Najla Dar-Odeh

Antibiotic prescribing practices by dentists: a review

Antibiotics are prescribed by dentists for treatment as well as prevention of infection. Indications for the use of systemic antibiotics in dentistry are limited, since most dental and periodontal diseases are best managed by operative intervention and oral hygiene measures. However, the literature provides evidence of inadequate prescribing practices by dentists, due to a number of factors ranging from inadequate knowledge to social factors. Here we review studies that investigated the pattern of antibiotic use by dentists worldwide. The main defects in the knowledge of antibiotic prescribing are outlined. The main conclusion is that, unfortunately, the prescribing practices of dentists are inadequate and this is manifested by over-prescribing. Recommendations to improve antibiotic prescribing practices are presented in an attempt to curb the increasing incidence of antibiotic resistance and other side effects of antibiotic abuse.

Oral Candidosis in patients with removable dentures

Summary

Narghile smoking and its adverse health consequences: a literature review.

Oral squamous cell carcinoma (OSCC) is a world health problem with approximately 50% of patients having a 5-year survival rate. A change in the demographics of the disease is now being recognised, particularly in Europe, where it is increasingly being seen in young males. While a variety of risk factors are important in OSCC, it is tobacco that plays a central part in the pathogenesis of the disease. Narghile is an old form of tobacco use but in the past decade, there has been a resurgence in this form of smoking. The practice is particularly common in young males and females from the Middle East but with the advent of immigration and globalisation, its use is becoming more widespread. It is now not uncommon to see narghile smoking in western countries such as the UK and USA. Studies describing the oral effects of narghile are unfortunately scarce. While adverse effects such as periodontal bone loss and dry socket have been described, its association with OSCC cannot be excluded. Variation in the type of narghile, the type of tobacco and the presence of co-factors such as cigarette smoking may all influence clinical outcome. In the present study, the practice of narghile smoking is reviewed in terms of its effect on health, particularly oral health. The association of narghile smoking and adverse effects on the orofacial region will be outlined, namely, periodontal disease, potentially malignant lesions and oral cancer.

The changing trends in tobacco smoking for young Arab women; narghile, an old habit with a liberal attitude

Narghile smoking by young females is becoming more acceptable than cigarettes in the conservative societies of Arab countries. Lack of social constraints on narghile smoking has resulted in an increased prevalence of narghile smoking among young Arab females and an earlier age of onset of this habit when compared to cigarette smoking.Documented health hazards of narghile smoking including pulmonary, cardiovascular and neoplastic ailments are consequently expected to affect this vulnerable sector of the population together with their offspring. In this commentary, we shed some light on the changing trend of tobacco use among young Arabic women as shown by an increasing number of studies investigating habits of tobacco use in young people.

Prevalence of putative virulence factors and antimicrobial susceptibility of Enterococcus faecalis isolates from patients with dental Diseases

BackgroundThis study investigated the prevalence of Enterococcus faecalis, its putative virulence factors and antimicrobial susceptibility in individuals with and without dental diseases. A total of 159 oral rinse specimens were collected from patients (n = 109) suffering from dental diseases and healthy controls (n = 50).ResultsE. faecalis was detected using only culture in 8/109 (7.3%) of the patients with various types of dental diseases, whereas no E. faecalis was found in the healthy controls weather using both culture and PCR. Phenotype characterizations of the 8 E. faecalis isolates indicated that 25% of the isolates produced haemolysin and 37.5% produced gelatinase. Most important virulence genes; collagen binding protein (ace) and endocarditis antigen (efaA) were present in all 8 E. faecalis isolates, while haemolysin activator gene (cylA) was detected only in 25% of isolates, and all isolates were negative for esp gene. All E. faecalis isolates were 100% susceptible to ampicillin, chloramphenicol, ciprofloxacin, vancomycin, and teicoplanin, and to less extent to erythromycin (62.5%).ConclusionThis study shows that all E. faecalis isolates were recovered only from patients with dental diseases especially necrotic pulps, and all isolates carried both collagen binding protein and endocarditis antigen genes and highly susceptible to frequently used antimicrobial drugs in Jordan.

Analysis of clinical records of dental patients attending Jordan University Hospital: Documentation of drug prescriptions and local anesthetic injections.

Objectives: The aim of this study was to analyze clinical records of dental patients attending the Dental Department at the University of Jordan Hospital: a teaching hospital in Jordan. Analysis aimed at determining whether dental specialists properly documented the drug prescriptions and local anesthetic injections given to their patients. Methods: Dental records of the Dental Department at the Jordan University Hospital were reviewed during the period from April 3rd until April 26th 2007 along with the issued prescriptions during that period. Results: A total of 1000 records were reviewed with a total of 53 prescriptions issued during that period. Thirty records documented the prescription by stating the category of the prescribed drug. Only 13 records stated the generic or the trade names of the prescribed drugs. Of these, 5 records contained the full elements of a prescription. As for local anesthetic injections, the term “LA used” was found in 22 records while the names and quantities of the local anesthetics used were documented in only 13 records. Only 5 records documented the full elements of a local anesthetic injection. Conclusion: The essential data of drug prescriptions and local anesthetic injections were poorly documented by the investigated group of dental specialists. It is recommended that the administration of the hospital and the dental department implement clear and firm guidelines for dental practitioners in particular to do the required documentation procedure.

