Browsing by Author "Maxwell, Lisa"

Now showing 1 - 5 of 5
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    Assessment of Salivary Adipokines Resistin, Visfatin, and Ghrelin as Type 2 Diabetes Mellitus Biomarkers
    (Hindawi Publishing Corporation, 2018-02-01) Srinivasan, Mythily; Meadows, Melinda L.; Maxwell, Lisa; Oral Pathology, Medicine and Radiology, School of Dentistry
    Type 2 diabetes mellitus (T2DM) is emerging as a metabolic epidemic worldwide. Pathologically, dysregulation of many biological pathways precedes hyperglycemia and the clinical diagnosis of T2DM. Changing trajectories along the process of T2DM development necessitates frequent measurement of biomarkers for early identification of at-risk individuals and successful prevention. Increase in circulating inflammatory adipokines has been suggested as predictive of T2DM. Human saliva is an easily accessible biospecimen amenable for painless frequent collection and possesses nearly 50% of serum proteome. In this study, we measured the adipokines resistin, visfatin, TNF-α, and ghrelin as markers for T2DM in unstimulated whole saliva (UWS) using specific assay kits. Resistin and visfatin concentrations were significantly higher in T2DM saliva. Although the concentration of acylated or unacylated ghrelin was lower in diabetic saliva, the decrease was not significant. Since resistin and visfatin are biomarkers integral to T2DM pathology, their salivary assessments may receive clinical acceptance.
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    The Dental Hygienist’s Role in Management in Oral Lichen Planus.
    (04/13/15) Lucas, Jessica; Magana, W; Maxwell, Lisa; Lucas, Jessica; Maxwell, Lisa; Dental Hygiene
    Objective: To understand the dental hygienist’s role in the management of patients with oral lichen planus (OLP). Signs of OLP are clinically seen as lacy white, raised patches of tissue and/or as red, swollen, tender patches of tissue. These lesions are most commonly visible on the buccal mucosa; other common locations are the gingiva, tongue, alveolar mucosa, and the palate. Patients with OLP typically experience a burning sensation or pain in the area. Our patient presented with generalized slight to moderate plaque induced and localized non-plaque induced gingivitis evidenced by hypersensitivity involving the papilla, white and pale pink gingiva, blunted, and sloughing papilla. Raised white patches were clinically noted on the left buccal alveolar mucosa, the left buccal mucosa, and with similar but fewer patches on the right buccal tissues. Patient indicated being more symptomatic a couple weeks prior to her visit, but she was unsure why. She expressed that the inside of her cheeks felt very painful and these symptoms “come and go.” Patient reported no history of medication. Her oral hygiene habits consist of brushing once a day with an electric tooth brush, flossing once a day, and using Listerine mouth rinse once a day. While there is no cure for OLP, current treatment includes systemic and topical corticosteroids. Palliative care during a dental hygiene appointment would include the use of topical and local anesthetics. When treating a patient with OLP, it is important that the dental hygienist recognizes the signs and symptoms in order to determine an appropriate care plan while keeping pain and discomfort to a minimum; and to provide the patient with the knowledge to care for lichen planus at home.
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    Management Strategies for Patients with Xerostomia (Dry Mouth).
    (4/13/2015) Chrzan, Marissa; Maxwell, Lisa; Chrzan, Marissa; Maxwell, Lisa; Dental Hygiene
    Objective: To discuss management strategies for patients presenting in the clinical setting with xerostomia (dry mouth). Xerostomia is a multifactorial problem and many times it is disabling for the individual and challenging to manage. A 66 year old Caucasian female presented to the dental hygiene clinic with a chief complaint of “constant dry mouth.” The patient’s medical history indicated a previous habit of smoking along with a current history of asthma, chronic obstructive pulmonary disease, and oral candidiasis infection. Contributing factors to the patient’s dry mouth include: the use of a CPAP machine at night, oxygen during the day, and two prescription medications whose side effects cause dry mouth (Zoloft and Spiriva). Upon examination this patient was determined to be high caries risk and evidence of a new carious lesion was found on the mesial aspect of tooth #27. The iteration of meticulous home care is an important role of the clinician in order to alleviate discomfort, taste disturbances, sore mouth, and to prevent future decay and candidiasis infections. Other recommendations that were given in order to combat dry mouth included: use of high fluoride toothpaste (PreviDent 5000), ACT dry mouth rinse, and ACT dry mouth lozenges. It is also important for this patient to drink eight glasses of water a day, avoid sugar containing beverages, and chew sugar-free gum to stimulate salivation. The patients’ overall quality of life can be improved if clinicians are able to properly recognize xerostomia and recommend personalized management routines.
