Visual Schedule System in Dental Care for Patients with Autism: A Pilot Study.

OBJECTIVES: A pilot study to test whether a visual schedule system using picture communication symbols can help children with autism have successful routine dental cleaning visits. STUDY DESIGN: 14 boys with autism between three- to eight-years-old presented to the dental clinic for four weekly consecutive dental appointments. Patients were randomly assigned to either the control group who received the tell-show-do method (i.e., standard of care), or the test group who received the tell-show-do method plus the visual schedule system. RESULTS: Patients in the test group completed an average of 1.38 more steps, at 35.52 seconds per step faster, and with 18.7% lower levels of behavioral distress than those in the control group. CONCLUSION: The use of a visual schedule system, along with repeated weekly visits, showed some promise in helping children with autism successfully complete more steps, progress at a quicker rate, and exhibit lower levels of behavioral distress within a dental appointment, compared to a traditional tell-show-do approach.

IrvA-dependent and IrvA-independent pathways for mutacin gene regulation in Streptococcus mutans.

Streptococcus mutans is a primary pathogen associated with dental caries. Its bacteriocin (mutacin) production ability is thought to play an important role in maintaining competitiveness in the multispecies oral biofilm. Previous studies have demonstrated that the production of the lantibiotic, mutacin I, is responsive to multiple input signals and that a putative inducible repressor, irvA, seems to be involved in the luxS-mediated mutacin I gene regulation pathway. In this study, we demonstrate that these multiple inputs can be divided into two pathways: irvA-dependent and irvA-independent. Similar to luxS, signals mediated through vicK, pttB and hk03 exert their effect possibly through modulating irvA transcription, whereas signals mediated through ciaH, hrcA, adhE, and Smu1281 exert their effect through an unknown mechanism independent of irvA.

Medical approach to dental caries: fight the disease, not the lesion.

Dental caries is one of the most prevalent and costly diseases in the United States and throughout the world. Although the manifestation of the disease is the dissolution of tooth structure, the biological nature of the disease is a microbial infection. Traditional dentistry has been heavily focused on repairing damaged tooth structure via surgical approaches. The advancement of microbiology and engineering is bringing a medical revolution to dentistry. The on-going exciting progress in caries research has offered us great opportunities to better understand, detect, and monitor the disease. Most importantly, these new biological discoveries and technological developments allow us to address the etiological cause of the disease (microbial infection), which can lead to more effective treatments and prevention of dental caries.

Identification of genes associated with mutacin I production in Streptococcus mutans using random insertional mutagenesis.

Streptococcus mutans is a major pathogen implicated in dental caries. Its virulence is enhanced by its ability to produce bacteriocins, called mutacins, which inhibit the growth of other Gram-positive bacteria. The goal of this study is to use a random insertional mutagenesis approach to search for genes that are associated with mutacin I production in the virulent strain UA140. A random insertional mutagenesis library consisting of 11,000 clones was constructed and screened for a mutacin-defective phenotype. Mutacin-defective clones were isolated, and their insertion sites were determined by PCR amplification or plasmid rescue followed by sequencing. A total of twenty-five unique genes were identified. These genes can be categorized into the following functional classes: two-component sensory systems, stress responses, energy metabolism and central cellular processes. Several conserved hypothetical proteins with unknown functions were also identified. These results suggest that mutacin I production is stringently controlled by diverse and complex regulatory pathways.

Dental caries and chemical warfare within the mouth.

To date, it appears that the dentists' war against dental caries has no end in sight due to the fact that dentists lack any genuine offensive firepower. Make no mistake, the defense has drastically improved as dentists have shifted the focus more toward the preventive aspects of dental care. But defense by itself cannot defeat the enemy; at best, it can maintain the status quo. In order to defeat the enemy, one must study and understand the enemy, to know its strengths and weaknesses, and to strike at those points of vulnerability. The aim of this research is to identify and characterize genes that are responsible for observed virulence factors in Streptococcus mutans, which is the primary pathogen involved in the development of dental caries. Once there is a more defined understanding of the many virulence factors of S. mutans, there will be a much more valuable insight into its role in the ecology of the oral cavity. Eventually, this knowledge could enable dentists to convert the bacterial "weaponry" into its own arsenal, which could then be innovatively employed as preventive, diagnostic, and therapeutic agents to treat oral bacterial-related diseases.