Toothbrushing and smoking behaviour in 14-year-old English schoolchildren.
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Biomedical subjects
Publications and source records attributed to I D Macgregor.
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Video recordings were obtained of 90 adults aged 18-22 yr brushing their teeth. Thirty subjects were unaware they were being filmed and 60 subjects had been informed that they would be filmed while they brushed their teeth. From repeated viewing of the tapes the areas of the mouth that were brushed, the total brushing time and the proportion of time spent brushing each of 16 areas of the mouth were obtained for each subject. Subjects who knew they were being filmed brushed significantly more mandibular occlusal surfaces, and lingual areas in both arches than subjects who were unaware they were being filmed. There was no significant difference in the mean toothbrushing time between the two groups. The informed group spent proportionally less time brushing posterior buccal areas and more time on occlusal and lingual areas than the group who were unaware they were being filmed, the difference being statistically significant for the mandibular arch areas. It was concluded that knowledge of filming alters toothbrushing behaviour to a small extent so that care should be taken when interpreting behavioural changes in future intervention studies.
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In 2 separate studies, plaque was harvested (i) from 15 smokers and 15 non-smokers after a 48-h period without oral hygiene, and (ii) from 15 smokers and 12 non-smokers after a 48 h hygiene-free period following complete plaque removal by toothbrushing. No significant association emerged between wet weight of accumulated plaque and cigarette smoking, in either study. In the second study, the mean plaque calcium concentration was raised in smokers compared with non-smokers, and significantly raised in 7 heavy smokers relative to non-smokers. In both instances, calcium concentration was significantly raised relative to (total) phosphorus concentration, which may indicate that the additional calcium was not in mineral deposits. These results may reflect an association between calcium concentration of plaque and tobacco consumption.
60 uninstructed adults aged 18-22 yr (agricultural students) brushed their teeth and were recorded on video tape. From repeated viewing of the tapes, the total brushing time and the numbers of strokes used in each of 16 areas of the mouth were obtained for each subject. The mean (+/- SD) brushing time was 33.0 s (+/- 12.0); the mean number of strokes employed by each subject was 302 (+/- 122). More strokes were used to brush the mandibular than the maxillary arch, labial and buccal than occlusal areas, and occlusal than lingual areas. The results are compared with those from a similar study in uninstructed schoolchildren, reported previously.
Video recordings were obtained of 50 men aged 18-20 yr (25 smokers, 25 non-smokers) brushing their teeth. From repeated viewing of the films the total brushing time and the number of strokes used in each of 16 areas of the mouth were obtained for each subject. Comparisons between smokers and non-smokers of time spent brushing, and number of brushing strokes used overall and in each area of the mouth, showed no significant differences. However, the distribution of brushing strokes around the mouth was more uniform in the non-smokers than in the smokers, which may indicate a tendency towards less favourable toothbrushing performance in smokers.
Periapical radiographs were taken of central incisor and first molar teeth in 264 Nigerian boys (12-20 years) from a school in Lagos. From the radiographs, bone loss involving central incisors and first molars was measured. Bone loss was evident in 28.4% of subjects examined. The prevalence of bone loss rose through the age groups from 23.2% at 12-13 years to 34.6% at 18-20 years. Over all ages the prevalence of bone loss involving mandibular central incisors was 14.4%, mandibular first molars 9.8%, maxillary first molars 8.3% and maxillary central incisors 7.6%. Two subjects showed features characteristic of juvenile periodontitis (periodontosis).
85 uninstructed children aged 11-13 years brushed their teeth and were unaware that they were recorded on video tape. By viewing the films, the time spent brushing in each of 16 areas of the dentition and the number of strokes used in each area were obtained. The mean overall brushing time was 60.3 s (+/- 23.8); the mean number of strokes used by each subject was 397 (+/- 224). More time was spent and more strokes employed brushing mandibular than maxillary arches, labial and buccal than occlusal areas, and occlusal than lingual areas. The percentages of time spent and number of strokes used brushing lingual areas were low.
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Unusual patterns of alveolar bone loss in 33 Nigerian Yorubas with severe periodontal disease are described. The subjects, aged 15-50 yr represented 1.4% of a population of dental patients in Western Nigeria. Periodontal pocketing and alveolar bone loss in the incisor and first molar regions, far in advance of other mouth areas, were the criteria for inclusion in this report. Intra-oral radiographs showed advanced horizontal or crescentic bone resorption in incisor regions, and vertical or arc-like bone defects around first molars. Incisors and first molars were frequently missing as a result of periodontal disease. Surveys of tooth mortality and periodontal pocketing in Western Nigeria, and immunological findings elsewhere, suggest these cases represent a severe form of plaque-induced inflammatory periodontal disease. The role of protein-calorie malnutrition as an aetiological factor is discussed.
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Data from a survey of 3727 14-year-old children from 31 secondary schools in England in 1984-85 were analysed to obtain information about bedtimes and sleep duration in relation to the number of children in the family. Subjects completed a questionnaire, anonymously, in class. The modal bedtime was 22 30 and the modal time spent in bed was 9 h. Males went to bed later than females (P less than 0.05) but there was no significant difference between the sexes in the time they spent in bed. As the number of siblings increased bedtimes became later (P less than 0.05) and the time spent in bed markedly decreased (P less than 0.001). These results suggest that young adolescents from large families (4 or more children) may be more at risk from inadequate sleep than those in smaller families.
The smoking habit is associated with a variety of deleterious changes in the mouth. In this review, the toxicology of tobacco smoke and its effects on the saliva, oral commensal bacteria and fungi, and oral polymorphonuclear leukocytes, are described. Smoking increases salivary flow rate, but does not alter the composition of plaque or its rate of deposition. Smoking appears to enhance anaerobiosis in the oral cavity, and depress the activity of oral leukocytes. Additionally, tobacco smoke components may have a selective toxic effect on particular species of microbiota. Gingival fluid exudate is reduced in smokers, with the consequence that the carriage of leukocytes and immunoglobulins is likely to be diminished.
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