Recall of an oral health education programme by nursing personnel in special housing facilities for the elderly

Objectives: To investigate the recall of oral health knowledge and confidence by nursing personnel in special housing facilities for the elderly, three years after an education programme. Design: A cross sectional design using a questionnaire. Sample: All nursing personnel, a total of 2,901 subjects, in five municipalities in south‐western Sweden; of whom 950 had attended the programme. The response rate was 67% (1930 subjects). Intervention: An oral health education programme consisting of four one‐hour lessons. Results: The oral health education programme still had an effect on the participants' attitudes towards oral health three years later. When comparing the trained group (OHEP+) which attended the programme with those who did not have training (OHEP‐), the perceived ability, opportunity and the knowledge of oral health were significantly better in the former group, p<0.01 Eurther, within the OHEP‐ group who did not attend the programme there was a significant difference in the perceived ability, opportunity and the knowledge of oral health between those with a higher level of health care education, p<0.01. Conclusions: The effect of an oral health education programme on the participants' attitudes towards oral health persists at least for three years. The data indicate that trainees with a low level of health care education benefit most.     

Oral microbial flora and oral malodour of the institutionalised elderly in Japan

Objectives: To determine the oral health status, especially the level of oral microbial flora and oral malodour, of institutionalised elderly people compared with non‐institutionalised elderly people. Setting: Three institutions and numerous private homes. Subjects: 56 institutionalised and 56 non‐institutionalised elderly people. Main Outcome Measures: Institutionalised elderly people had higher levels of Candida, staphylococci, and oral malodour. Results: Institutionalised elderly people had a higher level of Candida in denture wearers, and a higher level of staphylococci and oral malodour compared with the non‐institutionalised elderly. Conclusion: The institutionalised elderly have a higher risk of opportunistic infections and oral health care should be improved to protect them from these infections and to reduce oral malodour.     

Reduction of postoperative lymphedema after oral tumor surgery with sodium selenite

The objective of this double-blind, randomized study was to establish whether sodium selenite administered orally or intravenously reduces postoperative lymphedema after oral tumor surgery and to study the effect of sodium selenite on glutathione peroxidase (GPX) activity and oxygen radical production. Twenty patients were enrolled in the study. Each of the participants received 1000 μg sodium selenite intravenously or orally daily for 3 wk during the pre-, intra-, and postoperative period. The extent of lymphedema was measured for 2 wk and the plasma and whole-blood selenium concentration, GPX, reactive oxygen species (ROS), NO, and malonic dialdehyde were measured for 1 yr postoperatively. There was an inverse correlation between the severity of the lymphedema and the wholeblood/plasma selenium concentration and GPX activity. In addition, a positive correlation between the ROS concentration and the extent of lymphedema was observed. A significant reduction of lymphedema occurred in the sodium selenite-treated group. It is concluded that sodium selenite represents a suitable adjuvant treatment of secondary lymphedema in surgically treated patients with tumors in the oral and maxillofacial areas. Treatment with sodium selenite is especially advantageous as it can be instituted immediately after surgery prior to wound healing when manual lymphatic decongestion therapy cannot be applied.     

Evaluation of the Lon-deficient Salmonella strain as an oral vaccine candidate

We evaluated the efficacy of CS2022 (the Lon protease-deficient mutant strain of Salmonella enterica serovar Typhimurium) as a candidate live oral vaccine strain against subsequent oral challenge with a virulent strain administered to BALB/c and C57BL/6 mice. CS2022 persistently resided in the spleen, mesenteric lymph nodes, Peyer's patches, and cecum of both strains of mice after a single oral inoculation with 1 x 10(8) colony-forming units. Finally, CS2022 almost disappeared from each tissue sample by week 12 in BALB/c mice, whereas CS2022 still resided in each tissue type at week 12 after inoculation of C57BL/6 mice. A significant increase in the serovar Typhimurium lipopolysaccharide-specific secretory immunoglobulin A (s-IgA), as measured for one of the mucosal immune responses, was detected in bile and intestinal samples of both strains of immunized mice at week 4 after immunization. In addition, the expression of gamma interferon mRNA in the spleens of both strains of immunized mice, especially those of C57BL/6 mice, was significantly increased at week 4 after immunization and was boosted during the following 5 days after the challenge was administered to the mice. Furthermore, peritoneal macrophages isolated from immunized mice at week 4 after immunization exhibited an increase in intracellular killing activity against both virulent and avirulent Salmonella. The present results suggested that salmonellae-specific s-IgA on the mucosal surfaces induced by immunization with CS2022 generally prevented mice from succumbing to an oral challenge with a virulent strain. Simultaneously, CS2022 promoted the protective immunity associated with macrophages in both strains of mice.     

