Updated Criteria for the Selection of Antibiotic Dosage and Regimen in Dentistry

Antibiotic therapy in dentistry is essential for preventing and treating infections resulting from dental procedures.

📌 Recommended Article :

PDF 🔽 Antibiotics and its use in pediatric dentistry: A review ... Antibiotics are commonly used in dentistry for prophylactic as well as for therapeutic purposes. Very often antibiotics are used in unwarranted situations, which may give rise to resistant bacterial strains

Correct selection of antibiotic dosage and regimen not only ensures therapeutic efficacy but also minimizes the risk of developing bacterial resistance and adverse effects.

Advertisement

✅ A. Determining Factors in Antibiotic Selection

1. Identification of the Etiological Agent
Odontogenic infections are often polymicrobial, predominantly involving anaerobic and gram-positive aerobic bacteria. Precise identification of the causative agent allows for the selection of an antibiotic with an appropriate spectrum. However, due to the difficulty in isolating and culturing these microorganisms in daily practice, empirical selection based on local epidemiology and the nature of the infection is common.

2. Antibiotic Spectrum
The chosen antibiotic should be effective against the most common pathogens in odontogenic infections. For example, amoxicillin is effective against a wide range of gram-positive bacteria and some gram-negative ones, while clindamycin is preferred in patients allergic to penicillins due to its activity against anaerobes and gram-positive aerobes.

3. Pharmacokinetics and Pharmacodynamics
Understanding the absorption, distribution, metabolism, and excretion of the antibiotic is crucial for determining the dosage and frequency of administration. For instance, amoxicillin has good oral bioavailability and a half-life that allows for administration every 8 hours. Clindamycin, on the other hand, requires administration every 6 to 8 hours due to its shorter half-life.

4. Patient's Condition
The patient's systemic conditions, such as renal or hepatic insufficiency, can affect drug elimination, requiring dosage adjustments. Additionally, in immunocompromised patients, more aggressive or prolonged treatment may be necessary.

5. Possible Interactions and Adverse Effects
It is essential to consider drug interactions, especially in polymedicated patients. For example, erythromycin can interact with other drugs metabolized by the cytochrome P450 system, increasing the risk of toxicity. Moreover, some antibiotics can cause gastrointestinal adverse effects or allergic reactions that must be monitored.

📌 Recommended Article :

PDF 🔽 Dental pain in pediatric dentistry - Assessment tools ... We share an article that reviews the important aspects of pain in pediatric dentistry, and the tools for a correct evaluation today

✅ B. Dosage and Regimen of Common Antibiotics in Dentistry
Below are the dosage and regimen recommendations for the most commonly used antibiotics in dentistry, based on clinical guidelines and recent studies:

1. Amoxicillin
° Indications: Common odontogenic infections.
° Adult dosage: 500 mg orally every 8 hours.
° Pediatric dosage: 20–40 mg/kg/day divided into three doses.
° Considerations: In severe infections, the dose may be increased to 1 g every 8 hours. Dosage adjustment is recommended in patients with renal insufficiency.

2. Amoxicillin/Clavulanic Acid
° Indications: Resistant infections or when beta-lactamase-producing bacteria are suspected.
° Adult dosage: 875 mg/125 mg orally every 12 hours.
° Pediatric dosage: 25–45 mg/kg/day divided into two doses.
° Considerations: The combination with clavulanic acid broadens amoxicillin's spectrum but may increase the incidence of gastrointestinal effects.

3. Clindamycin
° Indications: Patients allergic to penicillins; infections by anaerobes.
° Adult dosage: 300 mg orally every 6–8 hours.
° Pediatric dosage: 8–20 mg/kg/day divided into three or four doses.
° Considerations: Monitor for gastrointestinal side effects and the risk of pseudomembranous colitis.

4. Azithromycin
° Indications: Patients allergic to penicillins; infections by susceptible bacteria.
° Adult dosage: 500 mg once daily for three days.
° Pediatric dosage: 10 mg/kg once daily for three days.
° Considerations: Has a prolonged half-life, allowing for simplified dosing regimens.

📌 Recommended Article :

PDF 🔽 Antimicrobial therapies for odontogenic infections in children and adolescents ... We share a literature review that establishes guidelines for antimicrobial therapy in infections of odontogenic origin and clinical recommendations

✅ C. Conclusions on the Selection of Antibiotic Dosage and Regimen in Dentistry

1. Evidence-Based Selection: The choice of antibiotics in dentistry should be based on the identification of the etiological agent, appropriate antibiotic spectrum, and updated clinical guidelines to ensure efficacy and safety in treating odontogenic infections.
2. Importance of Pharmacokinetics and Pharmacodynamics: Dosage and regimen should be adjusted considering the drug's absorption, metabolism, and excretion, as well as the patient's systemic condition, to avoid overdosing or bacterial resistance.
3. First-Line Antibiotics and Alternatives: Amoxicillin remains the antibiotic of choice for common dental infections, while clindamycin and azithromycin are safe options for patients with penicillin allergies.
4. Avoiding Antibiotic Abuse and Resistance: Empirical prescription should be prudent, considering the increasing bacterial resistance and the impact of indiscriminate antibiotic use on oral and general microbiota.
5. Individualized Treatment: Each patient should receive personalized antibiotic therapy, taking into account their clinical history, drug interactions, and potential adverse effects to optimize therapeutic response and reduce complications.

