Study protocol for a pilot quasi-experimental study on oral health education for nurses and community health workers in Nigeria.

Introduction: The primary health care system provides an ideal setting for the integration of oral health into general health care as well as equitable access to oral health care. However, the limited oral health knowledge of primary health care workers necessitates appropriate training before they can participate in health promotion efforts. This pilot training was designed to examine the impact of the Oral Health Education module for Nurses and Community Health Care Workers on their oral health awareness and referral practices. Methods: This study will utilize a quasi-experimental design (pre-and post with a non-equivalent control group) to assess the impact of a five-day pilot oral health education program on the knowledge and referral practices of Nurses and Community Health Workers in primary health care centers in three states in Nigeria-(Lagos, Oyo, and Kano). The training modules were developed based on the six iterative steps described in the intervention mapping framework - needs assessment, highlighting program objectives and outcomes, selection of theory and mode of intervention, designing program based on theory, designing implementation plans, and developing an evaluation plan. Only the intervention group will participate in the full educational training sessions but both groups will complete the pre-and post-intervention questionnaires. Discussion: This pilot training combined the standardized training modules from the recently launched "Oral Health Training Course for Community Health Workers in Africa" and a newly developed maternal and child oral health module by our group using an evidence-based approach. To the best of our knowledge, this is the first program to examine the impact of the standardized OpenWHO modules. The success of this training will lay the foundation for developing a sustained channel for providing oral health education at the primary health care level in Nigeria, West Africa, and Africa.

Three-dimensional visualization of dentine occlusion based on FIB-SEM tomography.

The occlusion of dentinal tubules has become a rapid and effective method for treating dentin hypersensitivity. Accurate evaluation of dentin occlusion is critical to illustrate the efficacy of oral care products and to optimize dental therapy in the clinics, which is limited by the conventional two-dimensional (2-D) characterization methods. Here, we demonstrate the visualization of the dentin occlusion via three-dimensional (3-D) characterization using a focused ion beam-scanning electron microscopy (FIB-SEM) tomography. Using the "Slice and View" approach, the material used for occluding dentin tubules is imaged with a very high-resolution voxel (10 nm × 10 nm × 20 nm) from 2-D SEM images and then reconstructed into a 3-D volume, which presents the mode of action of toothpaste for treating dentin hypersensitivity. Meanwhile, quantitative analysis of the depth of occlusion is successfully obtained. This work validates the feasibility of FIB-SEM tomography in the analysis of dentin occlusion within the complicated networks of dentine tubules at the nanoscale, and provides a novel approach to facilitate the research and development of oral care products.

Super high-quality SEM/FIB imaging of dentine structures without collagen fiber loss through a metal staining process.

Scanning Electron Microscope/Focused Ion Beam (SEM/FIB) system has become valuable and popular tool for the analysis of biological materials such as dentine structures. According to physiological and anatomical studies, dentine structures are a complicated system containing collagen fibers, nanocrystalline hydroxyapatite, and numerous networks of tubular pores. During a routine FIB milling process, collagen fibers and other organic structures are vaporized, which increases the number of pores on the milled surface of the dentine. This causes the final cross-section to be more porous than the pristine sample. Unfortunately, little attention has been paid to the collagen fiber loss and how to preserve them during a FIB milling process. In this work, we present a novel and simple approach to preserve the organic portions of the dentine structure through metal staining. By using this method, the porosity of the dentine structure after the FIB milling process is significantly reduced similar to the pristine sample. This indicates that the organic portion of the dentine structure is well protected by the metal staining. This approach enables the SEM/FIB system to generate super-high quality SEM images with less ion beam damage; and the SEM images can better reflect the original condition of the dentine structure. Further, serial energy-dispersive X-ray spectroscopy (EDS) mapping of the stained dentine structure is achieved without an additional metal coating; and three-dimensional (3-D) elemental mapping of an occluded dentine is achieved with a significantly reduced data acquisition time.

Effect of a stannous fluoride toothpaste on dentinal hypersensitivity: In vitro and clinical evaluation.

BACKGROUND: The authors conducted an in vitro and a clinical study to assess the effect of a toothpaste containing stannous fluoride to occlude dentin tubules and reduce dentinal hypersensitivity. METHODS: For the in vitro study, the authors treated the surface of human dentin specimens with test or control toothpaste slurries and then evaluated them by using various spectroscopic techniques. For the clinical study, male and female participants who met the inclusion criteria brushed their teeth twice daily for 1 minute with test or control toothpaste. The authors assessed dentinal hypersensitivity by using tactile and air blast stimuli at baseline and after 4 and 8 weeks. All statistical tests of hypotheses were 2 sided, with a significance level of α set at .05. RESULTS: Results from in vitro studies showed that the test toothpaste effectively occluded the dentinal tubules with a deposit consisting of tin, zinc, phosphate, and silicon. The test and control toothpastes occluded the tubules 82% and 35%, respectively. Clinically, at the 4- and 8-week examinations, the test toothpaste provided statistically significant (P < .001) improvements in tactile dentinal hypersensitivity scores of 27.8% and 42.0% and in air blast hypersensitivity scores of 21.4% and 32.3%, respectively, relative to the control toothpaste. CONCLUSIONS: The in vitro results indicate the toothpaste containing 0.454% stannous fluoride effectively coated dentin surfaces and occluded patent dentin tubules. Compared with the control toothpaste, the test toothpaste provided a significant reduction in dentinal hypersensitivity after 8 weeks of product use. PRACTICAL IMPLICATIONS: A multi-benefit option for patients with dentinal hypersensitivity.

Synthesis of a nanocomposite composed of reduced graphene oxide and gold nanoparticles.

We report a seeded-growth process that results in the adhesion of size-controlled gold (Au) nanoparticles (NPs) to the surface of reduced graphene oxide (rGO), leading to the formation of rGO-Au nanocomposites. The synthesis approach involves the utilization of Au molecular precursors (i.e., the seeds) bonded to oxygen functionalities which intrinsically exist on GO. Upon reduction of the Au precursors, surface deposition of Au NPs is ensured. It is found that the size of Au NPs is controlled via the variation of precursor concentration in the growth solution. The redox chemistry between GO and Au precursors causes the reduction of GO to rGO and the generation of Au NPs on the surface of rGO. Microscopic and spectroscopic measurements have been performed to provide evidence for the suggested redox chemistry.

Surface properties of porous carbon obtained from polystyrene sulfonic acid-based organic salts.

Pyrolysis ofpolysterene sulfonic acid-co-maleic acid salts at 800 degrees C resulted in formation of new materials consisting of porous carbon and metal species dispersed on the surface. After hydrochloric acid treatment, the metal oxides/salts were removed. Obtained materials were characterized using adsorption of nitrogen, thermogravimetric analysis, Raman spectroscopy, and scanning electron microscopy with energy dispersive analysis of X-rays. The results showed highly developed porous structures in the range of micro- and mesopores. The porous features of new materials resemble those characteristics for carbon foams. The differences in the porous structure are linked to the type of transition metal used for the modification of the initial polymer and the chelation process. Macro- and mesopores are spherical/cylindrical in shape, and they are likely formed when release of pyrolysis gases, such as CO2, NO2, SO2, H2S, and CxHy, occurs. Moreover, reduction of metal, its migration to the surface, and agglomeration contribute to development of porosity. Depending on the reactivity of the metal used for cation exchange (Fe, Co, or Ni) either sulfides (nickel and cobalt) or oxides (cobalt and iron) are formed on the carbon surface.