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Biomedical subjects

E Newbrun

Publications and source records attributed to E Newbrun.

At least 19 recordsLinked to original sources
PubMed1992

Current regulations and recommendations concerning water fluoridation, fluoride supplements, and topical fluoride agents.

In recent years, an increase in the prevalence of dental fluorosis, mostly of the very mild to mild category, has been seen in the United States. This paper therefore discusses the safety of dental fluoride products, primarily with respect to the risk of dental fluorosis due to chronic ingestion of these products by pre-school children. No change is indicated in the optimal fluoride level (0.7 to 1.2 ppm) for water fluoridation. A reduction in the dosage of fluoride supplements is recommended for children aged from three to six years (14.5 to 22 kg body weight) residing in communities with less than 0.7 ppm F. Physicians, pharmacists, and dentists need to be better educated in correctly prescribing fluoride supplements; such prescriptions should be based on the fluoride concentration of the domestic water supply and the child's weight/height/age. No change is recommended in the concentration of fluoride used in dentifrices and mouthrinses. The US Food and Drug Administration should require more explicit labeling of fluoride products with regard to avoidance of ingestion, use of small amounts, and need for supervised use by pre-school children. The efficacy of water fluoridation, fluoride supplements, and topical fluoride agents has been amply documented elsewhere.

Child↗
PubMed1992

Preventing dental caries: breaking the chain of transmission.

Besides using all possible techniques to increase host resistance (fluoride, sealants) and decrease exposure to fermentable carbohydrates (for example, use of sugar substitutes), dentists must treat caries as infectious and transmissible. Antimicrobial agents are recommended.

Child, Preschool↗
PubMed1992

Dental caries in the future: a global view.

Although the prevalence of caries has decreased markedly in children, adolescents, and young adults in most industrialized countries, caries continues to be the main reason for tooth loss, particularly among the high risk segment of the population. In many developing countries, where traditional dietary patterns have changed to include sugar-containing foods and beverages, caries prevalence has increased and will continue to do so in the immediate future. Accordingly, it would be a serious mistake to be complacent about caries prevention. In future industrialized countries will see computers playing a significant role in cariology, finding applications not only in research and practice administration but directly in clinical practice as well. They will be used in every operatory in the assessment of caries risk, the recording of caries prevalence, the direct storing of radiographic information, and the restoration of carious teeth, assisted by computer-aided design and computer-aided manufacture (CAD/CAM) technology. Fluoride therapy, both systemic and topical, will continue to be the basis of caries prevention. Dental sealants, which are highly effective in protecting pits and fissures when applied soon after the teeth erupt, will be more widely used in the future when insurance plans will pay for prevention. Substitution of sucrose and syrups by non-fermentable sweetening agents can also reduce caries increments, but most agents are more expensive than sucrose and require consumer education to pay for the additional cost. Caries, as an infectious and transmissible disease, is amenable to prevention by interfering with the chain of transmission or by suppressing the putative pathogens, the mutans streptococci, in infected patients.(ABSTRACT TRUNCATED AT 250 WORDS)

Analysis of Variance↗
PubMed1991

Electroencephalographic changes and periodontal status during short-term vitamin B-6 depletion of young, nonpregnant women.

As part of a larger investigation to determine the effect of animal vs. plant proteins on the vitamin B-6 requirement of young women, clinical changes during vitamin B-6 depletion were documented. Eight healthy young women were confined to a metabolic unit and fed a defined formula diet nearly devoid of vitamin B-6 (less than 0.05 mg/d). Serial electroencephalographic (EEG) tracings, peripheral nervous system tests, periodontal evaluations, and biochemical measures of vitamin B-6 status were conducted. Within 12 d on the depletion diet, two of the eight women exhibited abnormal EEG tracings. These changes were readily reversed by repletion of vitamin B-6 at the 0.5-mg/d level. Biochemical measures reflected lowered vitamin B-6 status but were not predictive of the onset of EEG changes. No detectable alterations in oral or periodontal status were found, nor did plaque flora change markedly. This study is the first report of EEG changes occurring in women undergoing vitamin B-6 depletion and the first report to document EEG changes in adults within 12 d on a vitamin B-6-depletion regimen.

Adult↗
PubMed1989

Frequent sugar intake--then and now: interpretation of the main results.

The Vipeholm Study is a unique diet-caries interventional study that has earned its place as a citation classic. One of the findings, that quantity of sugar consumed at meals in a non-sticky form had little influence on caries rate, has often been misinterpreted, as it is based on an institutional population under supervised dietary control. The other main finding, that sugary foods consumed in a sticky form at high frequency between meals are highly cariogenic, is generally accepted. Although the Vipeholm Study has been criticized on ethical grounds, relatively fewer teeth were extracted for caries than are currently extracted in an adult population. The results of two modern studies in Northumberland, UK, and Michigan, USA, on the relationship between dietary habits and caries increments in children have been compared with the Vipeholm findings. Currently the correlations between dietary habits and caries increments are low because of the low caries increments and relatively small differences in dietary patterns in non-interventional conditions. High frequency of snacking is uncommon and use of topical fluoride agents (dentifrices, rinses) is widespread. However, for the caries-susceptible person, between-meal consumption of sugary foods is still a risk factor.