In conclusion, the rational use of antibiotics in dentistry is essential for effective infection treatment, minimizing risks, and contributing to the fight against microbial resistance.

📚 References

✔ Bascones Martínez, A., Aguirre Urizar, J. M., Bermejo Fenoll, A., Blanco Carrión, A., Gay Escoda, C., González Moles, M. Á., ... & Llamas Martín, R. (2006). Documento de consenso sobre la utilización de profilaxis antibiótica en cirugía y procedimientos dentales. Avances en Odontoestomatología, 22(1), 43-53.

📌 More Recommended Items

► Update on antibiotic prophylaxis in pediatric patients
► Pharmacological treatment of oral infections in pediatric dentistry - Recommendations and dose calculation
► Severe Dental Infections: Symptoms, Treatment & Antibiotics

Medications Used in Pulpotomies: Properties, Drawbacks, and Brand Names

Pulpotomy is a conservative dental procedure aimed at preserving the vitality of the radicular pulp after removing the affected coronal pulp. This treatment is common in primary teeth and young permanent teeth.

📌 Recommended Article :

PDF 🔽 Management of Endodontic Emergencies: Pulpotomy Versus Pulpectomy ... The goal of management of endodontic emergencies is to quickly and effectively manage pain and infections thereby also minimizing the development of persistent pain and the formation of periapical pathology

Selecting the right medication is crucial for clinical success. Below is an overview of the most commonly used pulpotomy agents, their properties, drawbacks, and commercial names.

Advertisement

✅ 1. Formocresol

➤ Brand Name: Buckley’s Formocresol
➤ Composition: 19% formaldehyde, 35% cresol, 15% glycerin, 21% water
➤ Properties:
° Bactericidal and tissue-fixative agent
° Mummifies remaining pulp tissue
° Easy to handle and low cost
➤ Drawbacks:
° Potentially carcinogenic and mutagenic
° Cytotoxic and allergenic
° Does not promote pulp tissue regeneration
➤ Clinical Notes:
° Although historically effective, its use has declined due to toxicity concerns.

📌 Recommended Article :

Video 🔽 Technique for Primary Molar Tooth Pulpotomy ... The treatment of dental pulp is not only carried out when there is caries, it is also carried out when the tooth is blown. Pulpotomy is one of the most frequent procedures performed in dental practice

✅ 2. Ferric Sulfate

➤ Brand Name: Astringedent®
➤ Composition: 15.5% aqueous solution of ferric sulfate (pH 1.0)
➤ Properties:
° Effective hemostatic agent
° Forms a protein barrier sealing blood vessels
° Affordable and easy to apply
➤ Drawbacks:
° Does not promote pulp regeneration
° May cause radicular inflammation and resorption
➤ Clinical Notes:
° A less toxic alternative to formocresol, but with variable long-term success.

📌 Recommended Article :

Video 🔽 What is the difference between apexogenesis and apexification? ... In the presence of an open apex, apexogenesis (apicoformation) or apexification can be used. Both treatments have differences that will be resolved with the video that we show below

✅ 3. Calcium Hydroxide (Ca(OH)₂)

➤ Brand Name: Dycal®
➤ Properties:
° Stimulates reparative dentin formation
° Highly alkaline with bactericidal effect
° Biocompatible
➤ Drawbacks:
° May cause superficial pulp necrosis
° Lower success rate in primary teeth
° Tends to dissolve over time
➤ Clinical Notes:
° More suitable for young permanent teeth; limited use in primary dentition.

📌 Recommended Article :

Video 🔽 Pulpectomy: Clinical Tips and Tricks in Paediatric Dentistry ... The objective of this treatment is to maintain the tooth to avoid problems of poor dental position of the permanent teeth

✅ 4. Mineral Trioxide Aggregate (MTA)

➤ Brand Name: ProRoot® MTA
➤ Composition: Tricalcium silicate, dicalcium silicate, tricalcium aluminate, bismuth oxide
➤ Properties:
Highly biocompatible
Stimulates dentin formation
Excellent sealing and antimicrobial properties
➤ Drawbacks:
High cost
Difficult manipulation and long setting time
➤ Clinical Notes:
Studies report a 97.9% clinical success rate in pediatric pulpotomies, outperforming other agents.

📌 Recommended Article :

Video 🔽 Dental Treatment: Vital Pulp Therapy for Primary Teeth ... The anatomical characteristics of primary teeth are different from permanent teeth. It is important to know these differences when performing any dental procedure

✅ 5. Biodentine

➤ Brand Name: Biodentine®
➤ Composition: Tricalcium silicate, dicalcium silicate, calcium oxide, calcium chloride, zirconium oxide
➤ Properties:
° Bioactive dentin substitute
° Mechanical properties similar to natural dentin
° Fast setting time and good radiopacity
➤ Drawbacks:
° High cost
° Limited long-term clinical evidence compared to MTA
➤ Clinical Notes:
° A promising MTA alternative with easier handling and shorter setting time.

