Microbiota and Metatranscriptome Changes Accompanying the Onset of Gingivitis.

Over half of adults experience gingivitis, a mild yet treatable form of periodontal disease caused by the overgrowth of oral microbes. Left untreated, gingivitis can progress to a more severe and irreversible disease, most commonly chronic periodontitis. While periodontal diseases are associated with a shift in the oral microbiota composition, it remains unclear how this shift impacts microbiota function early in disease progression. Here, we analyzed the transition from health to gingivitis through both 16S v4-v5 rRNA amplicon and metatranscriptome sequencing of subgingival plaque samples from individuals undergoing an experimental gingivitis treatment. Beta-diversity analysis of 16S rRNA reveals that samples cluster based on disease severity and patient but not by oral hygiene status. Significant shifts in the abundance of several genera occurred during disease transition, suggesting a dysbiosis due to development of gingivitis. Comparing taxonomic abundance with transcriptomic activity revealed concordance of bacterial diversity composition between the two quantification assays in samples originating from both healthy and diseased teeth. Metatranscriptome sequencing analysis indicates that during the early stages of transition to gingivitis, a number of virulence-related transcripts were significantly differentially expressed in individual and across pooled patient samples. Upregulated genes include those involved in proteolytic and nucleolytic processes, while expression levels of those involved in surface structure assembly and other general virulence functions leading to colonization or adaptation within the host are more dynamic. These findings help characterize the transition from health to periodontal disease and identify genes associated with early disease.IMPORTANCE Although more than 50% of adults have some form of periodontal disease, there remains a significant gap in our understanding of its underlying cause. We initiated this study in order to better characterize the progression from oral health to disease. We first analyzed changes in the abundances of specific microorganisms in dental plaque collected from teeth during health and gingivitis, the mildest form of periodontal disease. We found that the clinical score of disease and patient from whom the sample originated but not tooth brushing are significantly correlated with microbial community composition. While a number of virulence-related gene transcripts are differentially expressed in gingivitis samples relative to health, not all are increased, suggesting that the overall activity of the microbiota is dynamic during disease transition. Better understanding of which microbes are present and their function during early periodontal disease can potentially lead to more targeted prophylactic approaches to prevent disease progression.

Admissions Criteria that Influence Dental Hygiene Students' Performance on Board Examinations.

Purpose: The purpose of the study is to assess which dental hygiene program admission variables contribute to the selection of students who are successful in passing the National Board Dental Hygiene Examination (NBDHE) and a clinical dental hygiene board examination.Methods: A retrospective study was conducted by investigating 121 educational records and application forms from graduates through the years 2008 to 2011 from one educational institution. Predictor variables included re-application status, student GPA, age, race/ethnicity, type of school attended for pre-requisite coursework, number of times the pre-requisite courses needed to be retaken, course load while taking the pre-requisites, previous degrees obtained, American College Test (ACT) scores and student participation in the university's lower division (LD) or upper pre-placement (UPP) program. Graduate success is defined by NBDHE scores and clinical board scores.Results: The data was analyzed using univariate analyses and multivariate regression statistical techniques. Univariate analyses did not identify any predictor variables to be significantly associated with the dental hygiene student's clinical board score. However, the variables of ACT scores and type of student, specifically the UPP students, demonstrated a significant relationship with NBDHE scores.Conclusion: ACT scores are a variable that is positively associated with higher NBDHE results. Results indicate that UPP students benefit from participating in supportive educational services while fulfilling requirements for admissions in the dental hygiene program. Results also indicate that there were no significant variables identified to predict clinical board scores.

Tobacco cessation treatment education for dental students using standardized patients.

The use of standardized patients (SPs) shows promise in tobacco cessation treatment (TCT) training by providing a simulated clinical environment for dental students to practice counseling skills with individuals trained to portray patients. The purpose of this study was to determine if there was a difference in attitudes, perceptions, and knowledge between dental students who received a lecture and practice sessions with SPs and those who received a lecture only. Dental students in an introductory clinical course at one dental school were invited to participate in the study by completing a pre and post questionnaire. The pre questionnaire was administered to all students prior to a tobacco cessation lecture. Students were group-randomized to either the intervention or control group. The intervention group completed the post questionnaire after the lecture and practice sessions with SPs, and the control group completed it after the lecture only. Of ninety-eight students who attended the lecture and were invited to participate in the study, a total of ninety-four from the two groups (96 percent) provided two linkable questionnaires for analysis. In the results, training with lecture and SPs increased the students' understanding of barriers, subjective norms, perceived skills, self-efficacy, and intentions to provide TCT more than those in the lecture only; however, it did not significantly increase their attitudes and knowledge. These findings suggest that using SPs is a valuable educational method to promote the provision of TCT by dental students and graduates.

Tobacco cessation counseling training with standardized patients.

A pilot study was conducted to assess clinician receptivity to tobacco cessation counseling training methods using standardized patients. Additionally, the study assessed changes in clinician knowledge and behavioral intentions following the training. Medical and dental residents and dental hygiene students from the University of Louisville attended a one- to two-hour lecture addressing the counseling strategies (the Five As/the Five Rs) and pharmacotherapy recommended in the U.S. Public Health Service Clinical Practice Guideline: Treating Tobacco Use and Dependence. Participants subsequently had three training encounters with standardized patients representing various stages of change including a patient ready to quit, a patient contemplating quitting, and a patient resistant to quitting. Thirty-six participants completed a preprogram survey prior to the lecture and a postprogram evaluation that included questions about their attitudes and beliefs about tobacco, their comfort level with various aspects of tobacco intervention, and eight knowledge questions. Participants demonstrated a statistically significant increase in objective knowledge about the practices recommended in the Clinical Practice Guideline following intervention. Results also indicate a significant increase in subjective measures of participant receptivity, self-reported comfort, and perceived skill with various aspects of tobacco intervention. Overall, participants were found to be very receptive to training sessions on tobacco cessation counseling with standardized patients. In light of the educational gains and positive response from participants, the use of standardized patients is a promising strategy for training on tobacco cessation counseling.