Background . Periodontitis and rheumatoid arthritis have similar epidemiology and pathophysiology. Understanding the interaction between these two diseases is vital in our settings. We set out to assess the effect of oral hygiene interventions on disease activity of rheumatoid arthritis patients with periodontitis in Kampala, Uganda. Methods. Fifty-eight patients attending an arthritis clinic with rheumatoid arthritis and periodontitis were randomly assigned to either an intervention group or a control group. Patients diagnosed with rheumatoid arthritis at least two years before, who were on the same medication, dose, or formulation for RA treatment during the preceding three months, were included. The patients were >18 years of age, would be available for all the study visits in the next six months, had at least six natural teeth, had periodontal disease classified as Dutch Periodontal Index (DPSI) >3 and provided written informed consent. Those who had a chronic disorder requiring chronic or intermittent use of antibiotics, were pregnant, were lactating, or had intent to become pregnant were excluded. The primary outcome measure was a change in Disease Activity Score of 28 Joints (DAS28 score) in two 3-month follow-up periods after the intervention. The secondary outcome measure was a change in periodontal status. Results. There was a statistically significant improvement in the DAS-28 score in both the intervention and control arms during the follow-up period (P<0.01). The participants carrying more than one bacterial species had worse DAS-28 scores. Conclusion. Oral hygiene interventions given to RA patients could drastically improve their RA treatment outcomes, especially in resource-limited settings.

Aim:This study aimed at establishing the age for third molar eruption among Ugandans aged 10–20 years.Materials and Methods:This was a cross-sectional study comprising 471 male and 541 female patients attending Mulago Dental Clinic. Patients’ orthopantomographs were assessed for third molar eruption as described by Olze et al. Age was summarized using means/SD. Jaw and sex differences were assessed using Student's t-test.Results:Complete eruption (Stage D) ranged between 13 and 20 years. The mean age at complete eruption for girls and boys was 17.5–18 years and 18.2–18.6 years, respectively. Mean age was statistically significantly (P < 0.05) lower among girls compared to boys for all third molar teeth (#18, #28, #38, and #48). The difference in mean eruption times between girls and boys was −0.62 (95% confidence interval: 0.2–1.0, P = 0.006). At 18 years, 40% or 41% maxillary and 52% or 53% mandibular molars were completely erupted. There were statistically significant differences in eruption between the sexes and jaws for all teeth (P < 0.05).Conclusions:Given the fact that the percentage of erupted third molars by age 18 was found to be <50% on an average in this Ugandan population, we should reconsider the use of third molar eruption as a definitive tool for age estimation in this population.

BackgroundDental caries is a multifactorial disease that affects many people. Even though microorganisms play a crucial role in causing dental caries, diagnosis is routinely macroscopic. In order to improve early detection especially in HIV patients who are disproportionately affected, there is need to reconcile the macroscopic and microscopic characteristics of dental caries. Therefore, the aim of this study was to characterize the oral microbiota profile along the decayed, missing, filled teeth (DMFT) index using amplicon sequencing data.MethodsAmplicon sequencing of the V6-V8 region of the 16S rRNA gene was done on DNA recovered from whole unstimulated saliva of 59 HIV positive and 29 HIV negative individuals. The microbial structure, composition and co-occurrence networks were characterized using QIIME-2, Phyloseq, Microbiome-1.9.2 and Metacoder in R.ResultsWe characterized the oral microbiota into 2,093 operational taxonomic units (OTUs), 21 phyla and 239 genera from 2.6 million high quality sequence reads. While oral microbiota did not cluster participants into distinct groups that track with the DMFT index, we observed the following: (a) The proportion of accessory microbiota was highest in the high DMFT category while the core size (∼50% of richness) remained relatively stable across all categories. (b) The abundance of core genera such as Stomatobaculum, Peptostreptococcus and Campylobacter was high at onset of dental caries, (c) A general difference in oral microbial biomass. (d) The onset of dental caries (low DMFT) was associated with significantly lower oral microbial entropy.ConclusionsAlthough oral microbial shifts along the DMFT index were not distinct, we demonstrated the potential utility of microbiota dynamics to characterize oral disease. Therefore, we propose a microbial framework using the DMFT index to better understand dental caries among HIV positive people in resource limited settings.

The study is aimed at determining the salivary flow rate (SFR) in adult Kenyans and investigates its relationship with chronic periodontitis. A descriptive cross sectional study was conducted on 333 participants (age between 18 and 45 years) among the patients attending Nairobi University Dental Hospital over a period of five months. Three groups were identified based on their periodontal status as healthy, gingivitis and chronic periodontitis. Unstimulated whole saliva was collected using the spit method. The British Society of Periodontology Basic Periodontal Examination index was used to determine the periodontal status of the participants. The salivary flow rate (g/min) ranged between 0.14 and 1.98 g/min in males and 0.08 and 1.68 g/min in females. The mean SFR was 0.66 ±0.31 g/min SD with a mode of 0.30 g/min. 256 participants were normal secretors within the range of 0.3 and 1.0 g/min, 43 were high secretors with over 1.0 g/min while 32 were low secretors with a range of 0.1 and 0.29 g/min. Participants with chronic periodontitis had a statistically significant higher salivary flow rate (M=0.68+0.33 SD) than those who had gingivitis (M=0.62+0.28 SD) with p=0.039. The unstimulated salivary flow rate in adult Kenyans is 0.66 g/min, which falls within the reported normal range. The salivary flow rate was found to increase with the severity of periodontitis suggesting a link between the two.

Background: Oral disease pathogenesis is primarily driven by microbial dysbiosis although diagnosis is routinely macroscopic. To improve early detection especially in HIV patients who are disproportionately affected, there is need to reconcile macroscopic and microscopic characteristics of disease. This study aimed to use amplicon sequencing data to characterize oral microbiota changes along the decayed, missing, filled teeth (DMFT) index.Methods: Amplicon sequencing of the V6-V8 region of the 16S rRNA gene was done on DNA recovered from whole unstimulated saliva of 59 HIV positive and 29 HIV negative individuals, respectively. The microbial structure, composition and co-occurrence networks were characterized using QIIME-2, Phyloseq, Microbiome-1.9.2 and Metacoder in R.Results: From a total of 2.6 million high quality sequence reads obtained, we characterized the oral microbiota into 2,093 operational taxonomic units (OTUs), 21 phyla and 239 genera. While oral microbiota did not cluster participants into distinct groups that track with the DMFT index, we observed the following: a) A steady increase in accessory microbiota while the core size (~50% of richness) remained stable. b) The abundance of core genera such as Stomatobaculum, Peptostreptococcus and Campylobacter increased at onset of pathology (low DMFT), c) A general increase in oral microbial biomass with a typical log difference between gingivitis and periodontitis. d) The onset of pathology (low DMFT) was associated with massive reduction in oral microbial entropy.Conclusions: Although oral microbial shifts along the DMFT index are not distinct, we have demonstrated the potential utility of microbiota dynamics to inform oral disease characteristics. We therefore propose a framework to inform future clinical oral metagenomic studies especially among HIV positive persons in resource limited settings.