📌 Recommended Article :

Video 🔽 Pulpotomy of Deciduous Molar - Step by step ... We share an interesting video that shows us how to perform a pulpotomy step by step, indicating the materials and the steps that we must follow

✅ 6. Zinc Oxide Eugenol (ZOE)

➤ Brand Name: IRM® (Intermediate Restorative Material)
➤ Properties:
° Soothing effect on dental pulp
° Antimicrobial and anti-inflammatory properties
° Easy to handle and inexpensive
➤ Drawbacks:
° Does not induce reparative dentin formation
° May dissolve over time
➤ Clinical Notes:
° Commonly used as a base or sealing material in pulpotomies.

📌 Recommended Article :

Video 🔽 Pulpectomy, everything you need to know: Diagnosis, indications, and filling materials ... The video that we share details everything related to pulpectomy: diagnosis, indications and contraindications, procedure, recommended filling materials, and the importance of post-treatment follow-up

✅ 7. Pulpotec® Paste

➤ Brand Name: Pulpotec®
➤ Composition:
° Powder: Polyoxymethylene, iodoform
° Liquid: Dexamethasone, formaldehyde, phenol, guaiacol
➤ Properties:
° Induces healing of the pulp stump
° Aseptic and quick treatment
° Effective in both primary and permanent teeth
➤ Drawbacks:
° Contains formaldehyde, which has cytotoxic potential
° Not resorbable
➤ Clinical Notes:
° Long-term success reported in studies, though formaldehyde content limits its use in some cases.

📌 Recommended Article :

Video 🔽 Apexogenesis: Step by step procedure ... We share a video that explains everything about apexogenesis: definition, indications, contraindications and the step-by-step procedure

💡 Conclusion
The choice of pulpotomy medication must be based on a careful evaluation of its properties, disadvantages, and available clinical evidence. While formocresol has been widely used, toxicity concerns have led to the rise of safer and more effective alternatives like MTA and Biodentine. The ideal agent depends on factors such as the patient's age, tooth condition, and specific clinical considerations.

📚 References

✔ Holguin Garcia, S. G. (2019). Eficacia clínica del MTA en Pulpotomías de pacientes pediátricos: Una Revisión Sistemática. Revista de Odontopediatría Latinoamericana, 11(1). https://doi.org/10.47990/alop.v11i1.228

✔ Wikipedia. (2025). Pulpotomía. Retrieved from https://es.wikipedia.org/wiki/Pulpotom%C3%ADa

✔ Apuntes De Odontología. (2015). Pulpotomía. Retrieved from https://apuntes-de-odontologia.blogspot.com/2015/04/pulpotomia.html

✔ Studocu. (2018). Terapia Pulpar I – Dra. Andrea Cárdenas Antonieta Montero. Retrieved from https://www.studocu.com/cl/document/universidad-finis-terrae/odontopediatria/terapia-pulpar-i/4935194

✔ Revista Odontopediatría. (2014). Tratamiento Endodóntico no Instrumentado en dientes deciduos. Retrieved from https://backup.revistaodontopediatria.org/ediciones/2014/1/art-6/

📌 More Recommended Items

► Myths About Root Canal Treatment
► Pulpotomy and pulpectomy procedures. Indications and Differences
► Pulp Therapy Procedures Manual for Primary and Immature Permanent Teeth

Oral Manifestations of Systemic Diseases: Updated Clinical Review

Systemic diseases affect more than internal organs—they often present oral signs that can be essential for early diagnosis.

📌 Recommended Article :

Video 🔽 Effects of tobacco on the oral cavity: Nicotine Stomatitis ... We must bear in mind that smoking generates short and long-term consequences. In the oral cavity it can generate periodontitis, gingivitis and pathologies in the oral mucosa

Due to its high vascularity and immune role, the oral cavity frequently reflects systemic conditions. In modern dentistry, recognizing these signs is key to preventive care and interdisciplinary treatment.

Advertisement

✅ Systemic Diseases and Their Oral Manifestations

1. Diabetes Mellitus
➤ Definition: A chronic metabolic disorder characterized by persistent hyperglycemia.
➤ Oral manifestations:
° Xerostomia (dry mouth)
° Advanced periodontal disease
° Delayed wound healing
° Oral candidiasis
➤ Common signs and symptoms: Gingival bleeding, tooth mobility, halitosis, recurrent oral infections.

2. Iron Deficiency Anemia
➤ Definition: A lack of iron leading to decreased oxygen-carrying capacity of the blood.
➤ Oral manifestations:
° Pale oral mucosa
° Atrophic glossitis (smooth, sore tongue)
° Angular cheilitis
➤ Common signs and symptoms: Burning sensation in the mouth, altered taste, oral ulcers.

📌 Recommended Article :

Video 🔽 Oral cancer: Risk factors, management, procedures and types of treatment ... Let's learn about the risk factors, management, and correct evaluation to identify the clinical manifestations of oral cancer. Let's also discover what the new technologies are for diagnosis and treatment

3. HIV/AIDS
➤ Definition: Infection caused by the human immunodeficiency virus, impairing the immune system.
➤ Oral manifestations:
° Pseudomembranous candidiasis
° Kaposi's sarcoma
° Oral hairy leukoplakia
° Necrotizing gingivitis/periodontitis
➤ Common signs and symptoms: White lesions, persistent ulcers, oral pain, gingival bleeding.

4. Systemic Lupus Erythematosus (SLE)
➤ Definition: A multisystem autoimmune disease affecting connective tissues.
➤ Oral manifestations:
° Painless oral ulcers
° Erythematous or purpuric lesions
° Xerostomia (often secondary to Sjögren’s syndrome)
➤ Common signs and symptoms: Mild pain, difficulty chewing, mucosal and lingual changes.

