bluuebunny/crossref_metadata_2025 huggingface dataset:
Dental Caries Status and Need for Dental Treatment of Pennsylvania Public School Children in Grades 1,3, 9, and 11
Authors: Weyant Robert J. , Manz Michael , Corby Patricia
Published: May 2007

Objectives: This cross‐sectional study was designed to determine the caries status and provide a general evaluation of the level of dental treatment need of Pennsylvania public school children in grades 1, 3, 9, and 11 on a statewide and regional basis. Methods: Between September 1998 and May 2000, caries status and treatment need were assessed using a school‐based dental examination, performed on a representative sample (n=6,040) of public school children in grades 1, 3, 9, and 11 (age range=6 to 21 years). Children's caries status in the primary and permanent dentition was assessed. Need for treatment was scored on a three‐level categorical scale—no treatment need identified, routine treatment need, and urgent treatment need—and was based on the presence and severity of caries and other oral conditions. Population estimates of the prevalence of untreated dental caries, DMFT and dft scores, and treatment need were calculated by grade and geographically, using the six Pennsylvania health districts and the cities of Pittsburgh and Philadelphia. The inequality of caries distribution in the population was assessed for both permanent and primary caries using Lorenz curves and Gini coefficients. Results: Dental caries has remained highly prevalent among Pennsylvania's public school children. Caries levels varied considerably by health districts and city. Urgent treatment needs were significant and also varied by health district and city. Conclusions: Dental caries remains the most prevalent disease affecting Pennsylvania's schoolchildren. Caries status varies significantly by region of the state, suggesting that environmental, social, and demographic contextual factors may be important determinants of disease prevalence.
Life‐style Correlates of Tooth Loss in an Adult Midwestern Population
Authors: Klein Barbara E. K. , Klein Ronald , Knudtson Michael D.
Published: May 2007

Objectives: To describe life‐style correlates of tooth loss in a representative rural American population. Methods: Information on tooth loss as well as past medical history and life‐style factors was obtained in a well‐defined cohort of 2,764 persons 53–96 years of age in Beaver Dam, WI (1998–2000). Results: There were 1,992 (68.2%) persons missing some and 447 (15.3%) missing all of their teeth. In univariable analyses, age, cigarette smoking, heavy drinking, education, multivitamin use, and diabetes status were associated with tooth loss. Tooth loss was associated with poorer self‐rated health and with difficulty eating solid food and inability to enjoy some food. In multivariable models age, education, smoking, heavy drinking, and diabetes were significantly associated with tooth loss. Conclusions: Tooth loss is common in older persons and is associated with many risk factors including education, smoking, and heavy drinking. It is possible that modifying these may influence risk of tooth loss.
Prevalence and Handedness Correlates of Recurrent Aphthous Stomatitis in the Turkish Population
Authors: Çiçek Yasin , Çanakçi Varol , Özgöz Mehmet , Ertas Ümlt , Çanakçi Ebru
Published: May 2007

Objectives: The present study was designed to determine the relationship between recurrent aphthous stomatitis (RAS) and handedness, and to assess the prevalence of RAS in the Turkish population. Methods: The present study was conducted among 11,360 persons (5,705 males and 5,655 females) with a mean age of 30.4 years. A questionnaire focusing on handedness was administered to these patients. Handedness was assessed according to the Edinburgh Handedness Inventory. The diagnosis of RAS was made on the basis of clinical appearance, location, and the patient's health history. RAS information of patients was collected by means of a data form specifically designed for this study. Subjects were informed about RAS. We took anamneses and filled out the investigation forms. Apart from patients with registration of current aphthae (average point prevalence, APP), patients who had a past two‐year history (self‐reported two‐year prevalence, SRTP) of the lesion were also included in this study. Data were analyzed using the chi‐square and logistic regression tests. Results: The prevalence of RAS (APP) was 2.7 percent and that of a history of RAS (SRTP) 22.8 percent. Thus, the total prevalence (APP + SRTP), including present lesions and a two‐year history (SRTP), was 25.5 percent. Adjusted results showed that females, left‐handers, 10–30‐year‐olds, and nonsmokers were 1.53, 1.69, 2.05, and 1.61 times more likely to have RAS (APP+SRTP) than males, right‐handers, 31–50‐year‐olds, and smokers, respectively (P <.0001). Conclusion: The present study suggests that left‐handedness appears to be a predictor factor for RAS.
Association Between Mandibular Retrognathia and TMJ Disorders in Adult Females
Authors: Miller James R. , Burgess Jeffrey A. , Critchlow Cathy W.
Published: May 2007