Level of education and incidence of caries in the elderly: a 5-year follow-up study

Objective: This study aimed to examine the possible association between level of education and 5‐year caries increment in the elderly inhabitants of Helsinki. Background: Low salivary flow and high numbers of salivary microorganisms are associated with the presence of caries, but cannot predict the increment in caries in the elderly. Materials and methods: This study group was derived from a population‐based Helsinki Aging Study, which consisted of a random sample of elderly born in 1904, 1909 and 1914. The 71 dentate elderly who underwent clinical oral examinations at baseline (1990–91) and 5 years later (1995–96) were included in the study group. Decayed, Missing or Filled Tooth (DMFT) and Root Caries Index (RCI) indexes were used to study subject’ caries experience. Data on subjects’ education came from questionnaire studies. The subjects were divided into four groups according to their level of education and occupation. Bivariate and multivariate analyses were used to evaluate relationships between subjects’ caries experience and level of education. Results: At baseline the elderly with high level of education had more teeth and more root surfaces at risk than those with low level of education. Number of teeth decreased (?1.085, p < 0.0001), while both DMFT (1.164, p < 0.0001) and RCI (0.081, p < 0.0001) indices increased during follow‐up. The increments in DMFT and RCI were not directly associated with the level of education. Multivariate analysis in which subjects’ gender, number of teeth, level of education, frequency of eating and frequency of brushing were taken into consideration, showed no significant association with caries increment. Conclusions: Within the limitations of this study it can be concluded that the level of education of the elderly is not directly associated with the increment in caries.     

Oral infections as predictors of mortality

Objective: Oral infections may increase the levels of cytokines in the blood which, in turn, are associated with early mortality in the elderly. We investigated the possible association between oral infections and mortality. Design: Prospective cohort study over a 5‐year follow‐up. Setting: Research laboratory. Participants: A cohort born in 1910 (n = 94) was examined in the year 1995. Five years later mortality data were obtained from the population register for 49 deceased subjects. Main outcome measures: Urgent need of dental treatment, lifetime, erythrocyte sedimentation rate (ESR). Results: The multivariate analysis adjusted for general health and lifestyle factors showed that the risk for death of subjects in urgent need of dental treatments was 3.9 times higher than that of the other subjects. Among men ESR correlated significantly with urgent need of dental treatment. Conclusions: Oral infections among frail elderly people may be a sign of early mortality.     

Gene Expression in Tilapia Following Oral Delivery of Chitosan-Encapsulated Plasmid DNA Incorporated into Fish Feeds

DNA delivery into fish is important for transient gene expression, (e.g., DNA vaccination). Previous studies have generally focused on intramuscular injection of DNA vaccines into fish. However, this method is obviously impractical and laborious for injecting large numbers of fishes. This study reports oral delivery of a construct expressing the β-galactosidase reporter gene into fish by encapsulating the DNA in chitosan and incorporating it into fish feeds. We found that β-galactosidase expression could be observed in the stomachs, spleens, and gills of fishes fed with flakes containing the chitosan-DNA complex. These results suggest that DNA vaccines and other constructs can be easily and cheaply delivered into fishes orally by use of carriers and incorporation into fish feeds.     

Zymographic characterization of bacteriolytic enzymes produced by oral streptococci

Zymographic analysis was performed to know the bacteriolytic enzyme profiles of 4% SDS extracts of oral streptococci, Streptococcus mutans, S. sobrinus, S. sanguis, S. mitis and S. salivarius. We investigated the five strains in each species and found that the profile was very similar among strains of the same species except for S. salivarius(the profile was classified into two types). On the other hand, the profile was considerably different among species. Two major bacteriolytic enzymes of S. mutans showing molecular mass of 80 and 100 kDa were found using SDS-boiled S. mutans or S. sobrinus cells as substrate. These bacteriolytic activities were less apparent in the gel containing S. mitis or S. salivarius, and also not detectable in the gel containing S. sanguis. S. sobrinus extract showed only one bacteriolytic band (78 kDa) as strong activity using S. sobrinus cells as substrate. S. sanguis extract showed no bacteriolytic bands using any streptococcal cells. Extracts of either S. mitis or S. salivarius showed weak activity by using respective strains as substrate.