📌 Recommended Article :

PDF 🔽 Mouth Breathing: Its Consequences, Diagnosis & Treatment ... Mouth breathing has serious consequences for craniofacial and occlusive development. Mouth breathing patients have a longer face, this is due to the functional adaptation of breathing

5. Chronic Kidney Disease (CKD)
➤ Definition: Progressive, irreversible loss of kidney function.
➤ Oral manifestations:
° Uremic breath odor
° Oral ulcerations
° Gingival bleeding
Enamel hypoplasia (especially in children)
➤ Common signs and symptoms: Metallic taste, oral pain, delayed tooth eruption in children.

📌 Recommended Article :

Video 🔽 What Top 10 Mouth Cancer Symptoms ... The early detection of cancer ensures a better recovery and success of the treatment, for that we must know the warning signs and the changes that happen in our mouth

✅ Recommendations for Dental Practice

° Conduct thorough medical histories that screen for systemic illnesses.
° Treat oral signs as potential indicators of undiagnosed systemic disease.
° Work collaboratively with physicians for interdisciplinary care.
° Educate patients on the oral-systemic health connection.
° Schedule frequent cleanings and periodontal evaluations for at-risk patients.

📌 Recommended Article :

PDF 🔽 Management of Angular Cheilitis in children ... Angular cheilitis also called perleche or angular cheilitis is a lesion marked with fissures, cracks on corner of lip, reddish, ulceration accompanied by burning sensation, pain and dryness on the corner of the mouth.

💡Conclusions
Oral signs of systemic diseases serve as critical indicators for early diagnosis and comprehensive treatment. Timely recognition of these signs can improve patient outcomes, reduce complications, and enhance quality of life. Dentists play a key role in identifying these manifestations and guiding patients to appropriate medical care.

📚 References

✔ Chávez, E. M., et al. (2022). Oral health considerations in patients with chronic kidney disease. Journal of Clinical Nephrology and Renal Care, 8(1), 110. https://doi.org/10.23937/2572-3286.1510110

✔ Kottoor, R., et al. (2020). Oral manifestations in patients with systemic lupus erythematosus. Lupus, 29(3), 274–281. https://doi.org/10.1177/0961203320903073

✔ López-López, J., et al. (2021). Oral manifestations of iron deficiency anemia: A clinical approach. Clinical Oral Investigations, 25(1), 123–130. https://doi.org/10.1007/s00784-020-03418-z

✔ López-Pintor, R. M., et al. (2020). Diabetes mellitus and oral health: A bidirectional relationship. Medicina Oral, Patología Oral y Cirugía Bucal, 25(4), e559–e566. https://doi.org/10.4317/medoral.24012

✔ Patton, L. L., et al. (2021). Oral manifestations of HIV infection and treatment: A clinical guide. Oral Diseases, 27(S1), 59–68. https://doi.org/10.1111/odi.13742

📌 More Recommended Items

► Stomatitis in children - Symptoms, Causes, and Treatment
► How the symptoms of Dry Mouth can be combated ?
► Smoking ruins your oral health

Lingual Coating: Causes, Characteristics, Bacterial Profile, Consequences, and Treatment

Lingual coating, also known as tongue biofilm or tongue plaque, is a common condition in the oral cavity characterized by a whitish, yellowish, or brownish layer on the dorsal surface of the tongue.

📌 Recommended Article :

Dental Article 🔽 What Does Your Tongue Say About Your State Of Health? ... We leave you this interesting video where it shows us the different colors that our language may have and the pathologies that may be happening to us

This layer is primarily composed of desquamated epithelial cells, food debris, leukocytes, mucins, and a significant number of microorganisms, especially anaerobic bacteria. Often underestimated, lingual coating can indicate poor oral hygiene, systemic disorders, or imbalances in the oral microbiome.

Advertisement

✅ Clinical Characteristics of Lingual Coating
The main clinical features include:

° Whitish or yellowish appearance on the dorsal surface of the tongue.
° Pastelike or sticky texture.
° Halitosis (bad breath) present in most cases.
° Dry mouth sensation or unpleasant taste.
° Possible dysgeusia (altered taste) or burning tongue sensation.

The most commonly affected area is the posterior dorsal region, where filiform papillae are more abundant, facilitating retention of debris and microorganisms.

📌 Recommended Article :

Video 🔽 ORAL MEDICINE: What are tonsil stones? ... These stones are not malignant, but if it is a factor of bad breath (halitosis), in case these stones are larger it can cause odinogafia (pain when passing food)

✅ Microbiota Involved in Lingual Coating
The tongue harbors a complex microbiota of both aerobic and anaerobic bacteria. Lingual coating is especially associated with a high concentration of Gram-negative anaerobic bacteria that produce volatile sulfur compounds (VSCs), the main cause of halitosis.

➤ Key bacterial species identified:
° Porphyromonas gingivalis
° Fusobacterium nucleatum
° Prevotella intermedia
° Treponema denticola
° Tannerella forsythia
° Solobacterium moorei

These bacteria break down proteins from food and epithelial cells, producing VSCs such as hydrogen sulfide (H₂S), methyl mercaptan, and dimethyl sulfide, which are highly volatile and malodorous.
A recent metagenomic study by Seerangaiyan et al. (2017) confirmed that the tongue is one of the most microbiologically diverse sites in the oral cavity.