Adolescent↗
PubMed1989

Effectiveness of water fluoridation.

The efficacy of communal water fluoridation in reducing dental caries has been reviewed based on surveys conducted in the last decade of caries prevalence in fluoridated and nonfluoridated communities in the United States as well as in Australia, Britain, Canada, Ireland, and New Zealand. The efficacy is greatest for the deciduous dentition, with a range of 30-60 percent less caries in fluoridated communities. In the mixed dentition (ages 8 to 12), the efficacy is more variable, about 20-40 percent less caries. In adolescents (ages 14-17), it is about 15-35 percent less caries. Current data on caries prevalence in adults and seniors are extremely limited and include several populations living in communities with higher than optimal fluoride levels. For these adults and seniors, a range of 15-35 percent less caries would also apply. Viewed in toto, the current data for children, adolescents, adults and seniors show a consistently and substantially lower caries prevalence in fluoridated communities. For an accurate measurement of the efficacy of water fluoridation in reducing dental caries, it is essential that only persons with a record of continuous or long-term residency in fluoridated versus nonfluoridated areas be included in such assessments. Because of the high geographic mobility in our society and the widespread use of fluoride dentifrices, supplements, and other topical fluoride agents, such comparisons are becoming more difficult to conduct. Accordingly, the effectiveness (rather than the efficacy) of water fluoridation has decreased as the benefits of other forms of fluoride have spread to communities lacking optimal water fluoridation.

DMF Index↗
PubMed1988

The effect of previous diet on plaque pH response to different foods.

In this study we investigated the effect of previous diet on the response of plaque pH to three test foods. The study population consisted of 11 dental students. Plaque pH was measured, by means of the touch electrode method, on the first two upper molars. The study was conducted at two sessions, one week apart. Subjects followed a 48-hour high-sugar diet before the first test session and a 48-hour low-sugar diet before the second test session. During both 48-hour periods, students refrained from all oral hygiene practices and fluoride utilization. At each session, three foods were ingested at one-hour intervals: cola, beer, and chocolate bar. pH measurements at baseline and at selected times after food ingestion were recorded and analyzed. Multivariate analysis of variance revealed significant independent effects of food, previous diet, and their interaction on plaque pH. After the same foods were ingested, plaque pH response after a previous high-sugar diet was significantly more acidic than after a previous low-sugar diet.

Adult↗
PubMed1987

Topical fluoride therapy: discussion of some aspects of toxicology, safety, and efficacy.

Although ingestion of an acute toxic dose of fluoride is extremely rare in dental treatments, practitioners should be familiar with the signs and symptoms and with emergency measures of treating accidental overdosage. The amount of fluoride ingested chronically from the use of self-applied topical fluoride can be reduced to safe limits by instructing parents to dispense small amounts of toothpaste for their young children and to ensure that fluoride dentifrices and mouthrinses are fully expectorated. Similarly, when custom-fitted trays are used, only minimal amounts of fluoride gels are necessary. The minimal amount of such gels that can be dispensed appears to be influenced by their viscosity. Clinical efficacy does not support a reduction in the concentration of fluoride in commercial dentifrices.

Diet↗
PubMed1986

Clinical and microbiologic effects of single-dose metronidazole or scaling and root planing in treatment of adult periodontitis.

Sites affected with adult periodontitis were observed for 3 months to compare their clinical and microbiologic responses to a single 2 g dose of metronidazole, scaling and root planing, or no treatment. 2 sites with probing depths greater than or equal to 5 mm in each of 18 female subjects (6 in each treatment group) were evaluated clinically (plaque and bleeding indices, probing depth, attachment loss) and microbiologically (%s of cocci, motile rods, non-motile rods and spirochetes, and of obligate anaerobic colony-forming units, black-pigmented Bacteroides, Fusobacterium and Actinobacillus actinomycetemcomitans in subgingival plaque). No significant differences in these variables existed between the 3 groups at baseline. The no-treatment (control) group showed no substantial clinical or microbiologic changes during the study. After 1 month, scaling and root planing had effected significant clinical improvement and significant shifts in the subgingival flora to a pattern more consistent with periodontal health; these changes were still evident at 3 months. In contrast, 1 month after metronidazole, there was some clinical improvement and a significant increase in cocci and a decrease in motile rods, but at 3 months these changes were no longer evident. The results show that the benefits of scaling and root planing are sustained for at least 3 months. However, the benefits of a single 2 g dose of metronidazole are both few and transient, indicating that this regimen, while effective against anaerobic infections in other organ systems, is not clinically or microbiologically effective in the treatment of adult periodontitis.

Adult↗