Objective: This study assesses the association between temporomandibular joint (TMJ) disorders and mandibular retrognathia. Methods: We conducted a case‐control study among women, aged 18–70 years, recruited from Kaiser Permanente Northwest Division (KPNW, Portland, OR) and Group Health Cooperative of Puget Sound (GHC, Seattle, WA). Cases (N=160) were women seeking treatment for TMJ disorders at KPNW and GHC clinics. Controls (N=151) were women without TMJ disorders, selected from among adult female dental hygiene patients at KPNW or GHC enrollees. Case status was determined by questionnaire; mandibular sagittal position (orthognathic, mildly retrognathic, severely retrognaihic, or prognathic) was measured using digitized facial photographs. Odds ratios (OR) and associated 95 percent confidence intervals (CI) estimated the magnitude of the association between TMJ disorders and mandibular sagittal position. Results: Women with TMJ disorders were 4.0 times (95% CI/1.5, 10.8) more likely than controls to have severe retrognathia; no association with mild retrognathia or prognathia was seen. Results were similar when cases were restricted to those with recent onset of TMJ pain (OR/6.3; 95% CI=1.8, 21.8). Conclusions: We found a strong association between TMJ disorders and severe mandibular retrognathia in adult females. In some women this likely resulted from TMJ disorders influencing mandibular development over time. However, among a subset of women, our data support the reverse hypothesis—that severe mandibular retrognathia may influence the development of TMJ disorders. Despite this strong association, abnormal mandibular position contributed only a small portion to the overall rate at which women sought treatment for TMJ disorders.
Oral Cancer Knowledge and Examination Experiences Among North Carolina Adults
Authors: Patton Lauren L. , Agans Robert , Elter John R. , Southerland Janet H. , Strauss Ronald P. , Kalsbeek William D.
Published: May 2007

Objective: This study assesses knowledge of oral cancer risk factors, clinical signs, and oral cancer examination experience among North Carolina adults. Methods: A statewide random digit dial, computer‐assisted telephone interview was conducted in 2002, Data from 1,096 respondents, with a response rate of 62 percent, were poststratified to 2000 census data by sex, race, and age group to produce population‐based estimates. Knowledge of one sign of oral cancer, four or more risk factors for oral cancer, and having ever had an oral cancer examination were compared in logistic regression models using normalized weights. Results: Fourteen (95% confidence interval [CI]±2) percent of adults had never heard of oral or mouth cancer. Risk factor knowledge was high for 56 percent (95% CI±3) and associated in a logistic regression model with younger age, feeling personal factors cause cancer, and nonuse of snuff. One sign of oral cancer (sore/lesion, red or white patch in mouth, and bleeding in the mouth) was correctly identified by 53 percent (95% CI±3) with significantly more correct responses from younger people, nonsmokers, and some college education. Only 29 percent (95% CI±3) reported ever having had an oral cancer examination when this procedure was described. Most respondents reported exams performed by dentists. In a weighted logistic regression model, older age, being dentate, nonsmokers, alcohol users, and those with some college education were significantly more likely to report having ever had an oral cancer examination. Conclusions: Although there is moderate knowledge of signs and risk factors for oral cancer among North Carolina adults, knowledge deficits remain. Oral cancer examinations need to be increased, particularly among tobacco smokers.
Association of Denture Use with Sleep‐disordered Breathing Among Older Adults
Authors: Endeshaw Yohannes W. , Katz Sheri , Ouslander Joseph G. , Bliwise Donald L.
Published: May 2007

Objective: This study investigates the relationship between sleep‐disordered breathing and denture use. Methods: This was a cross‐sectional study of community‐dwelling older adults. Information about denture use was obtained using a questionnaire. Ambulatory sleep recording in subjects' homes was performed using Embletta PDS (Medcare, Iceland). Chi‐square tests and logistic regression analysis were used for statistical analysis. Results: A total of 58 subjects completed the study. The mean apnea hypopnea (AHI) index was 15.1 ± 16.1. Twenty‐two subjects (38%) used dentures and most removed them before sleep. There was significant association between denture use and AHI ≥ 15 per hour of sleep (odds ratio [OR]/6.29; 95% confidence interval [CI]=1.71, 23.22; P=.006). Conclusions: This preliminary study found an association between sleep‐disordered breathing and denture use, which may represent a proxy for a relationship between sleep‐disordered breathing and edentulism. Given the common occurrence of both conditions among older adults, the observed relationship warrants a more detailed investigation of the mechanisms whereby loss of teeth leads to upper airway closure during sleep.
An Assessment of the Dental Public Health Infrastructure in the United States
Authors: Tomar Scott L.
Published: May 2007

Objectives: The National Institute of Dental and Craniofacial Research commissioned an assessment of the dental public health infrastructure in the United States as a first step toward ensuring its adequacy. This study examined several elements of the US dental public health infrastructure in government, education, workforce, and regulatory issues, focused primarily at the state level. Methods: Data were drawn from a wide range of sources, including original surveys, analysis of existing databases, and compilation of publicly available information. Results: In 2002, 72.5% of states had a full‐time dental director and 65% of state dental programs had total budgets of $1 million or less. Among U.S. dental schools, 68% had a dental public health academic unit. Twelve and a half percent of dental schools and 64.3% of dental hygiene programs had no faculty member with a public health degree. Among schools of public health, 15% offered a graduate degree in a dental public health concentration area, and 60% had no faculty member with a dental or dental hygiene degree. There were 141 active diplomates of the American Board of Dental Public Health as of February 2001; 15% worked for state, county, or local governments. In May 2003, there were 640 US members of the American Association of Public Health Dentistry with few members in most states. In 2002, 544 American Dental Association members reported their specialty as Dental Public Health, which ranged from 0 in five states to 41 in California. Just two states had a public health dentist on their dental licensing boards. Conclusions: Findings suggest the US dental public health workforce is small, most state programs have scant funding, the field has minimal presence in academia, and dental public health has little role in the regulation of dentistry and dental hygiene. Successful efforts to enhance the many aspects of the US dental public health infrastructure will require substantial collaboration among many diverse partners.
Decision‐Making Process for Treatment of Mandibular Fractures among Minority Groups
Authors: Der‐Martirosian Claudia , Gironda Melanie W. , Black Edward , Leathers Richard , Atchison Kathryn A.
Published: May 2007