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    Motivational Factors for the Non- Compliant Patient.
    (04/13/15) Miller, Nia; Ranis, D; Maxwell, Lisa; Miller, Nia; Maxwell, Lisa; Dental Hygiene
    Objective: To evaluate the oral hygiene attitudes of non-compliant patients and find motivating strategies to improve their adherence to oral hygiene recommendations. Assessment: A 33 year old male Caucasian patient presented to our clinic with the chief complaint of “I need to get my teeth cleaned.” He had not been to the dentist in 17 years. His medical history was positive for HIV/AIDS. The patient stated that he has smoked a half of a pack of cigarettes daily for the last 20 years and that he drinks socially. The patient stated that he brushes once a day with a manual toothbrush and rarely flosses. His gingival description was generalized mild plaque induced marginal, papillary gingivitis as evidenced by pale pink, bulbous, spongy gingiva with slight BOP. Localized moderate to severe plaque induced gingivitis on lingual mandibular tissue as evidenced by red, rolled, inflamed papilla with easy BOP on the mandible. His periodontal description was generalized 4-6 mm CAL most likely due to inflammation from pseudo-pocketing. Generalized healthy bone levels as evidenced radiographically by 1-2 mm measurements from the CEJ to crest of alveolar bone. DH Care Plan: Prophylaxis, extensive OHI that includes finding motivating factors for this patient to maintain effective plaque control at home. Evaluation: When evaluating this patient’s success in treatment, we found he was not compliant 5 out of the 10 appointments that we had agreed to schedule. His behavior and attitude remained unchanged despite the efforts used to motivate the patient. His attitude reflected his desire for a quick resolution to improve his oral health, rather than making the commitment and effort to alter his lifestyle. Conclusion: Finding the right motivating strategies for your patient will determine how successful their treatment outcomes will be in achieving optimal oral health.
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    A visual evaluation of oral plaque removal utilizing an adjunct enzyme pre-rinse in orthodontic subjects
    (Allen Press, 2020-11-01) Rose, Jennifer; Ghoneima, Ahmed; Lippert, Frank; Maxwell, Lisa; Eckert, George; Stewart, Kelton T.; Orthodontics and Oral Facial Genetics, School of Dentistry
    Objective: To determine if an adjunct proteolytic pre-rinse along with contemporary methods of dental cleaning may more effectively remove visual plaque in subjects with fixed orthodontic appliances. Materials and methods: Forty-three orthodontic subjects, ages 10 to 25, completed this single site, double-blind, crossover clinical trial. Subjects randomly received bromelain enzyme or a powdered-sugar placebo pre-rinse, followed by manual tooth brushing and use of a Waterpik. Subjects received the alternate pre-rinse during the subsequent visit. Baseline and residual plaque accumulation were recorded via disclosing tablet and digital photography. A single, blinded examiner scored visual plaque scores from randomized photographs. Treatment effects on composite plaque score were evaluated using repeated-measures analysis of variance. A 5% significance level was used for all tests. Results: No significant differences in plaque scores were noted at baseline or post-rinse between the enzyme and placebo. The changes from baseline to post-rinse (P = .190), post-brushing (P = .764), and post-Waterpik (P = .882) were not significantly different between interventions. Significant reduction in plaque scores were observed in both arms of the study after brushing (P < .01) and waterjet use (P < .01). Neither age (P = .220) nor gender (P = .449) impacted plaque scores. Conclusions: Use of a bromelain enzyme pre-rinse alone did not significantly enhance plaque removal. A significant reduction in retained plaque was observed with the application of brushing and or Waterpik.