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Biomedical subjects

D Birkhed

Publications and source records attributed to D Birkhed.

At least 19 recordsLinked to original sources
PubMed1992

Variation of posterior approximal caries incidence with consumption of sweets with regard to other caries-related factors in 15-18-year-olds.

The aim of this study was to analyze the relationships between caries incidence and a number of caries-related factors in 15-18-yr-olds, in order to estimate the explanatory value of consumption of sweets under different conditions. Sixty-nine 18-yr-olds were interviewed about consumption of sweets and other sugar-containing products during the past 3 yr. Data on oral hygiene, salivary counts of mutans streptococci and lactobacilli, salivary flow rate and oral sugar clearance time were collected when the individuals were 15 and 18 yr old. Caries incidence for the 3-yr period was expressed as a percentage of the number of caries-free approximal surfaces of premolars and molars at the age of 15. Simple linear correlations between caries incidence and the different variables showed that lactobacilli count ranked first (r = 0.26), sweets second (r = 0.25), and mutans streptococci count third (r = 0.24). The r value for caries incidence and consumption of sweets increased in subgroups with combinations of poor oral hygiene, a high intake of other sugary products and a low salivary flow rate (r = 0.67-0.70). In conclusion, consumption of sweets should still be considered an important caries-related factor and particularly harmful when oral hygiene is poor and consumption of other sugary products is high.

Adolescent↗
PubMed1992

Progression of approximal caries in primary molars and the effect of Duraphat treatment.

The progression of caries lesions over a 2-yr period was studied in 3-6-yr-olds. All 468 children included in the study lived in an area during 1977-85 (Malmö, Sweden) with a low fluoride concentration (0.2 ppm) in the drinking water. Radiographs were taken with a standardized periodic identical technique. Caries lesions were scored on the distal surface of the first and on the mesial surface of the second primary molars (maximum 8 per child) according to Gröndahl et al. Half of the children were treated semiannually with a fluoride varnish (Duraphat). In all, 421 surfaces with caries at baseline were available at the 1-yr examination and 369 at the 2-yr examination. After 1 yr, 34.1% of the shallow enamel lesions remained unchanged, while a progression was seen in 60.9%. 5.1% had been restored. The corresponding figures after 2 yr were 20.6, 52.1 and 27.3%. Of the deeper enamel lesions at baseline, 28.8% remained unchanged after 1 yr and 13.7% after 2 yr. Of the lesions extending into the dentin, 81.5% had been restored after 1 yr and all after 2 yr. When evaluating the effect of Duraphat, only the percentage of individuals with one or more superficial enamel lesions showing progression was determined. After 1 yr, 51.2% in the Duraphat (n = 41) and 82.8% in the control group (n = 29) showed progression (restored surfaces included). The corresponding figures after 2 yr were 66.7 (n = 42) and 91.2% (n = 34). The differences after both 1 yr and 2 yr were statistically significant.(ABSTRACT TRUNCATED AT 250 WORDS)

Child↗
PubMed1992

Longitudinal study of stimulated whole saliva in an elderly population.

The aim of this investigation, which is part of the longitudinal gerontologic population study in Gothenburg (H-70), was to examine the effect of aging on salivary flow. Three 70-yr-old cohorts, born in 1901/02, 1906/07, and 1911/12, were studied both cross-sectionally and longitudinally. Representative subsamples (n = 931) were followed up to 82 yr in the first and up to 75 yr in the second and third cohorts. Whole saliva secretion was stimulated by paraffin wax chewing for 5 min and all sampling was carried out in the morning after an overnight fast. The mean secretion rate was 1.24 for men and 0.94 ml/min for women at the age of 70 (all cohorts pooled). The percentage values for extremely low secretion rate (< 0.2 ml/min) were 2 and 6%, respectively. Neither the cross-sectional nor the longitudinal comparison showed any decrease in secretion rate on a group basis either in the age interval 70-82 yr in the first or between 70 and 75 yr in the other two cohorts. However, an increased prevalence of complaints of mouth dryness was found, especially among women. The main conclusion from this study is that there is no decline on a population basis in paraffin-wax-stimulated salivary flow with increasing age.