Objectives: While patients' preferences for medical care are widely studied, only a small number of studies have looked at the decision‐making process for dental treatment of mandibular fracture. This study examines the decision‐making process for treatment of mandibular fractures among minority groups. Study participants were asked to consider Maxillomandibular Fixation (MMF ‐ a non‐surgical approach of wiring the teeth for 4–8 weeks) or Rigid Internal Fixation (RIF ‐ surgical placement of bone plate). Methods: A qualitative study of patients receiving care at an inner‐city hospital for either 3rd molar extraction under general anesthesia or a mandibular fracture were recruited to participate in an hour‐long focus group to discuss their preferences. The 3rd molar group was selected as a comparison group exemplifying experience with oral surgery and recovery from general anesthesia. Results: Seven decision‐making factors affecting choice of treatment were discussed by both jaw fracture and 3rd molar groups, including: side effects, effectiveness of each treatment, trusting doctor's recommendation, what to expect from each procedure, use of pictures from previous case studies, surgery location of scar/ incision, and size of scar. Rigid Internal Fixation (RIF) participants discussed a different set of concerns compared to Maxillomandibular Fixation (MMF) participants. Conclusions: Regardless of gender, the treatment of choice for both 3rd molar and jaw fracture participants was the non‐surgical method of wiring of the teeth for 4–8 weeks. The Phase II part of this study will systematically examine patient preferences among a larger sample of 3rd molar and jaw fracture patients by incorporating the patient‐reported concerns about treatment of jaw fracture found in this inductive, phenomenological study.
Opinions of South Carolina Dental Students toward Tobacco Use Interventions
Authors: Cannick Gabrielle F. , Horowitz Alice M. , Reed Susan G. , Drury Thomas F. , Day Terry A.
Published: May 2007

Objectives: Tobacco use accounts for 75 percent of oral cancer deaths in the United States. One objective of Healthy People 2010 is to increase the percentage of dentists who provide smoking cessation counseling. However, studies of dentists have shown that the majority feel inadequately prepared to do so. The objective of this study was to determine the opinions of dental students at the Medical University of South Carolina (MUSC) regarding the provision of tobacco use interventions for patients. Methods: In 2002, 163 students were administered a written questionnaire which included questions about tobacco use interventions (response rate = 80 percent). Opinion items were analyzed using factor analysis, Fisher's Exact Test, and ANOVA (a 50.025). Results: While 89 percent of students agreed that dentists should be trained to provide tobacco cessation education, only 39 percent thought that they themselves were adequately trained. Students' opinions toward the role and training of dentists in providing tobacco use interventions differed by academic year. Only 14.1 percent of dental students were quite or very confident in their ability to help patients to stop smoking. Conclusions: This study indicates that although MUSC dental students support tobacco cessation training for dentists, the majority responded that they are not adequately trained and are not comfortable providing tobacco cessation education to patients. A comprehensive tobacco prevention and cessation program is indicated for the objective of Healthy People 2010 to be met.
The Cost‐Effectiveness of Large Amalgam and Crown Restorations Over a 10‐Year Period
Authors: Kolker Justine L. , Damiano Peter C. , Flach Stephen D. , Bentler Suzanne E. , Armstrong Steven R. , Caplan Daniel J. , Kuthy Raymond A. , Warren John J. , Jones Michael P. , Dawson Deborah V.
Published: May 2007

Objective: To assist clinical decision making for an individual patient or on a community level, this study was done to determine the differences in costs and effectiveness of large amalgams and crowns over 5 and 10 years when catastrophic subsequent treatment (root canal therapy or extraction) was the outcome. Methods: Administrative data for patients seen at the University of Iowa, College of Dentistry for 1,735 large amalgam and crown restorations in 1987 or 1988 were used. Annual costs and effectiveness values were calculated. Costs of initial treatment (large amalgam or crown), and future treatments were determined, averaged and discounted. The effectiveness measure was defined as the number of years a tooth remained in a state free of catastrophic subsequent treatment. Years free of catastrophic treatment were averaged, and discounted. The years free of catastrophic treatment accounted for individuals who dropped out or withdrew from the study. Results: Teeth with crowns had higher effectiveness values at a much higher cost than teeth restored with large amalgams. The cost of an addition year free of catastrophic treatment for crowns was $1,088.41 at 5 years and $500.10 at 10 years. Teeth in women had more favorable cost‐effectiveness ratios than those in men, and teeth in the maxillary arch had more favorable cost‐effectiveness ratios than teeth in the mandibular arch. Conclusions: Neither the large amalgam or crown restoration had both the lowest cost and the highest effectiveness. The higher incremental cost‐effectiveness ratio for crowns should be considered when making treatment decisions between large amalgam and crown restorations.
Demographic Factors Associated with Dental Utilization Among Community Dwelling Elderly in the United States, 1997
Authors: Skaar Daniel D. , Hardie Nancy A.
Published: May 2007

