Special care dentistry.
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Dental Care for Persons with Disabilities↗
Biomedical subjects
L Zoitopoulos
Publications and source records attributed to L Zoitopoulos.
Genotypic heterogeneity of Streptococcus oralis and distinct aciduric subpopulations in human dental plaque.
The genotypic heterogeneity of Streptococcus oralis isolated from the oral cavity was investigated using repetitive extragenic palindromic PCR. Unrelated subjects harbored unique genotypes, with numerous genotypes being isolated from an individual. S. oralis is the predominant aciduric bacterium isolated from noncarious tooth sites. Genotypic comparison of the aciduric populations isolated at pH 5.2 with those isolated from mitis-salivarius agar (MSA) (pH 7.0) indicated that the aciduric populations were genotypically distinct in the majority of subjects (chi(2) = 13.09; P = 0.0031). Neither the aciduric nor the MSA-isolated strains were stable, with no strains isolated at baseline being isolated 4 or 12 weeks later in the majority of subjects. The basis of this instability is unknown but is similar to that reported for Streptococcus mitis. Examination of S. oralis strains isolated from cohabiting couples demonstrated that in three of five couples, genotypically identical strains were isolated from both partners and this was confirmed by using Salmonella enteritidis repetitive element PCR and enterobacterial PCR typing. These data provide further evidence of the physiological and genotypic heterogeneity of non-mutans streptococci. The demonstration of distinct aciduric populations of S. oralis implies that the role of these and other non-mutans streptococci in the caries process requires reevaluation.
Dental Plaque↗
Special care dentistry: moving towards a specialty. A view from the executive of the BASCD Section in Clinical Community Dentistry. British Association for the Study of Community Dentistry.
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Community Dentistry↗
An effective strategy for the transfer of children from the CDS to the GDS.
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Child↗
Dental attendance patterns and oral hygiene habits of 5-year-old children in Athens and in south London.
This study compared the dental attendance patterns and oral hygiene habits of 5-year-old children in the London boroughs of Lambeth, Lewisham and Southwark with those in the municipality of Athens in the light of differing provision of oral health education. Questionnaires were sent to the parents of 384 children in London and 318 children in Athens who took part in a survey of dental health. Response rates of 51% and 53% respectively were obtained. More children visit the dentist in South London than in Athens, the difference being highly significant. In South London the majority of children visit every 6 months, whereas in Athens they only visit when they have toothache. More London children brush their teeth than Athens children, the difference being significant. Of those brushing in London, most brush twice daily. The above findings indicate marked differences in dental attendance patterns and oral hygiene habits, and this may be partly attributable to differences in the delivery of dental care and oral health education in the two countries.
Chi-Square Distribution↗
Dental caries and caries-associated micro-organisms in the saliva and plaque of 3- and 4-year-old Afro-Caribbean and Caucasian children in south London.
Three and four-year-old Caucasian and Afro-Caribbean children (n = 641) attending childcare facilities in the London boroughs of Lambeth, Lewisham and Southwark were studied in order to determine the prevalence of caries and caries-associated micro-organisms and the interactions between these for each of the racial groups; dmft (decayed, missing or filled teeth) scores were recorded using British Association for the Study of Community Dentistry criteria. Saliva and plaque samples were taken from each child and the numbers of mutans streptococci, lactobacilli and yeasts per sample were determined. The mean dmft scores of the 3- and 4-year-old Afro-Caribbean children were 0.36 +/- 0.10 and 0.51 +/- 0.13, respectively, compared to 0.80 +/- 0.17 and 1.48 +/- 0.24 for the equivalent Caucasian children (p < 0.001). Mutans streptococci and lactobacilli were recovered less frequently from the Afro-Caribbean children than from the Caucasian, but in both groups there were significant correlations between the plaque and salivary levels of mutants streptococci and caries experience. In both groups, children from whom both mutans streptococci and lactobacilli were isolated had the greatest mean dmft scores and these were not significantly different. Multiple regression analyses demonstrated that, after controlling for age and dmft, there were still significant associations between race and salivary levels of mutans streptococci and lactobacilli, p = 0.0013 and p = 0.0167, respectively. These data indicate that Afro-Caribbean children had lower levels of dental caries than Caucasian children living in the same London boroughs and attending the same preschool care facilities and, after controlling for age and caries experience, they also had lower salivary levels of mutans streptococci and lactobacilli.