Orofacial findings in chronic granulomatous disease: report of twelve patients and review of the literature

BackgroundChronic granulomatous disease is an extremely rare primary immunodeficiency syndrome that can be associated with various oral complications. This can affect high number of patients. However, data on oral complications is sparse. Here we will review the literature and describe the orofacial findings in 12 patients.FindingsThe age range was 5-31 years. Oral findings were variable, and reflected a low level of oral hygiene. They included periodontitis, rampant caries, gingivitis, aphthous-like ulcers, and geographic tongue. One patient had white patches on the buccal mucosa similar to lichen planus. Another patient had a nodular dorsum of the tongue associated with fissured and geographic tongue. Biopsies from the latter two lesions revealed chronic non-specific mucositis. Panoramic radiographs showed extensive periodontitis in one patient and periapical lesions in another patient.ConclusionPatients with chronic granulomatous disease may develop oral lesions reflecting susceptibility to infections and inflammation. It is also possible that social and genetic factors may influence the development of this complication. Therefore, oral hygiene must be kept at an optimum level to prevent infections that can be difficult to manage.

An analysis of therapeutic, adult antibiotic prescriptions issued by dental practitioners in Jordan.

Objective: The aim of this study was to determine the therapeutic adult antibiotics prescribed by dental practitioners working in the Jordan University Hospital. Methods: Adult dental prescriptions for therapeutic antibiotics issued between 1 January 2003 and 31 May 2004 by dental specialists working in the Jordan University Hospital were included in this study. Data included the name of the antibiotic as well as the dose, quantity and presentation of the drug. Descriptive statistical analysis was carried out. Results: Amoxycillin and metronidazole were the most commonly prescribed antibiotics, with 60% of the prescriptions containing amoxycillin and 39.4% containing metronidazole. 20.4% of the prescriptions were combination prescriptions containing metronidazole. In this study, long courses were observed for amoxycillin (60.5%), cephalosporins (21%) and metronidazole (59.7%). Conclusions: It seems that in the sample studied, Jordanian dental specialists have a tendency towards overprescribing antibiotics both in quantity and duration. This may constitute a problem particularly when considering the remaining sectors of less well-educated dental practitioners. The results will be used to increase awareness among dental practitioners in the field of antibiotic prescribing throughout the University of Jordan and the Jordanian Dental Association.

The Mental Foramen I: Radiographic Study of the Anterior-Posterior Position and Shape in Iraqi Population

Informacion precisa sobre la ubicacion horizontal y forma del foramen mental puede tener importancia clinica en la reduccion de complicaciones durante procedimientos quirurgicos maxilofaciales que involucran el area mental. Fueron reportadas variaciones geograficas en relacion a estas variables. El objetivo fue estudiar la posicion horizontal y forma del foramen mental, a partir de 518 radiografias panoramicas de una muestra aleatoria en sujetos de Irak (257 varones, 261 mujeres; edad media= 46,5 anos), quienes fueron evaluados con respecto a la posicion horizontal, forma y la simetria de los foramenes mentales. En individuos de edad avanzada se encontro una asociacion con un aumento en la frecuencia de un posicionamiento posterior y con forma irregular. La posicion horizontal y forma del foramen fueron asimetricos en 21,6% y 31,6% de los casos, respectivamente. La diferencia hallada en relacion a la simetria en posicion horizontal y forma de los foramenes mentales fue estadisticamente significativa entre sexos (p=0,041), y entre los grupos de edad jovenes y mayores (P=0,001), respectivamente. Se encontro con mayor frecuencia la posicion horizontal entre los ejes longitudinales de los dos premolares mandibulares, y la forma circular, en relacion a la posicion antero-posterior y forma del foramen, respectivamente. Estos fueron resultados similares a estudios anteriores sobre otras poblaciones. Los foramenes mentales son simetricos, respecto a su ubicacion horizontal y su forma.

Tongue cancer subgroup

to minimise long term morbidity for the patient. Complications include trismus, pain, infection, and damage to the inferior alveolar and lingual nerves.1 To prevent needle breakage practitioners should use 27-gauge 35 mm needles for IAN block, avoid inserting to full length or burying the needle in the tissues, ensure patient cooperation thus avoiding sudden movements, and avoid bending needles or changing direction while still located deep in the tissues or exerting lateral pressure on withdrawal.3 A. Bawor-Omatseye, A. Majumdar By email