Objectives: The purpose of this study was to characterize dental service utilization in 1997 by community dwelling Medicare beneficiaries. Methods: The Medicare Current Beneficiary Survey, or MCBS, is a continuous annual series of nationally representative surveys of Medicare beneficiaries. Univariate comparisons were made between dependent variables (dental utilization and types of dental services) by each of the independent variables (age group, gender, race, income, education, population density, marital status and US Census Bureau regions using weighted proportions to test for independence between dependent and independent variables. Results: Overall, an estimated 41% of the population had a dental visit. Although utilization declined with aging, 24% of those 85 and older visited a dentist. Conclusions: This descriptive study provides important information about dental utilization and services in the American elderly population. Younger, high income, white or educated elderly Americans had higher dental utilization.
Response to “Comments on the Proposed Pediatric Oral Health Therapist”
Authors: Friedman Jay W.
Published: May 2007

Note: The referenced article was orginially printed in the Journal of Public Health Dentistry, 2005, Volume 65, pp 123 ‐127, and was authored by J.B. Bramson and A.H. Guay. Both are affiliated with the American Dental Association.
Prevalence and Causes of Oral Injuries in a Population of Canadian Adults Aged 18 to 50 Years ‐ A Brief Communication
Authors: Locker David
Published: May 2007

Objective: To determine the prevalence and causes of injuries to the mouth and teeth among adults aged 18 to 50 years in Ontario, Canada. Methods: 2001 individuals in the target age range participated in a telephone interview survey based on random digit dialling. Results: Overall, 15.5% of subjects reported a history of injury with 5.4% having multiple episodes of injury. One third of the injuries occurred in adulthood. The majority (85.0%) with a history of trauma reported damage to the teeth and of these, 26.0% broke one or more teeth, 25.4% reported one or more teeth being knocked out and 6.5% reported displacement of teeth. The most common cause of injury was playing sports, followed by collisions and falls. Violence accounted for 10.0% of the injuries reported. The causes of injury varied according to gender; education and the age at which the injury occurred. Conclusion: Oral and dental injuries occur throughout the lifespan, although the causes appear to vary according to the age at which they happen.
Dental Anxiety Among Young Israeli Male Adults as Related to Treatment Received during Childhood
Authors: Levin Liran , Eli Llana , Ashkenazi Malka
Published: May 2007

Objectives: To evaluate dental fear and anxiety among young male adults treated during childhood either by a certified pediatric dentist or a general dental practitioner. Methods: A structured questionnaire that included information regarding issues related to dental fear and anxiety (Intake Interview Questionnaire and the Dental Anxiety Scale) was completed by 497 young male army recruits (18 years old). Results: During childhood, 59 (11.9%) of the participants were treated on a regular basis by a certified pediatric dentist and 344 (69.2%) by a general dental practitioner. Sporadic care (not regular care) by general dental practitioners was given to 94 participants (18.9%). Average level of dental anxiety among participants treated by certified pediatric dentists was 7.9 compared to 8.2 (general dentists) and 8.7 (sporadic care by general dentists). There were no significant differences between the groups. However, significant differences were found in the prevalence of high dental anxiety between participants treated by a regular dentist in childhood and those treated sporadically (15.4% vs. 23.4%, respectively). Negative emotions were common. Environmental etiologic factors were infrequently reported. Conclusions: The general level of dental anxiety among young Israeli males was normal. No relation was found between level of dental anxiety and the professional education of the treating dentist in Childhood. Regular dental care in childhood has more effect on preventing the development of high dental anxiety than the professional education of the early caregiver.
Prevalence of Xerostomia in Population‐based Samples: A Systematic Review
Authors: Orellana M.F. , Lagravère M.O. , Boychuk D.GJ. , Major P.W. , Flores‐Mir C. , Ortho Cert
Published: May 2007

The consequences of xerostomia on oral health have been studied for decades; however, the actual prevalence of this disorder on the general population remains controversial. The purpose of this systematic review was to determine the prevalence of xerostomia in population‐based samples. Electronic databases were screened for relevant articles and reference lists of pertinent articles were also hand‐searched. Thirteen articles meeting the final inclusion criteria were identified. Based on the definition of xerostomia used in this review, only publications including a subjective diagnosis of the disorder were included. All of the self‐repotted diagnoses were achieved through a questionnaire either by mail, telephone, interview or self‐administered by the patient. There was a variation across papers regarding number and content of the questions as well as guidelines for the diagnosis of xerostomia (i.e. answer yes to one or more than one question). The prevalence of xerostomia in the selected articles ranged from 0.9% to 64.8%. The majority of these studies were performed in Scandinavia. In 9 of the articles, the studied samples were 50 years and older. None of the studies evaluated the prevalence xerostomia among individuals younger than 18 years. Based on these observations, it can be concluded that there is a need for population‐based studies on prevalence of xerostomia in regions other than Scandinavia. A standardized protocol to diagnose xerostomia needs to be developed. Patient‐perceived treatment needs and impact on quality of life should be included to have a complete picture of public health implications of the disease.
Periodontitis and Gestational Diabetes Mellitus: Exploring the Link in NHANES III
Authors: Novak Karen F. , Taylor George W. , Dawson Dolphus R. , II James E. Ferguson , Novak M. John
Published: May 2007