Africa↗
Caries prevalence of 5-year-old children in Athens and in South London.
This study compared the dental health of 5-year-old children in the London boroughs of Lambeth, Lewisham and Southwark with that in the municipality of Athens, Greece. Three hundred and eighty-four children were examined in London, and 318 in Athens; both samples had a mean age of 5 years 6 months. The proportion of London children who were caries free was 56%, and of Athens children 57.5%, and the mean dmft was 1.63 and 1.48, respectively; these differences were not statistically significant. However, excluding caries-free children from the analysis, the London children had significantly fewer decayed teeth (mean 2.35 compared with 2.93 in Athens) and significantly more missing teeth (mean 0.63 compared with 0.02), indicating marked differences in treatment patterns.
Child, Preschool↗
Community dental service based out of hours emergency dental care--a pilot study.
Twenty-nine out-of-hours calls were received during the 6-week period. Advice was offered to 27 patients and two call-outs were made for treatment of acute abscesses in children. Eight patients claimed to be under treatment with the CDS, 17 claimed to be registered with a general dental practitioner, while four claimed not to be registered. A demand for an emergency service was demonstrated, as was the need to define accurately the categories of patients eligible for emergency treatment within the CDS. The pilot study also highlighted the requirement to fund this service adequately.
Community Health Services↗
Referral of child patients from the Community Dental Service to the General Dental Service: one year's experience.
The Community Dental Service has been encouraged to refer regular attending patients to General Dental Practice whilst maintaining a monitoring system to ensure that referred patients do not 'fall through the net'. The referral and monitoring system run by Halton Health Authority for one year is described. During this period 112 motivated patients were identified as being suitable for referral to general practice. Of these, 85 agreed to referral and 27 refused. Of those referred, 69 subsequently attended but 16 failed to attend and 14 of these did not respond to a further recall by the CDS. Far from acting as a safety net service the CDS may, in pursuing this referral policy, be actually increasing the number of irregular attenders in some localities and for this reason Halton is reviewing the speed with which the referral policy is being implemented.
Adolescent↗
Simple methods for denture identification: a clinical trial.
The persistence of identification marks applied to dentures with two spirit solvent based fibre tip pens and graphite pencil covered with an experimental and a proprietary sealant were studied under service conditions. In general, the marks applied with the pens were rapidly lost, but those covered with the sealants persisted satisfactorily. The experimental sealant performed slightly better than the proprietary product.
Aged↗
Comparison between visual examination and a laser fluorescence system for in vivo diagnosis of occlusal caries.
This study compared a laser fluorescence (LF) system (DIAGNOdent) with a visual caries scoring system for in vivo detection and diagnosis of occlusal caries under the conditions of an epidemiological study, in 132 mandibular and 38 maxillary first permanent molars in 170 children (mean age: 6.85 +/- 0.58 years). The teeth were cleaned and occlusal caries status in a selected investigation site recorded using both visual and LF systems. The LF readings were interpreted both according to the cut-off points recommended by the manufacturers and those based on laboratory research with histological validation. The percentage agreement of the LF and visual scoring system was better using the cut-off limits recommended by the manufacturer. Histological validation was not possible in this clinical study, but it appeared that either the LF method was overscoring some lesions or the visual method was underscoring them. Since the LF instrument cannot be expected to differentiate caries from hypomineralisation, it should probably be used as an adjunct to a clinical examination.
Child↗
The microflora of the erupting first permanent molar.
The relationship between microflora, eruption status and caries status in the first permanent molar of young children was investigated in 177 children aged 6-7 years. A significantly greater proportion of fully erupted teeth were classified as sound and plaque-free compared to partially erupted teeth. Fully erupted teeth yielded greater numbers and proportions of mutans streptococci compared with significantly greater numbers and proportions of Actinomyces israelii in partially erupted teeth. Logistical regression analysis showed significant associations between white spot lesions in partially erupted teeth and increased numbers of Streptococcus oralis, mutans streptococci and Streptococcus salivarius whereas the presence of Actinomyces naeslundii was associated with health. Significantly greater numbers and proportions of S. oralis and S. salivarius were isolated from partially erupted teeth with white spot lesions whereas Streptococcus mutans was isolated in significantly greater numbers and proportions from fully erupted molars with white spots. This study suggests that organisms other than mutans streptococci are associated with caries development in erupting permanent molar teeth.
Actinomyces↗