Age Factors↗
PubMed1992

Use of palladium touch microelectrodes under field conditions for in vivo assessment of dental plaque pH in children.

The aim of this study was to assess the applicability of palladium touch microelectrodes, connected to battery-run pH meters, for in vivo plaque pH measurements in children. The pH was assessed in 20 7-year-old and in 19 14-year-old caries-active and caries-inactive rural Kenyan children. The resting pH was measured at non-carious interproximal and occlusal sites and in open dentine cavities. Independent repeated measurements were performed at given sites at intervals of 15 s and 5 min and on different days. The resting plaque pH varied widely among the children, and there was no significant difference between caries-active and caries-inactive groups. The most striking feature was the considerable erratic fluctuations of pH at a given site with time, both in resting and in sucrose-challenged plaque. These fluctuations were sensitively recorded by palladium touch microelectrodes. After a sucrose rinse, not all sites in the same mouth behaved in a similar fashion, and thus the classical 'Stephan curve' was not always apparent. In conclusion, the palladium touch microelectrodes are highly applicable for plaque pH measurements in children, even under extreme field conditions.

Adolescent↗
PubMed1992

Effect of sugarcane chewing on plaque pH in rural Kenyan children.

In 5 rural Kenyan children, the effect of sugarcane chewing on plaque pH was compared with the effect of a mouthrinse with 10% sucrose at various intraoral sites. They all had poor oral hygiene and at least two carious cavities in occlusal surfaces of molars. pH measurements were conducted under field conditions using paladium touch microelectrodes connected to a battery-operated pH meter. There was a marked difference in pH response of non-carious approximal sites between maxilla and mandible, with the lowest values in the maxilla. However, the pH recovery following the instantaneous drop occurred in parallel even if most pH values had not returned to baseline values 30 min after the sucrose rinse. Following the sugarcane chewing, the pH fall was less pronounced on all sites, and within 5-10 min the values had returned to resting pH and even exceeded this. In carious cavities, a similar pattern was observed, although the acidity in these sites was more pronounced, also reflected in a lower resting mean pH. The main conclusion from this study is that sugarcane chewing yields a less pronounced pH drop and a quicker pH recovery in dental plaque than is seen following a mouthrinse with 10% sucrose. This difference probably results from stimulation of salivary flow associated with the chewing.

Adolescent↗
PubMed1992

Oral sugar clearance and root caries prevalence in rheumatic patients with dry mouth symptoms.

The relationship between root caries, oral sugar clearance, salivary flow rate, and salivary counts of mutans streptococci, lactobacilli and candida has been studied in a group of 22 rheumatic patients (age range 40-72 years). The study group comprised all subjects volunteering for a clinical trial on relief of dry mouth symptoms. The median salivary flow was 0.09 ml/min at rest and 0.9 ml/min during chewing stimulation. The median sugar clearance time was about 5 min in the sublingual area and 16 min in the lower buccal vestibule. For subjects with 0-2 root caries lesions the clearance time at both sites was shorter than for subjects with 3 or more lesions (p < 0.05). A long oral clearance time was significantly correlated with age, root caries (DS and DFS), low resting salivary flow, and high salivary counts of mutans streptococci. It is concluded that root caries in rheumatic patients with low salivary flow is significantly related to oral sugar clearance time.

Adult↗
PubMed1992

Prediction of root caries in periodontally treated patients maintained with different fluoride programmes.

The aims of the investigation were to evaluate the effect of different fluoride programmes, as adjuncts to professional plaque control every 3-4 months, on root caries incidence in periodontally treated patients and to identify risk factors for root caries development. Ninety-nine individuals, 33-76 years old, who had been treated for periodontal disease were subjected to one of three fluoride programmes during a 2-year period: (1) professional application, 3-4 times/year, of Duraphat (n = 34) or (2) of a 0.4% stannous fluoride gel (n = 33), or (3) daily mouthrinsing with a 0.05% sodium fluoride solution (n = 32). A number of clinical recordings and laboratory tests, used as presumptive risk indicators for root caries, were carried out before and on three different occasions after the periodontal treatment. No statistically significant differences were found between the various fluoride programmes. During the 2-year period, a total of 246 new decayed or filled surfaces (DFS) were recorded, 72 (29.3%) of which were diagnosed as active and 124 (50.4%) as inactive root caries lesions; 50 (20.3%) of the surfaces had been restored. Individuals with > or = 1 new root DFS during the 2 years (n = 50) differed significantly from those with 0 new root DFS (n = 49) as concerns salivary counts of mutans streptococci and lactobacilli, root plaque scores and percentage of exposed root surfaces. Baseline root caries prevalence (r = 0.43) and root plaque scores (r = 0.36) showed the highest correlations with new root DFS.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1992

An individual training programme for speeding up prolonged oral sugar clearance in hospitalized elderly patients. A pilot study.

