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.
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.Ms.
We conclude that there are marked differences in systemic cytokine levels over the course of short-term experimentally induced gingivitis and further conclude that a long-term periodontitis study must be considered to address mechanisms whereby oral diseases may affect systemic diseases.
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.
Dentists can playa key role in helping patients quit tobacco use by providing tobacco cessation treatment (TCT) in their practice. Although the majority of dentists receive training in TCT, most do not provide adequate intervention. Many feel they are not adequately trained. Using standardized patients (SPs) shows promise in TCT training by providing a simulated clinical environment for students to practice counseling skills with individuals trained to portray patients. Standardized patients evaluate students' skills and provide immediate feedback. The purpose of this study is to determine if there is a difference in dental students' attitudes, perceived barriers, subjective norms, perceived skills, self-efficacy, intentions to provide TCT, and cessation knowledge between those students who receive a lecture along with practice sessions using SPs and those students who receive a lecture only. Variables were selected to coincide with the constructs of the theory of planned behavior.Freshman dental students in an introductory clinical course were invited to participate in the study by completing a pre-and post-questionnaire. The prev questionnaire was administered to all students in the course prior to a two hour tobacco cessation lecture. The intervention group of students (n = 42) completed the second questionnaire after the lecture, practice sessions with SPs and a debriefing session. The control group (n = 52) completed the second questionnaire after the lecture.The training using SPs increased dental students' perceived barriers, subjective norms, perceived skills, self-efficacy, and intentions to provide TCT (p < .05) more than lecture only; however, it did not significantly increase attitude and knowledge. Dental students' attitude, perceived barriers, subjective norms, perceived skills and knowledge significantly impacted intent to provide TCT (p < .005), while training type, tobacco status and use did not. The time between the groups receiving the lecture and practice sessions with SPs did not significantly affect the variables. The findings suggest that using SPs is a valuable educational method that increases dental students' social pressures, skills, confidence and intentions to provide TCT. The training using SPs did increase students' awareness of barriers in providing TCT. Additional research is needed to reduce barriers in providing TCT.vi
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