The aim of this study was to investigate the relationship between dental anxiety and dental decay experience among antenatal mothers attending Maternal and Child Health clinics in Malaysia. A cross-sectional study was conducted on a consecutive sample of 407 antenatal mothers in Seremban, Malaysia. The questionnaire consisted of participants' demographic profile and the Dental Fear Survey. The D(3cv)MFS was employed as the outcome measure and was assessed by a single examiner (intraclass correlation = 0.98). A structural equation model was designed to inspect the relationship between dental anxiety and dental decay experience. The mean Dental Fear Survey score for all participants was 35.1 [95% confidence interval (34.0, 36.3)]. The mean D(3cv)MFS score was 10.8 [95% confidence interval (9.5, 12.1)]. Participants from low socio-economic status groups had significantly higher D(3cv)MFS counts than those from high socio-economic status groups. The path model with dental anxiety and socio-economic status as predictors of D(3cv)MFS showed satisfactory fit. The correlation between dental anxiety and dental decay experience was 0.30 (standardized estimate), indicating a positive association. Socio-economic status was also statistically significantly associated with the D(3cv)MFS count (beta = 0.19). This study presented robust evidence for the significant relationship between dental anxiety and dental decay experience in antenatal mothers.
Animal studies suggest that inducible nitric oxide synthase (iNOS) may be associated with destructive periodontal disease. l-N(6)-(1-Iminoethyl)-lysine (L-NIL) has been shown to inhibit iNOS in a selective manner, and hence the aim of the present study was to test the hypothesis that treatment with l-NIL may induce a T-cell helper 1 (Th1)-like immune response by Aggregatibacter (Actinobacillus) actinomycetemcomitans lipopolysaccharide (LPS)-stimulated murine spleen cells in vitro. BALB/c mice were either sham-immunized or immunized with A. actinomycetemcomitans LPS. Spleen cells were stimulated with A. actinomycetemcomitans LPS in the presence or absence of L-NIL. Nitric oxide (NO), iNOS activity, specific IgG subclass antibodies, interferon-gamma (IFN-gamma), and interleukin-4 (IL-4) levels and cell proliferation were determined. The results showed that treatment with L-NIL suppressed both NO production and iNOS activity but enhanced specific IgG2a, IFN-gamma levels, and increased cell proliferation following stimulation with A. actinomycetemcomitans LPS-stimulated cells. The results of the present study suggest that inhibition of iNOS activity by L-NIL may skew the A. actinomycetemcomitans LPS-stimulated murine splenic immune response towards the Th1-like immune profile in vitro.
Oral lichen planus (OLP) is an immune-mediated disease of the oral mucosa with idiopathic aetiology. It is frequently treated with topical corticosteroids (applied as gels, mouthwashes, or sprays); however, the mucosal exposure times of topical corticosteroids are short because of removal by the constant flow of saliva and mechanical forces. In this study we used cell monolayers, as well as oral mucosal equivalents (OMEs) containing activated T-cells, to examine corticosteroid potency and delivery of clobetasol-17-propionate from a novel electrospun mucoadhesive patch. The OMEs displayed tight junctions, desmosomes, hemidesmosomes, and an efficient permeability barrier. Following application of corticosteroids to cells cultured as monolayers, the degree of cytotoxicity measured correlated to the level of potency recognized for each corticosteroid; by contrast, OMEs were largely unaffected by corticosteroid treatment. Permeation of clobetasol-17-propionate into and through the OMEs was time- and dose-dependent, regardless of whether this corticosteroid was delivered in liquid form or from a mucoadhesive patch, and both liquid- and patch-delivered clobetasol-17-propionate significantly reduced the secretion of interleukin-2 by activated T-cells. This study confirms that OMEs are more suitable models than cell monolayers for evaluating toxicity and drug delivery. After topical exposure, clobetasol-17-propionate accumulated in OMEs at a higher level than betamethasone-17-valerate and hydrocortisone-17-valerate, and exerted its immunosuppressive actions following application via the patch delivery system, highlighting the efficacy of this mode of drug delivery to treat OLP.