The aim of this pilot study was to evaluate an individual programme for speeding up prolonged oral sugar clearance in hospitalised elderly patients. Six patients at a university hospital for geriatric medicine, aged 67-85 years, completed a 6-week study. Every second week one of the authors gave: 1) information on the importance of oral sugar clearance for oral health, 2) instruction in oral hygiene, and 3) professional tooth cleaning. Moreover, the staff responsible for each patient provided 1) massage and training of the lips, cheeks and tongue shortly before each main meal, 3 times daily, 2) supervision of chewing on a sugar-free chewing gum for at least 20 min, 4 times daily, and 3) support and encouragement of the patients throughout the day. Salivary glucose clearance was measured both sublingually and vestibularly in the lower jaw after chewing a glucose tablet and after a mouth rinse with 10% glucose solution. There was a clear tendency that the oral sugar clearance was reduced after the 6-week period and some of the reductions in the clearance variables were statistically significant. All patients, especially those suffering from cerebral haemorrhage, reported an improved ability to chew while proceeding with the programme, which was also confirmed by the staff. The main conclusion from this pilot study is therefore that it might be possible to speed up prolonged oral sugar clearance in elderly hospitalised patients using an individual training programme.

Aged↗
PubMed1991

Oral sugar clearance in elderly people with prosthodontic reconstructions.

The aim was to study oral sugar clearance in elderly individuals, around 70 yr of age, with various types of prosthodontic reconstructions. Salivary glucose concentration was measured under the tongue after chewing a glucose tablet in four groups of individuals with: 1) complete dentures (CD) (n = 19), 2) removable partial dentures (RPD) (n = 22), 3) fixed partial dentures (FPD) (n = 24), and 4) no dentures (controls) (n = 23). Salivary glucose clearance was also studied after a mouthrinse with 10% glucose in 18 of the 19 individuals with CD and in 13 of the 22 with RPD both with and without the dentures. Saliva samples for glucose analysis were taken, in this part of the experiment, at two separate locations: under the tongue and in the labial vestibule near the mandibular right first molar. After the tablet intake, the group with CD showed the highest initial salivary glucose concentration, the longest oral sugar clearance time and the largest area under the curve, followed by the group with RPD. FPD did not seem to influence the oral sugar clearance. After the glucose rinse, higher values for the various clearance variables were obtained in the vestibule than under the tongue and, to some extent, when the experiments were carried out with than without the dentures. Thus, the results from this study indicate that removable dentures, especially CD, contribute to less effective oral sugar clearance in elderly people and that the oral clearance seems to be more dependent on the site than on the presence or absence of removable dentures in the oral cavity.

Aged↗
PubMed1991

Oral sugar clearance in children compared with adults.

The aim of the present investigation was to study oral sugar clearance of various types of foodstuffs in children of different ages in comparison with adults. Thirty children and 20 adults were selected constituting five groups, each containing 10 individuals: 3-, 7-, 15-years-olds and adults, all with normal salivary secretion rate, and adults with low salivary secretion rate (dry mouth patients). Oral sugar clearance was studied using three glucose-containing products: solution, tablet and biscuit. Repeated saliva samples were collected every other minute, between 1 and 11 min after the intake, with a convenient method suitable for very young children. For that purpose, a small circular paper disc, absorbing approximately 20 microliters of saliva, was placed under the tongue for 10 s. The glucose concentration of the samples was then analyzed enzymatically. The results showed that, in children, the oral sugar clearance became faster with increasing age. The adults and the 15-year-olds had similar patterns of clearance, while the dry mouth patients had the slowest oral clearance of all groups. The 3- and 7-year-olds showed the greatest variation in oral clearance between the various foodstuffs; the solution had faster clearance than both the biscuit and the tablet. The main conclusion from this study is that young children (3- and 7-year-olds) have both slower salivary sugar clearance and larger variation in clearance among various foodstuffs than older children and adults.

