This study has assessed the durability of four brands of latex gloves, Ansell Medical 'Medi-Grip', Regent 'Biogel D', Surgikos 'Microtouch' and the London Rubber Company 'Supreme', under conditions of repeated washing and re-use in a clinical dental setting. The microbiological effectiveness of 'Hibiscrub' as a decontaminating washing agent was examined simultaneously. Examination by an electrical test for micropunctures in 200 unused gloves of each brand revealed such defects in 6(3%) of Ansell 'Medi-Grip', 3(1.5%) of 'Biogel D', 14(7%) of Surgikos 'Microtouch' and 2(1%) of LRC 'Supreme' gloves. Following repeated clinical use, micropunctures were detected in 18% of Ansell 'Medi-Grip', 10% of 'Biogel D', 75% of Surgikos 'Microtouch' and 56% of LRC 'Supreme'. Microorganisms were isolated from the glove surfaces after 45% of the occasions on which the gloves were washed for 1 min in 'Hibiscrub' (ICI Dental). Eighty-five per cent of these isolates were environmental organisms, but oral streptococci were isolated from 8.4% of the pairs of gloves examined. The high rate of micropuncture development following repeated washing and re-use of latex gloves indicates that they cannot effectively perform their barrier function under such conditions. The microbiological data have also revealed the potential for cross-infection between patients through inadequate decontamination of glove surfaces. For operative dental surgery, the results suggest that heavier, surgical type gloves are to be preferred, and that multiple use of any glove type should be discouraged.

Bacteriological Techniques↗

PubMed1992

Increased production of tumour necrosis factor by peripheral blood leukocytes in patients with recurrent oral aphthous ulceration.

Much evidence suggests that recurrent oral aphthous ulceration (RAU) is an immunologically mediated disease. Tumour necrosis factor has multiple biologic properties, some of which may be relevant to the pathogenesis of RAU. This study has assessed its production by peripheral blood leukocytes from aphthous patients in active and remission phases of disease and from patients with nonaphthous ulceration (diseased controls). Each ulcer patient was studied in parallel with a matched healthy control volunteer. A bioassay against the standard mouse fibrosarcoma line, L929, was used to assess the levels of tumour necrosis factor-alpha (TNF). Significantly greater amounts of TNF were released from unstimulated monocyte-enriched and monocyte-depleted leukocyte fractions in active RAU compared with those from healthy control donors, suggesting that this cytokine may be associated with RAU.

Adolescent↗

PubMed1992

Oral carriage of yeasts, coliforms and staphylococci in patients with advanced malignant disease.

Many patients with advanced cancer have oral problems, some of which may have a microbiologic basis. The oral flora in such patients has not, however, been characterized. This study has assessed the prevalence of yeasts, coliforms and coagulase positive staphylococci in the oral flora of 197 patients with advanced cancer. Both imprint cultures (n = 197) and oral rinses (n = 161) were collected. Yeasts were isolated from the mouths of 83% of the patients, coliforms from 49.1% and coagulase-positive staphylococci from 28%. All these percentages are considerably in excess of reported levels for healthy individuals. The results indicate a loss of colonization resistance of the oral mucosa in terminal cancer, with potential implications for the development of mouth care regimes for such patients.

Adult↗

PubMed1992

Viral infections in dentistry.

Viral diseases of relevance to dentistry have recently been reviewed with respect to human immunodeficiency virus disease, other immunocompromised persons, oral malignancies, infection control, and antiviral therapy. This review discusses the most recent advances in the understanding of aspects of human immunodeficiency virus relevant to dentistry and relevant aspects of the herpesviruses, human papillomaviruses, hepatitis viruses, and other viruses. Further detail is available in other recent reviews.

HIV Infections↗

PubMed1991

The influence of dental status on the detection of IgG class anti-viral antibodies in human saliva.

An antibody-capture radioimmunoassay was used to measure levels of IgG class antibodies to rubella and hepatitis A viruses in serum and saliva of 30 edentulous, 30 partially dentate and 31 dentate individuals. The prevalence of seropositivity for rubella was 98.9 per cent and for hepatitis A 73.6 per cent. The serum reactivities were generally greater than those for saliva. There were 8 false-negative results for saliva out of the 182 tests performed, of which 4 were in the edentulous group, 3 in the partially dentate and 1 in the dentate group. For both rubella and hepatitis A virus antibodies the (geometric) mean ratios between the saliva and serum reactivities were similar across the three dental groups. The values for sensitivity, specificity and positive predictive value suggest that assay of saliva for antiviral IgG antibody is a satisfactory technique regardless of dental status.

Adult↗

PubMed1991

Human herpesvirus-6: the latest human herpes virus.

Human herpesvirus-6 (HHV-6) was first isolated in 1986 from peripheral blood leukocytes of patients with lymphoproliferative disorders. Although HHV-6 is distinct from the other human herpes viruses, DNA studies have revealed some genomic similarities with cytomegalovirus. It has recently become evident that up to 95% of older children and adults are HHV-6 seropositive. Infection is believed to occur early in life, after maternal antibody has waned. Up to 92% of healthy adults shed HHV-6 in saliva, and evidence indicates that this secretion is important in spread of the virus. In situ hybridization and immunochemical studies suggest that the salivary glands themselves may be the site of replication and persistence of HHV-6. There is good evidence that HHV-6 is causally linked to exanthema subitum, a common febrile disease of infants. Associations of HHV-6 with postviral fatigue syndrome, lymphoproliferative disorders and progression of AIDS have all been examined, but the evidence in these cases remains conflicting.