Objectives: The authors hypothesized that women with a history of gestational diabetes mellitus (GDM) during pregnancy would exhibit more severe periodontal disease than controls without a history of diabetes during pregnancy. Methods: Data from NHANES III provided information for 4,244 women ages 20–59. One hundred and thirteen had a history of GDM (GDM+), while 4,131 had no history of diabetes before or during their pregnancies (GDM‐). Women were further classified by the presence or absence of diabetes mellitus (DM+ or OM‐) at the time of their NHANES 111 examination. Periodontal disease (PO) was defined as one or more teeth with one or more sites with probing depth ≤4mm, loss of affachment ≤2mm, and bleeding on probing. Results: The PD prevalence among women who were GDM+DM‐ was 9.0% and 4.8% for those who were GDM‐DM‐. PD prevalence for women who were GDM+DM+ was 30.5% and 11.6% for GDM‐DM+ subjects, respectively. A logistic regression model, controlling for age, calculus, smoking, and income estimated women who were GDM+DM+ were more likely to have periodontal disease than women who were GDM‐DM‐ and women who were GDM‐DM+. The GDM+DM‐ group also tended to be more likely to have PD than the GDM‐DM‐ and GDM‐DM+ groups. However, the odds ratios were not statistically significant. Conclusions: These results support the hypothesis that women with gestational diabetes mellitus (GDM) during pregnancy may be at greater risk for developing more severe periodontal disease than pregnant women without GDM.
Assessment of Dental Caries Predictors in a Seven‐year Longitudinal Study
Authors: Tagliaferro Elaine Pereira da Silva , Pereira Antonio Carlos , Meneghim Marcelo de Castro , Ambrosano Glaucia Maria Bovi
Published: May 2007

Objective: To identify, in a group of 6–8‐year‐old schoolchildren, risk factors for dental caries increment in permanent dentition. Methods: Two hundred and six children from three different schools in Piracicaba, Brazil, were examined at baseline and after 7 years by the same two calibrated dentists. Data on dental caries (dmfs, DMFS, presence of initial lesions), fluorosis, oral hygiene and presence of sealant were collected at the clinical examination that was performed in an outdoor setting, under natural light, using a dental mirror and probe following the WHO recommendations. Information on socioeconomic level, fluoride usage, dental service utilization, dietary and oral hygiene habits was also obtained at baseline in a semi‐structured questionnaire sent to the parents. The dependent variable was the 7‐year DMFS increment. A univariate analysis was performed to test the association of independent variables in caries increment. Then a logistic regression model was used to estimate the adjusted Odds Ratio for caries increment. Results: Clinical (dmfs, DMFS) and non‐clinical variables (daily toothbrushing, use of preventive topical methods, parents' educational level) were entered in the multiple logistic regression analysis. The prediction model included the clinical and socioeconomic variables, DMFS, dmfs and mother's educational level. The best caries predictor was the dmfs variable. Conclusion: Caries experience and mother's educational level were predictors of caries increment in permanent dentition.
Associations Between Dental Fluorosis of the Permanent and PrimarvJ Dentitions
Authors: Levy Steven M. , Warren John J. , Broffitt Barbara , Kanellis Michael J.
Published: May 2007

Objectives: Relatively little is known about associations between primary and permanent tooth fluorosis. In this study, associations between dental fluorosis of the permanent and primary dentitions were assessed. Methods: Subjects (n=601) are in the Iowa Fluoride Study, which included fluorosis examinations of the primary and early‐erupting permanent dentitions by trained dentist examiners. Relative risks, correlations, and logistic regression assessed associations between permanent tooth fluorosis and primary molar fluorosis. Results: Ten percent had primary molar fluorosis at age 5; 36% had definitive (mostly mild), 28% questionable, and 36% no permanent incisor fluorosis at age 9. Those with primary molar fluorosis were significantly more likely to have definitive permanent incisor fluorosis (76% vs. 32%), and permanent molar fluorosis (59% vs. 16%). The strong association between primary and permanent tooth fluorosis is independent of level of fluoride intake. Conclusions: Detection of primary tooth fluorosis in pre‐school children should alert clinicians and parents to the high likelihood of subsequent fluorosis in the permanent dentition.
The Working Practices and Job Satisfaction of Dental Hygienists in New Zealand
Authors: Ayers Kathryn M.S. , Meldrum Alison M. , Thomson W. Murray , Newton J. Timothy
Published: May 2007

Objectives: To describe the current working practices and level of job satisfaction of dental hygienists in New Zealand. Methods: Postal survey of all dental hygienists on the New Zealand Dental Council's database. An initial mailing was followed by a 3‐week follow‐up. Information was sought on respondents' demographic characteristics, current occupation and working practice, history of career breaks, continuing education and career satisfaction. Results: 213 responses were received (73.2%); 90.6% were currenfly working as hygienists, mostly in private practice. Many worked part time, particularly those with children. Almost 50% of respondents had taken at least one career break, most frequently for childrearing. The mean time taken in career breaks was 3.6 years. Overall, dental hygienists reported high levels of satisfaction with their careers and their income. Older hygienists had higher career satisfaction scores. Most respondents were actively involved in continuing education. Almost half were interested in expanding the range of procedures they perform. Over one‐third plan to retire within the next 10 years. Conclusions: While many hygienists take career breaks and work part time, most have a high level of career satisfaction, actively participate in continuing education, and are satisfied with their remuneration.
The Views of Dentists, Nurses and Nutritionists on the Association Between Diabetes and Periodontal Disease: A Qualitative Study in a Latino Community
Authors: Koerber Anne , Peters Karen E. , Kaste Linda M. , Lopez Esther , Noorullah Khatija , Torres Izadora , Crawford John M.
Published: May 2007