📌 Recommended Article :

Article 🔽 Bruxism: A medical or dental issue? ... Bruxism is a parafunctional habit characterized by teeth grinding or clenching, usually at night. This activity generates a series of problems in the teeth, chewing muscles and jaw joint

✅ Causes of Lingual Coating
Several factors contribute to the development of lingual coating:

1. Poor oral hygiene
Failure to brush the tongue promotes debris and microbial buildup.
2. Xerostomia (dry mouth)
Reduced salivary flow impairs the self-cleansing ability of the tongue.
3. Tobacco and alcohol use
These habits disrupt the oral flora and irritate the tongue’s surface.
4. Systemic diseases
Conditions like diabetes, chronic kidney disease, or gastrointestinal infections can manifest with tongue coating.
5. Use of antibiotics or antiseptic mouthwashes
Certain medications can alter the oral microbiome.

📌 Recommended Article :

Video 🔽 What can cause tongue injuries? - Management ... Self-examination and visits to the dentist are good ways to prevent any pathology, and thus maintain our oral and general health

✅ Clinical Consequences of Lingual Coating
Though often considered minor, lingual coating can lead to significant consequences:

° Chronic halitosis: The primary source of intraoral bad breath (Morita & Wang, 2001).
° Taste alterations: Due to mechanical obstruction of taste buds.
° Psychological discomfort: Bad breath may lead to social anxiety or isolation.
° Risk of periodontal disease: Lingual bacteria can colonize the gums.
° Indicator of systemic conditions: May be an early sign of candidiasis or immunosuppression.

📌 Recommended Article :

Video 🔽 How is oral health affected by diabetes? ... Diabetic people should visit the dentist to eliminate infectious sources (cavities, gum inflammation, fractured restorations) and to maintain oral hygiene

✅ Prevention of Lingual Coating
Effective preventive strategies include:

° Daily tongue cleaning: Using tongue scrapers or brushes with a cleaner surface.
° Proper oral hygiene: Brushing and flossing to reduce overall biofilm.
° Antimicrobial mouth rinses: Chlorhexidine 0.12% or zinc lactate in severe cases.
° Adequate hydration: To stimulate saliva production.
° Avoidance of tobacco and alcohol.
° Regular dental visits: For professional evaluation and monitoring.

📌 Recommended Article :

Video/PDF 🔽 How to Manage a Pediatric Patient with Oral Ulcers ... We share an interesting article on the management of oral ulcers in pediatric patients, where the symptoms and treatments that are required are discussed

✅ Treatment of Lingual Coating
Treatment should be multifactorial and individualized, addressing the underlying cause:

1. Tongue scraping
° Mechanical removal of coating using specialized tools—highly effective and affordable.
2. Antimicrobial therapy
° Rinses with chlorhexidine, cetylpyridinium chloride, or chlorine dioxide to reduce microbial load.
° Antibacterial toothpastes may support overall reduction of pathogens.
3. Correction of predisposing factors
° Manage dry mouth and systemic conditions (e.g., diabetes, kidney failure).
° Eliminate irritants such as smoking or alcohol.
4. Complementary therapies
° Oral probiotics (e.g., Lactobacillus reuteri) to modulate microbiota.
° Patient education on hygiene techniques and healthy lifestyle choices.

📌 Recommended Article :

Video 🔽 What are Oral Potentially Malignant Disorders? ... Early detection is recommended in these cases, in this way we prevent neoplasms from developing and increase the possibility of successful treatment

💡 Conclusion
Lingual coating is more than an aesthetic concern. It reflects microbial imbalances in the oral ecosystem and can impact systemic and psychosocial health. Its prevention and treatment are simple yet require consistency and patient education. A comprehensive approach—addressing both local and systemic factors—is essential for effective management.

📚 References

✔ Morita, M., & Wang, H. L. (2001). Association between oral malodor and adult periodontitis: a review. Journal of Clinical Periodontology, 28(9), 813–819. https://doi.org/10.1034/j.1600-051x.2001.028009813.x

✔ Seerangaiyan, K., Jüch, F., Winkel, E. G., & Winkelhoff, A. J. V. D. (2017). Tongue Microbiome in Healthy Subjects and Patients with Intra-Oral Halitosis. Journal of Breath Research, 11(3), 036010. https://doi.org/10.1088/1752-7163/aa6f9e

✔ Takeshita, T., Suzuki, N., Nakano, Y., & Yamashita, Y. (2008). Relationship between oral malodor and the global composition of indigenous bacterial populations in saliva. Applied and Environmental Microbiology, 74(2), 562–569. https://doi.org/10.1128/AEM.02039-07

✔ Tangerman, A., & Winkel, E. G. (2010). Intra- and extra-oral halitosis: findings of a new classification. Journal of Clinical Periodontology, 37(9), 807–814. https://doi.org/10.1111/j.1600-051X.2010.01699.x

✔ Faveri, M., Gonçalves, L. F., Feres, M., Figueiredo, L. C., & de Figueiredo, C. A. (2006). Prevalence and microbiological diversity of tongue coating in subjects with and without halitosis. Revista da Associação Paulista de Cirurgiões Dentistas, 60(2), 150–155.

