continuum of implementation of infection control (IC) programmes that comply with evidence-based recommendations. Poor IC training may result in low compliance and negative attitudes against patients infected with blood borne pathogens (BBP). OBJECTIVE: To evaluate students' knowledge on IC and attitudes toward occupational BBP risks, in six dental schools in Latin America. METHODS: This survey was administered to convenience samples of dental students at one school in Costa Rica; four schools in Mexico, and one in Venezuela. The questionnaire included Likert-type scale evaluations of agreement with statements. Study variables included knowledge about and confidence in recommended IC procedures, degree of concern about HIV and HBV transmission in dental settings, and attitudes toward patients infected with BBP. Possible associations between variables were analysed using Pearson's Chi square and Kruskal Wallis tests. RESULTS: Substantial numbers of students had incomplete knowledge and often lacked confidence on IC and procedures; believed that HIV and HBV could be transmitted during clinical procedures; felt worried about occupational exposure to BBP, and held prejudices towards HIV and HBV infected individuals. CONCLUSIONS: Educational efforts are needed to enhance IC teaching and compliance. Diverse educational resources and international networks for research collaboration are available from organisations specialised in IC, hopefully paving the way to harmonising regional standards.

Short communication: oral lesions in HIV/AIDS patients undergoing HAART including efavirenz.

Oral lesions (OL) have an important prognostic value for HIV/AIDS patients. However, the behavior of OL in HIV/AIDS patients undergoing highly active antiretroviral therapy including efavirenz (HAART/EFV) has not been documented. Our objective was to establish the prevalence of OL in HIV/AIDS patients undergoing HAART/EFV and to compare it with the prevalence of OL in patients undergoing antiretroviral therapy including a protease inhibitor (HAART/PI). Seventy-three HIV/AIDS patients undergoing antiretroviral treatment for at least for 6 months at "La Raza" Medical Center's Internal Medicine Unit (IMSS, Mexico City) were included. To detect OL, a detailed examination of oral soft tissues was performed in each patient. Patient records recorded gender, seropositivity time, route of contagion, antiretroviral therapy type and duration, CD4 lymphocyte count/ml, and viral load. Two groups were formed: 38 patients receiving HAART/EFV [two nucleoside analogue reverse transcriptase inhibitors (NARTI) plus efavirenz] and 35 patients receiving HAART/PI (two NARTIs plus one PI). OL prevalence was established in each study group. The Chi-square test was applied (p < 0.05(IC95%)). OL prevalence in the HAART/EFV group (32%) was lower (p < 0.007) than in the HAART/PI group (63%). Candidosis was the most prevalent OL in both groups. Herpes labialis, HIV-associated necrotizing periodontitis, xerostomia, hairy leukoplakia, and nonspecific oral sores were identified. The highest prevalence for all OL was found in the HAART/PI group. These findings suggest that HIV/AIDS patients undergoing HAART/EFV show a lower prevalence of oral lesions than patients undergoing HAART/PI.

Caries risk assessment from dental plaque and salivary Streptococcus mutans counts on two culture media.

This study attempted to determine which combination of plaque or saliva, and tryptic soy agar, bacitracin (TSY20B) or mitis salivarius, bacitracin media, yielded the highest caries-predictive values for mutans counts in children with different caries prevalence. Sixty children were divided into three equally sized groups: caries free, low caries and high caries. Eighteen months later, their caries incidence and initial mutans count were compared. Fissure plaque on TSY20B yielded a high correlation between mutans counts and caries prevalence (P<0.009, r=3346) and incidence (P<0.003, r=4521). The caries-predictive values obtained demonstrate that the coefficient of variation of mutans counts from lower first-molar fissure plaque on TSY20B accounts for 20.4% of the variation in final caries index. This strong correlation provides a valuable tool for the identification of caries-prone individuals.

[Secretory immune response in the oral cavity]. / Respuesta inmune secretoria en cavidad bucal.

Secretory IgA antibodies may modulate colonization of the epithelial and dental surfaces by different species of microorganisms. The application of enteric vaccines may probably permit controlling caries frequency infants and children. However, the complexity of bacterial communities involved in inflammatory periodontal diseases, currently prevent developing strategies aimed at preventing these processes through immunological mechanisms.

[Pemphigus vulgaris in the dental clinic]. / Pénfigo vulgar en la clínica estomatológica.

If left untreated, pemphigus is usually fatal. Therefore, it is important that therapy be started early in the course of the disease. In most cases, the oral mucosa is the first site of involvement. Hence, responsibility for early diagnosis often falls on the dental surgeon.