Objective: To interview health professionals in a Latino community about the association between diabetes and periodontitis, and provide a basis to develop interventions for them to promote oral health and good glycemic control among patients with diabetes. Methods: Five dentists, seven nurses and two nutritionists were interviewed about their practices relevant to oral health and diabetes, knowledge about the association, beliefs about Latinos, recommendations on reaching others in their fields, and barriers. The interviews were audiotaped, transcribed, and analyzed qualitatively. Results: Professionals identified policy, community and practice barriers for promoting diabetic control and oral health. Conclusions: Producing a resource list, cross‐educating professionals about diabetes and oral health, training professionals to better serve Latino patients, developing appropriate protocols for each profession regarding the association between diabetes and periodontitis, and educating the community about diabetic control, oral health and disease prevention were identified as potential strategies to improve oral health among Latino persons with diabetes.
Binding of Ceftobiprole and Comparators to the Penicillin-Binding Proteins of
Escherichia coli
,
Pseudomonas aeruginosa
,
Staphylococcus aureus
, and
Streptococcus pneumoniae
Authors: Davies Todd A. , Page Malcolm G. P. , Shang Wenchi , Andrew Ted , Kania Malgosia , Bush Karen
Published: May 2007

Ceftobiprole exhibited tight binding to PBP2a in methicillin-resistant
Staphylococcus aureus
, PBP2x in penicillin-resistant
Streptococcus pneumoniae
, and PBP3 and other essential penicillin-binding proteins in methicillin-susceptible
S. aureus
,
Escherichia coli
, and
Pseudomonas aeruginosa
. Ceftobiprole also bound well to PBP2 in the latter organisms, contributing to the broad-spectrum antibacterial activity against gram-negative and gram-positive bacteria.
Identification and Phenotypic Characterization of a β-Lactam-Dependent, Methicillin-Resistant
Staphylococcus aureus
Strain
Authors: Goldstein Fred , Perutka Jiri , Cuirolo Arabela , Plata Konrad , Faccone Diego , Morris Joanne , Sournia Aude , Kitzis Marie Dominique , Ly Aicha , Archer Gordon , Rosato Adriana E.
Published: May 2007

Methicillin resistance in
Staphylococcus aureus
is primarily mediated by the acquired penicillin-binding protein PBP 2a, which is encoded by
mecA
. PBP 2a acts together with native PBP 2 to mediate oxacillin resistance by contributing complementary transpeptidase and transglycosylase activities, respectively. In this study, we have investigated a phenotype of β-lactam dependence in a clinical methicillin-resistant
S. aureus
strain (strain 2884D) obtained by in vitro selection with ceftobiprole. 28884D, which grew very poorly in blood agar, required the presence of the β-lactam antibiotics to grow. On the basis of this observation, we hypothesized that a gene or genes essential for growth were dependent on oxacillin induction. Identification and analysis of genes regulated by oxacillin were performed by both real-time reverse transcription-PCR and spotted microarray analysis. We found that
mecA
was constitutively expressed in strain 2884D and that the constitutive expression resulted from perturbations in the two systems involved in its regulation, i.e., MecI/MecR1 (staphylococcal chromosome cassette
mec
type I) and BlaI/BlaR1 (nonfunctional penicillinase operon). PBP 2 appeared to be poorly induced by oxacillin in 2884D. Further analysis of the PBP 2 two-component VraSR regulatory system showed that it was nonfunctional, accounting for the lack of response to oxacillin. Together, these results support the notion that limited PBP 2 availability may have led 2884D to become dependent on oxacillin-mediated
mecA
induction as a required survival mechanism.
Identification and Characterization of a New Metallo-β-Lactamase, IND-5, from a Clinical Isolate of
Chryseobacterium indologenes
Authors: Perilli Mariagrazia , Caporale Bibiana , Celenza Giuseppe , Pellegrini Cristina , Docquier Jean Denis , Mezzatesta Marilina , Rossolini Gian Maria , Stefani Stefania , Amicosante Gianfranco
Published: May 2007

A new natural IND-type metallo-β-lactamase variant, IND-5, was identified in a clinical isolate of
Chryseobacterium indologenes
. IND-5 shared 92.8% and 92.4% amino acid homology with IND-1 and IND-3, respectively. Purified enzyme (pI = 8.8,
M
r
= 25,000) was able to hydrolyze penicillins, some narrow- and expanded-spectrum cephalosporins, and carbapenems but not monobactams.
Neutralizing Viruses in Suspensions by Copper Oxide-Based Filters
Authors: Borkow Gadi , Sidwell Robert W. , Smee Donald F. , Barnard Dale L. , Morrey John D. , Lara-Villegas Humberto H. , Shemer-Avni Yonat , Gabbay Jeffrey
Published: May 2007

We report the capacity of copper oxide-containing filters to reduce infectious titers of a panel of viruses spiked into culture media. Enveloped, nonenveloped, RNA, and DNA viruses were affected, suggesting the possibility of using copper oxide-containing devices to deactivate a wide spectrum of infectious viruses found in filterable suspensions.
Transferable Resistance to Aminoglycosides by Methylation of G1405 in 16S rRNA and to Hydrophilic Fluoroquinolones by QepA-Mediated Efflux in
Escherichia coli
Authors: Périchon Bruno , Courvalin Patrice , Galimand Marc
Published: May 2007