📌 More Recommended Items

► How to Use a Tongue Scraper - Benefits
► Black hairy tongue: Why it happens?
► Smoking ruins your oral health

How Long Should Orthodontic Treatment Last? Procedures, Duration, and Scientific Justification

Orthodontic treatment is a complex but highly effective dental intervention that corrects malocclusion, dental crowding, spacing, and skeletal discrepancies.

📌 Recommended Article :

PDF 🔽 Pseudo class III treatment in 2-year-old children ... Untreated pseudo class III may lead to serious problems. The case report describes pseudo class III in primary dentition successfully treated by using Protrusive Arch Wire

Although many patients expect fast results, the duration of orthodontic treatment is determined by biological, mechanical, and individual patient factors—all of which are backed by current clinical research.

Advertisement

✅ How Is Orthodontic Treatment Carried Out?
Orthodontic therapy is delivered in four main phases:

1. Diagnosis and Treatment Planning
The orthodontist collects diagnostic data including panoramic X-rays, lateral cephalograms, intraoral scans, and facial photographs. These are analyzed to formulate an individualized treatment plan.
2. Active Phase (Tooth Movement)
Brackets, archwires, or aligners (e.g., Invisalign) are applied to exert controlled forces on the teeth. This phase typically lasts between 6 and 24 months depending on the severity of malocclusion and patient cooperation.
3. Space Closure and Bite Correction
During this phase, spaces from extractions (if any) are closed and bite alignment is refined using interarch elastics or bite correctors.
4. Retention Phase
After the desired tooth positions are achieved, retainers are used to stabilize the teeth and prevent relapse, often for a lifelong period.

📌 Recommended Article :

Video 🔽 5 questions to ask before orthodontic treatment ... It is important to know the experience of the orthodontist, thus avoiding a bad procedure and an unwanted result. For more recommendations we recommend watching the video below

✅ What Is the Recommended Duration?
The average orthodontic treatment duration is 18 to 30 months, depending on case complexity, appliance type, and biological response. Some mild cases may be completed in as little as 12 months, while more complicated malocclusions—such as skeletal Class II or III discrepancies—may require over 36 months, sometimes in combination with orthognathic surgery.

✅ Scientific Justification for Treatment Duration
Tooth movement is mediated by bone remodeling, a physiological process involving osteoclastic and osteoblastic activity in response to controlled mechanical forces.
Rapid orthodontic movement risks:

° Root resorption
° Periodontal breakdown
° Bone dehiscence

Clinical guidelines support the use of light, continuous forces rather than aggressive force applications. According to Papageorgiou et al. (2022), the efficacy and safety of orthodontic treatment are optimized when aligned with biomechanical principles that respect tissue physiology.

Additionally, the pace of treatment is influenced by:
° Age: Adolescents show faster remodeling than adults.
° Type of appliance: Self-ligating brackets and clear aligners may reduce friction and duration in select cases.
° Patient compliance: Missed appointments or broken appliances delay progress.
° Oral hygiene: Poor hygiene may result in gingival inflammation or caries, which can temporarily suspend treatment.

📌 Recommended Article :

Video 🔽 Orthodontics: What is Interproximal Reduction (IPR) ... The interproximal wear should not be greater than 0.5mm and is done with the objective of having small spaces to align the teeth.

✅ Conclusion
Orthodontic treatment requires a minimum of 18 to 30 months for safe, stable, and functional results. Each phase of treatment plays a critical role, and shortening the process unnecessarily can compromise long-term outcomes. Duration should always be tailored to individual clinical needs and grounded in evidence-based protocols.

📚 References

✔ Papageorgiou, S. N., Cobourne, M. T., & Eliades, T. (2022). Clinical effectiveness of orthodontic treatment: A systematic review and meta-analysis. Progress in Orthodontics, 23(1), 1–15. https://doi.org/10.1186/s40510-022-00420-3

📌 More Recommended Items

► Causes of Gum problems with braces
► What is the importance of the Space Maintainer?
► Anterior crossbite - Diagnosis and orthopedic treatment

Is Gingivitis or Periodontitis Contagious? A Scientific Overview of Transmission, Symptoms, and Microbiota

Gingivitis and periodontitis are common forms of periodontal disease affecting millions worldwide. While traditionally considered non-communicable, emerging research has challenged this notion, raising concerns about whether these conditions might be transmissible through saliva and close contact.

📌 Recommended Article :

Video 🔽 Diabetes and gum health - Periodontitis ... Control of diabetes is essential to achieve successful periodontal treatment. That is why it is important to visit your doctor and dentist regularly for an early evaluation and treatment

This article explores updated scientific evidence regarding the contagious nature of periodontal diseases, highlighting signs, symptoms, microbial profiles, and possible transmission routes.

Advertisement

✅ Gingivitis and Periodontitis: Definitions and Symptoms
Gingivitis is an early stage of periodontal disease characterized by inflammation of the gingiva without loss of attachment. Its signs include red, swollen gums, bleeding on brushing, and halitosis.
Periodontitis, a progression from untreated gingivitis, involves destruction of the supporting structures of teeth, including alveolar bone. It manifests as gingival recession, deep periodontal pockets, tooth mobility, and eventual tooth loss.
Both conditions are influenced by poor oral hygiene, genetic predisposition, smoking, and systemic diseases. However, increasing attention has turned to the potential of direct bacterial transmission.