Adolescent↗
PubMed1991

Factors associated with active and inactive root caries in patients with periodontal disease.

The aim of this study was to analyze a number of microbial, salivary, and dietary factors in patients with clinically active and inactive root caries. 147 patients, aged 30-78 years, referred for specialist treatment of periodontal disease, were randomly selected. 645 decayed and 539 filled root surfaces were found. Out of the carious lesions, 372 (58%) were recorded as clinically active and 273 (42%) as inactive. 30 patients showed no lesions (group 1), 46 had only fillings or inactive lesions (group 2), and 35 showed 1-2 (group 3) and 36 greater than or equal to 3 active lesions (group 4). The lactobacillus count differed significantly between all groups, except group 1 vs. 2, and the mutans streptococcus count between groups 1 vs. 4 and 2 vs. 3 and 4. Group 4 differed in plaque score from the other groups, and the salivary buffer effect differed between the inactive groups 1 and 2 and the active group 4. By stepwise multiple regression analysis, it was shown that lactobacillus count, plaque index, salivary buffer effect, dietary habit index, and number of exposed root surfaces contributed significantly to the coefficient of determination.

Adult↗
PubMed1991

Effect of dentifrices containing either xylitol and glycerol or sorbitol on mutans streptococci in saliva.

In 76 adults, randomly distributed between two groups, a comparison was made of the effect on the level of mutans streptococci in saliva between two dentifrices containing: (1) xylitol (9.9%) and glycerol (20%) or (2) sorbitol (28%) as humectants. After the use of the dentifrices twice daily for 3 months, the levels of mutans streptococci had not changed significantly in the sorbitol-treated group, whereas a significant reduction (p less than 0.0005) was found in subjects using the xylitol/glycerol dentifrice. The difference between the two dentifrice groups based on the changes observed during the 3-month period was also significant (p less than 0.02).

Adult↗
PubMed1991

Effect of a buffering sugar-free lozenge on intraoral pH and electrochemical action.

Two double-blind crossover studies were performed to test a sugar-free lozenge containing bicarbonate and phosphate buffers (Profylin). The studies were performed in groups of 20 and 13 individuals. In Study I active buffering or placebo lozenge (not buffered) was given, and the pH of plaque and saliva was measured after 2, 5, 10, 20, and 30 min. In study II the lozenges were given 10 min after a sucrose rinse, and both the pH and the potential and polarization of amalgam restorations that made contact in the oral cavity were measured. In study I both lozenges increased the pH of plaque and saliva, but the values after sucking on the active lozenge were significantly higher than after placebo. In study II a pH recovery of plaque and saliva after the sucrose rinse was recorded for both types of lozenge, but it was most pronounced for the active, buffering lozenge. A statistically significant difference was, however, found only 5 min after sucking on the lozenge. No influence on the current magnitude was observed. The results thus indicate that the buffering sugar-free lozenge raises the pH of plaque and saliva and accelerates the pH recovery after a sucrose rinse but seems to have no influence on the galvanic current magnitude of amalgam restorations in contact.

Buffers↗
PubMed1991

Secondary caries related to various marginal gaps around amalgam restorations in vitro.

Secondary caries lesions were produced in vitro by immersing human tooth-blocks with amalgam restorations every third day for 4 weeks in glucose- or sucrose-containing broth inoculated with a strain of Streptococcus mutans. The lesions at the cavity walls were related to various standardized micro-spaces (0, 30, 40, 60 and 80 microns) around the restorations. When a thick, sucrose induced layer of plaque covered the margin, dentine caries was found in all cases where a gap was present (30 microns or more). In the presence of a thin, glucose induced layer of plaque, dentine caries was detected only in the specimens with 60 and 80 microns gap-widths. Caries lesions were detected on the outer free enamel surfaces in all specimens. Lesions in the enamel of the cavity walls were observed with polarized light in 46% in the presence of sucrose- and in 21% in the presence of glucose-induced plaque.

Dental Amalgam↗