Plasmid pIP1206 was detected in
Escherichia coli
strain 1540 during the screening of clinical isolates of
Enterobacteriaceae
for high-level resistance to aminoglycosides. The sequence of this IncFI conjugative plasmid of ca. 100 kb was partially determined. pIP1206 carried the
rmtB
gene for a ribosome methyltransferase that was shown to modify the N7 position of nucleotide G1405, located in the A site of 16S rRNA. It also contained the
qepA
(
q
uinolone
e
fflux
p
ump) gene that encodes a 14-transmembrane-segment putative efflux pump belonging to the major facilitator superfamily of proton-dependent transporters. Disruption of membrane proton potential by the efflux pump inhibitor carbonyl cyanide
m
-chlorophenylhydrazone in a transconjugant harboring the
qepA
gene resulted in elevation of norfloxacin accumulation. The transporter conferred resistance to the hydrophilic quinolones norfloxacin and ciprofloxacin.
Selective Inhibition of Porcine Endogenous Retrovirus Replication in Human Cells by Acyclic Nucleoside Phosphonates
Authors: Shi Minyi , Wang Xin , De Clercq Erik , Takao Sonshin , Baba Masanori
Published: May 2007

Several anti-human immunodeficiency virus type 1 reverse transcriptase inhibitors were evaluated for their antiviral activities against porcine endogenous retrovirus in human cells. Among the test compounds, zidovudine was found to be the most active. The order of potency was zidovudine > phosphonylmethoxyethoxydiaminopyrimidine = phosphonylmethoxypropyldiaminopurine > tenofovir ≥ adefovir > stavudine.
Nonnucleoside Inhibitor of Measles Virus RNA-Dependent RNA Polymerase Complex Activity
Authors: White Laura K. , Yoon Jeong-Joong , Lee Jin K. , Sun Aiming , Du Yuhong , Fu Haian , Snyder James P. , Plemper Richard K.
Published: May 2007

Paramyxoviruses comprise several major human pathogens. Although a live-attenuated vaccine protects against measles virus (MV), a member of the paramyxovirus family, the virus remains a principal cause of worldwide mortality and accounts for approximately 21 million cases and 300,000 to 400,000 deaths annually. The development of novel antivirals that allow improved case management of severe measles and silence viral outbreaks is thus highly desirable. We have previously described the development of novel MV fusion inhibitors. The potential for preexisting or emerging resistance in the field constitutes the rationale for the identification of additional MV inhibitors with a diverse target spectrum. Here, we report the development and implementation of a cell-based assay for high-throughput screening of MV antivirals, which has yielded several hit candidates. Following confirmation by secondary assays and chemical synthesis, the most potent hit was found to act as a target-specific inhibitor of MV replication with desirable drug-like properties. The compound proved highly active against multiple primary isolates of diverse MV genotypes currently circulating worldwide, showing active concentrations of 35 to 145 nM. Significantly, it does not interfere with viral entry and lacks cross-resistance with the MV fusion inhibitor class. Mechanistic characterization on a subinfection level revealed that the compound represents a first-in-class nonnucleoside inhibitor of MV RNA-dependent RNA polymerase complex activity. Singly or in combination with the fusion inhibitors, this novel compound class has high developmental potential as a potent therapeutic against MV and will likely further the mechanistic characterization of the viral polymerase complex.
Ampicillin-Resistant Non-β-Lactamase-Producing
Haemophilus influenzae
in Spain: Recent Emergence of Clonal Isolates with Increased Resistance to Cefotaxime and Cefixime
Authors: García-Cobos Silvia , Campos José , Lázaro Edurne , Román Federico , Cercenado Emilia , García-Rey César , Pérez-Vázquez María , Oteo Jesús , de Abajo Francisco
Published: May 2007

The sequence of the
ftsI
gene encoding the transpeptidase domain of penicillin-binding protein 3 (PBP 3) was determined for 354 nonconsecutive
Haemophilus influenzae
isolates from Spain; 17.8% of them were ampicillin susceptible, 56% were β-lactamase nonproducing ampicillin resistant (BLNAR), 15.8% were β-lactamase producers and ampicillin resistant, and 10.4% displayed both resistance mechanisms. The
ftsI
gene sequences had 28 different mutation patterns and amino acid substitutions at 23 positions. Some 93.2% of the BLNAR strains had amino acid substitutions at the Lys-Thr-Gly (KTG) motif, the two most common being Asn526 to Lys (83.9%) and Arg517 to His (9.3%). Amino acid substitutions at positions 377, 385, and 389, which conferred cefotaxime and cefixime MICs 10 to 60 times higher than those of susceptible strains, were found for the first time in Europe. In 72 isolates for which the repressor
acrR
gene of the AcrAB efflux pump was sequenced, numerous amino acid substitutions were found. Eight isolates with ampicillin MICs of 0.25 to 2 μg/ml showed changes that predicted the early termination of the
acrR
reading frame. Pulsed-field gel electrophoresis analysis demonstrated that most BLNAR strains were genetically diverse, although clonal dissemination was detected in a group of isolates presenting with increased resistance to cefotaxime and cefixime. Background antibiotic use at the community level revealed a marked trend toward increased amoxicillin-clavulanic acid consumption. BLNAR
H. influenzae
strains have arisen by vertical and horizontal spread and have evolved to adapt rapidly to the increased selective pressures posed by the use of oral penicillins and cephalosporins.
Safety and Activity of the Immune Modulator HE2000 on the Incidence of Tuberculosis and Other Opportunistic Infections in AIDS Patients
Authors: Stickney Dwight R. , Noveljic Zoja , Garsd Armando , Destiche Daniel A. , Frincke James M.
Published: May 2007