📌 Recommended Article :

Video 🔽 What to expect after periodontal surgery - Post-Operative Guide ... Thanks to this procedure we can eliminate dental stones that could not be removed during the initial phases of periodontal treatment

✅ Microbiota in Periodontal Disease
The development of gingivitis and periodontitis is driven by a dysbiosis in the oral microbiota. Key pathogens involved include:

° Porphyromonas gingivalis
° Tannerella forsythia
° Treponema denticola
° Aggregatibacter actinomycetemcomitans

These bacteria are organized in complex biofilms and have virulence factors that allow them to evade the immune system and promote inflammation. Studies have shown these microbes can be found in the saliva of affected individuals, suggesting a potential route for interpersonal transmission.

📌 Recommended Article :

Video 🔽 What is the treatment of receding gums? ... Gum retraction is one of the most common pathologies that can be observed in dental offices. The causes are varied and is usually due to the presence of chronic periodontal diseases

✅ Is Periodontal Disease Contagious?
While periodontal diseases are not classified as infectious diseases, evidence supports the possibility of bacterial transmission, especially among close contacts such as spouses, parents, and children.

➤ Salivary Transmission
A 2020 study by Kuru et al. demonstrated that spouses often share similar subgingival microbiota, especially when one partner has periodontitis (Kuru et al., 2020). Salivary exchange through kissing or sharing utensils may facilitate bacterial transfer.
➤ Vertical Transmission
Vertical transmission (from parent to child) has been observed with A. actinomycetemcomitans and P. gingivalis. A 2022 study by Liu et al. confirmed the early colonization of periodontal pathogens in children from mothers with periodontitis (Liu et al., 2022).
➤ Horizontal Transmission
Peer-to-peer transmission, though less documented, may occur in communal living environments or through shared personal items.

📌 Recommended Article :

Video 🔽 Causes of Gum problems with braces ... The orthodontic patient must be informed about the responsibilities that he adopts once he is a holder of braces. The consequences of poor dental hygiene can be very serious

✅ Clinical and Public Health Implications
Understanding the possible transmissibility of periodontal pathogens emphasizes the importance of:

° Early diagnosis and treatment
° Improved hygiene habits within households
° Avoiding shared oral hygiene tools
° Raising awareness among dental professionals and the public

However, the presence of pathogens does not guarantee disease. Host response, immune status, and environmental factors significantly influence disease development.

📌 Recommended Article :

Video 🔽 Risk of gum disease for smokers ... In conclusion, the job of the dentist is not only to treat periodontal disease, but also to influence the patient to stop smoking

✅ Conclusion
Current evidence suggests that gingivitis and periodontitis may be transmissible to a degree, particularly via saliva among close contacts. Though not contagious in the traditional sense like influenza, the oral microbiota associated with these diseases can spread and potentially contribute to periodontal pathology in others. This underscores the need for preventive strategies not only at the individual but also at the familial level.

📚 References

✔ Kuru, B. E., Laleman, I., Yalçin, F., & Teughels, W. (2020). The influence of periodontitis on oral microbiota transmission among family members. Journal of Clinical Periodontology, 47(3), 333–342. https://doi.org/10.1111/jcpe.13236

✔ Liu, X., Zhang, W., Wang, Y., Li, Y., & Zhou, X. (2022). Early transmission and colonization of key periodontal pathogens in children: A longitudinal study. Clinical Oral Investigations, 26(9), 5195–5205. https://doi.org/10.1007/s00784-022-04639-9

✔ Teles, R., & Wang, C. Y. (2021). Mechanisms involved in the association between periodontal diseases and cardiovascular disease. Periodontology 2000, 87(1), 254–273. https://doi.org/10.1111/prd.12380

✔ Slots, J. (2017). Periodontitis: Facts, fallacies and the future. Periodontology 2000, 75(1), 7–23. https://doi.org/10.1111/prd.12211

📌 More Recommended Items

► Do You Have Gingivitis or Periodontitis? | Different Stages Of Gum Disease
► What Causes Bad Breath? - How to get rid of it?
► What is Peri-implantitis and how do we prevent it? 3D video

Fluoride Varnish in Pediatric Dentistry: Benefits, Indications, Mechanism, and Application Protocol

Dental caries remains one of the most prevalent chronic diseases in childhood worldwide. According to the World Health Organization (WHO), up to 60–90% of school-aged children are affected by dental caries, significantly impacting their health and quality of life. In this context, fluoride varnish has emerged as a highly effective preventive strategy in pediatric dentistry, endorsed by major health organizations globally.

📌 Recommended Article :

PDF 🔽 Fluoride Varnish in the Prevention of Dental Caries in Children and Adolescents: A Systematic Review ... We share an article that reviews the literature and develops a protocol for the use of fluoride varnish as a caries preventive agent in children and adolescents

Fluoride varnish is a topical treatment used to prevent, slow down, or even reverse the early stages of dental caries in children. Due to its ease of application, safety, and efficacy, it has become an essential part of caries management in clinical pediatric practice.