Herpesviridae Infections↗

PubMed1991

Defective regulation of electrolyte and protein secretion in submandibular saliva of cystic fibrosis patients.

Explore the source record for details and available documents.

Adult↗

PubMed1991

HCV and HEV: the newly identified non-A non-B hepatitis viruses.

The last 2 years have seen dramatic advances in our understanding of the agents responsible for non-A, non-B hepatitis. The family of recognized hepatitis agents now numbers five. In this article, the authors update readers on the characteristics of the two most recent additions, hepatitis C and E, the former posing a potential risk to the dental surgeon.

Cross Infection↗

PubMed1990

A laboratory assessment of the antimicrobial effectiveness of glove washing and re-use in dental practice.

This study has assessed the ability of five hand-washing agents, Hibisol, Hibiscrub, Betadine, 70% isopropyl alcohol and bar soap, to decontaminate the surfaces of Biogel D, Surgikos Microtouch and Ansell Gammex latex medical gloves after repeated inoculation with Staphylococcus aureus. The glove and hand-washing agents were compared in a Latin Square experiment, and a standardized handwashing regime followed. Each of the gloves used in the study was later tested electrically for micropuncture formation. On the basis of microbial recovery, no specific combination of glove and hand washing agent proved superior, the marker organism being isolated on a sporadic basis. In addition, 17% of the gloves showed evidence of micropunctures after five sequential inoculations and washings. These results suggest that, even under strictly controlled conditions, glove surfaces cannot be reliably and consistently cleaned of microbial contamination, nor can they be guaranteed to remain puncture-free. Ideally, therefore, a new pair of gloves should be worn for each patient.

Cross Infection↗

PubMed1990

Electrolyte concentrations in control and cystic fibrosis submandibular saliva.

Explore the source record for details and available documents.

Adult↗

PubMed1990

Characterisation of the effector cells responsible for the in vitro cytotoxicity of blood leucocytes from aphthous ulcer patients for oral epithelial cells.

This study was designed to identify the cells responsible for the spontaneous cell mediated cytotoxic effect (SCMC) exerted by peripheral blood leucocytes from patients with recurrent aphthous ulceration, towards cultured oral epithelial cells. Peripheral blood leucocytes from recurrent aphthous ulceration patients exerted a significantly greater (p less than 0.01) degree of cytotoxicity towards the oral epithelial target cells than did peripheral blood leucocytes from healthy control subjects, or from patients with non-specific ulceration. Depletion of CD-5 positive cells (T-lymphocytes) resulted in a significant decrease in the SCMC in aphthous patients. Depletion of CD-16 positive cells (NK-cells) produced no significant change in cytotoxicity. T-lymphocytes, therefore, appear to be intimately involved in the in vitro SCMC effect in recurrent aphthous ulceration.

Adolescent↗

PubMed1990

Colour teaching aids in oral pathology.

A simple and cost effective photographic method is described for presenting case materials to assist in the practical teaching of Oral Medicine and Pathology to undergraduate dental students. The information contained in each presentation is comprised of clinical radiographic and histopathological material.

Audiovisual Aids↗

PubMed1990

Examination of submandibular fluid in cystic fibrosis.

A novel collecting device was used to obtain pure submandibular saliva from control and Cystic Fibrosis (CF) individuals. Vitamin C stimulation induced a 2-fold increase in flow rate relative to resting; CF rates were lower under both conditions. Control and CF saliva differed in that stimulation did not result in increased Na+ and Cl- levels in CF saliva and that elevated levels of Ca2+ and PO4(2-) were observed in CF. The results imply altered electrolyte secretion in CF in response to a stimulus in vivo.

Adult↗

PubMed1989

Rapid diagnosis of oral herpes simplex or zoster virus infections by immunofluorescence: comparison with Tzanck cell preparations and viral culture.

This study compared viral culture with routine cytology and immunofluorescent staining of oral epithelial cell smears for the diagnosis of orofacial infections due to herpes simplex virus (HSV) or herpes zoster (HZ). Twenty-one patients were studied. Viral culture gave the greatest number of positive results, with an assumed sensitivity and specificity of 100%, but the test took at least 24 hours. For haematoxylin and eosin cytology, the corresponding figures for sensitivity and specificity were 54% and 100%, respectively. Direct staining of epithelial smears with FITC-conjugated monoclonal antibodies to HSV type 1, HSV type 2 and HZ had a sensitivity of 82% and specificity of 71%. Smears prepared from oral washings, and stained with the same fluorescent antibodies, yielded a sensitivity of 83% and specificity of 86%. To allow rapid diagnosis, oral epithelial smears for immunofluorescent examination should also be prepared, since in more than 80% of cases such smears will confirm an herpetic infection in less than one hour.

Adult↗