Twenty-five AIDS patients were treated with HE2000, a synthetic adrenal hormone. The drug was well tolerated and safe and reduced both the incidence of tuberculosis coinfection by 42.2% (
P
< 0.05) and the cumulative incidence of opportunistic infections (
P
< 0.05). These results warrant further clinical investigation of HE2000.
Extended-Spectrum β-Lactamases of the CTX-M Type Now in Switzerland
Authors: Lartigue Marie-Frédérique , Zinsius Catherine , Wenger Aline , Bille Jacques , Poirel Laurent , Nordmann Patrice
Published: May 2007

The epidemiology of clavulanic acid-inhibited extended-spectrum β-lactamases (ESBLs) was investigated among infection-associated enterobacterial isolates at the University Hospital in Lausanne, Switzerland, from January 2004 to June 2005. Out of 57 nonrepetitive ESBL producers (prevalence rate of 0.7%), 45 produced CTX-M-like ESBLs. CTX-M enzymes were mostly from clonally nonrelated
Escherichia coli
isolates, from urinary infections and community-acquired infections. Pediatric patients (20 out of 57) accounted for a large number of CTX-M producers. CTX-M-15 was the most frequent CTX-M-type enzyme. The plasmid-located
bla
CTX-M
genes were associated with either IS
Ecp1
or IS
CR1
insertion sequences. This study is the first published report of CTX-M-type β-lactamases in Switzerland.
Recombinant Group B Streptococcus Beta C Protein and a Variant with the Deletion of Its Immunoglobulin A-Binding Site Are Protective Mouse Maternal Vaccines and Effective Carriers in Conjugate Vaccines
Authors: Yang Hsiao-Hui , Madoff Lawrence C. , Guttormsen Hilde-Kari , Liu Yong-Dong , Paoletti Lawrence C.
Published: May 2007

Immunogenic vaccines against group B
Streptococcus
(GBS) have been created by coupling the GBS capsular polysaccharides (CPS) to carrier proteins. The GBS beta C protein (BCP) serves as an effective carrier while inducing protective immunity against BCP-expressing strains. BCP also binds human immunoglobulin A (IgA), a characteristic that may be undesirable for use in humans. Here, we examined the immunogenicity and protective efficacy of a recombinant GBS BCP (rBCP), an rBCP modified to eliminate its IgA-binding site (rBCP
ΔIgA
), and their corresponding GBS serotype III CPS conjugates (III-rBCP and III-rBCP
ΔIgA
). Deletion of the IgA-binding site or conjugation to CPS did not alter antigenic BCP epitopes. Recombinant proteins and conjugates elicited specific, high-titered IgG in mice. Antisera to rBCP, rBCP
ΔIgA
, III-rBCP, and III-rBCP
ΔIgA
opsonized GBS strains A909 (Ia/BCP
+
) and H36B (Ib/BCP
+
) for killing by HL-60 cells; antiserum to III-rBCP and III-rBCP
ΔIgA
also opsonized strain M781 (III/BCP
−
). Vaccination of female mice with either rBCP or rBCP
ΔIgA
protected ∼40% of their pups challenged with GBS strain A909. Pups born to III-rBCP- or III-rBCP
ΔIgA
-vaccinated dams survived at rates of 56% and 66%, respectively. Over 90% of pups born to dams that received the type III CPS conjugates survived challenge with GBS strain M781. In summary, rBCP and rBCP
ΔIgA
proteins and the conjugates containing them were immunogenic in mice, inducing both CPS- and protein-specific functional IgG. These results suggest that the rBCP
ΔIgA
could be used as a carrier to augment the immunogenicity of the CPS while expanding coverage to GBS strains bearing BCP.
TheNeisseria meningitidisCapsule Is Important for Intracellular Survival in Human Cells
Authors: Spinosa Maria Rita , Progida Cinzia , Talà Adelfia , Cogli Laura , Alifano Pietro , Bucci Cecilia
Published: May 2007

While much data exist in the literature about howNeisseria meningitidisadheres to and invades human cells, its behavior inside the host cell is largely unknown. One of the essential meningococcal attributes for pathogenesis is the polysaccharide capsule, which has been shown to be important for bacterial survival in extracellular fluids. To investigate the role of the meningococcal capsule in intracellular survival, we used B1940, a serogroup B strain, and its isogenic derivatives, which lack either the capsule or both the capsule and the lipooligosaccharide outer core, to infect human phagocytic and nonphagocytic cells and monitor invasion and intracellular growth. Our data indicate that the capsule, which negatively affects bacterial adhesion and, consequently, entry, is, in contrast, fundamental for the intracellular survival of this microorganism. The results of in vitro assays suggest that an increased resistance to cationic antimicrobial peptides (CAMPs), important components of the host innate defense system against microbial infections, is a possible mechanism by which the capsule protects the meningococci in the intracellular environment. Indeed, unencapsulated bacteria were more susceptible than encapsulated bacteria to defensins, cathelicidins, protegrins, and polymyxin B, which has long been used as a model compound to define the mechanism of action of CAMPs. We also demonstrate that both the capsular genes (siaDandlipA) and those encoding an efflux pump involved in resistance to CAMPs (mtrCDE) were up-regulated during the intracellular phase of the infectious cycle.