Advertisement

✅ Benefits of Fluoride Varnish in Children
The use of fluoride varnish offers multiple benefits in the pediatric population:

🛡️ Caries prevention: Enhances enamel resistance to acid attacks by increasing fluoride availability on the tooth surface.
🦷 Enamel remineralization: Promotes the repair of early carious lesions (white spots), avoiding invasive treatments.
👶 Safe for young children: Due to its quick setting time and minimal ingestion risk, it is ideal for toddlers and young patients.
⏱️ Fast and non-invasive: Application is completed within minutes and causes minimal discomfort.
📈 Cost-effective: Reduces the need for restorative treatments and associated healthcare costs.

📌 Recommended Article :

Video 🔽 What are the causes of white spots on teeth? ... It can occur in both primary and permanent dentition, and a professional evaluation is necessary to determine what is the cause of the white spots and perform an appropriate treatment

✅ Clinical Indications in Pediatric Dentistry
Fluoride varnish is recommended in various clinical situations, including:

➤ Children at high risk of dental caries, particularly those with poor oral hygiene, high sugar intake, or socioeconomic barriers to dental care.
➤ Children undergoing orthodontic treatment, where plaque retention increases caries risk.
➤ Patients with enamel hypoplasia or demineralization.
➤ Children with special healthcare needs, who may have difficulties with standard oral hygiene routines.
➤ As a preventive adjunct during routine dental check-ups, typically every 3 to 6 months.

The American Dental Association (ADA) and the American Academy of Pediatric Dentistry (AAPD) both support the use of fluoride varnish as a routine preventive intervention in children beginning at the eruption of the first primary tooth.

📌 Recommended Article :

Video 🔽 Fluoride varnish application in children ... Fluoride varnish treatments can best help prevent decay when a child is also brushing using the right amount of toothpaste with fluoride, flossing regularly, getting regular dental care, and eating a healthy diet

✅ Mechanism of Action
Fluoride varnish functions by:

➤ Enhancing enamel remineralization: When applied to teeth, the varnish delivers a high concentration of fluoride ions that interact with calcium and phosphate in saliva, forming fluorapatite — a more acid-resistant mineral than hydroxyapatite.
➤ Inhibiting demineralization: Fluoride ions integrate into the enamel matrix, making it less soluble under acidic conditions.
➤ Antimicrobial effect: Fluoride can inhibit the enzymatic activity of cariogenic bacteria, such as Streptococcus mutans, thereby reducing acid production.

Typically, the varnish contains 5% sodium fluoride (NaF), equivalent to 22,600 ppm of fluoride, suspended in a resin or alcohol-based solution that hardens upon contact with saliva, ensuring prolonged fluoride contact with the enamel surface.

📌 Recommended Article :

Video 🔽 How to Apply: Clinpro Sealant - Step by step ... There are several benefits of dental sealants, for example: it contributes to good brushing, prevents the accumulation of plaque in pits and fissures, avoids the presence of cavities on the occlusal surfaces, etc

✅ Frequency of Application
The recommended frequency depends on the child’s caries risk:

➤ Low caries risk: Every 6 months.
➤ Moderate to high caries risk: Every 3 to 4 months.

These intervals are supported by clinical trials demonstrating that repeated applications significantly reduce caries incidence in primary and permanent teeth. Importantly, fluoride varnish is safe to use even in children under the age of six, as ingestion is minimal due to the rapid setting time and small quantity used.

📌 Recommended Article :

Video 🔽 Use of Silver Diamine Fluoride (SDF) - General Guide on its application ... It offers several advantages such as its easy application, low cost, it avoids the use of dental anesthetics, and it can be applied in places that do not have dental equipment

✅ Conclusion
Fluoride varnish is a cornerstone of modern pediatric preventive dentistry. Its proven efficacy in caries prevention, ease of application, and safety profile make it an indispensable tool for dental professionals. Early and regular use, especially in high-risk children, not only improves oral health outcomes but also reduces the need for restorative interventions, promoting a lifetime of healthy smiles.

📚 References

✔ American Academy of Pediatric Dentistry. (2023). Guideline on Fluoride Therapy. The Reference Manual of Pediatric Dentistry. Chicago, IL: American Academy of Pediatric Dentistry. Retrieved from https://www.aapd.org/research/oral-health-policies--recommendations/fluoride-therapy/

✔ Centers for Disease Control and Prevention. (2022). Use of Fluoride in the Prevention of Dental Caries in the Primary Care Setting. MMWR Recommendations and Reports. Retrieved from https://www.cdc.gov/mmwr/preview/mmwrhtml/rr5014a1.htm

✔ Weyant, R. J., Tracy, S. L., Anselmo, T. T., Beltrán-Aguilar, E. D., Donly, K. J., Frese, W. A., ... & Zero, D. T. (2013). Topical fluoride for caries prevention: Executive summary of the updated clinical recommendations and supporting systematic review. Journal of the American Dental Association, 144(11), 1279–1291. https://doi.org/10.14219/jada.archive.2013.0057

✔ Marinho, V. C. C., Worthington, H. V., Walsh, T., & Clarkson, J. E. (2013). Fluoride varnishes for preventing dental caries in children and adolescents. Cochrane Database of Systematic Reviews, (7). https://doi.org/10.1002/14651858.CD002279.pub2

📌 More Recommended Items

► Silver Diamine Fluoride in Pediatric Dentistry: Clinical Guide 2025
► ORAL HYGIENE : How to care for your baby's gums
► Atraumatic Restorative Treatment - Indications, Advantages and Disadvantages