Biomedical subjects
M E Mallatt
Publications and source records attributed to M E Mallatt.
Acute fluoride ingestion: recognition and management.
Occasionally, the Oral Health Division of the Indiana State Department of Health receives inquiries regarding diagnosis and treatment of acute fluoride ingestion. Because a wide variety of fluoride preparations are available in the dental setting and over the counter, excessive ingestion of fluoride can occur if these products are not used properly. The following article is meant to be a quick and easy guide in the recognition and management of instances of acute fluoride ingestion.
Oral mucosal injury caused by denture cleanser tablets: a case report.
A case of chemical injury to the oral mucosa that resulted in obstructive sialadenitis of the submandibular glands is presented. The injury occurred when a patient chewed, swished, and expectorated an immersion-type denture-cleansing tablet attempting to clean a fixed bridge. The literature is reviewed for similar oral mucosal injury caused by improper use of denture-cleansing products. Suggestions for the prevention of such injuries are made.
The clinical effect of dentifrices containing stabilized stannous fluoride on plaque formation and gingivitis--a six-month study with ad libitum brushing.
The effects of stabilized 0.454% stannous fluoride dentifrices on supragingival plaque, gingival inflammation and gingival bleeding were studied in 549 adult male and female subjects who completed a six-month, double blind clinical study. Following an oral prophylaxis, subjects were randomly assigned to brush with one of the following dentifrices: 1) 0.454% SnF2 stabilized with 2.08% sodium gluconate, 2) 0.454% SnF2 stabilized with 4.16% sodium gluconate, 3) an experimental dentifrice, or 4) 0.243% NaF control dentifrice. Follow-up examinations were conducted at 3 and 6 months. Compared to the control dentifrice at 6 months, stannous fluoride dentifrices stabilized with 2.08% or 4.16% sodium gluconate significantly reduced gingivitis by 18.8% and 18.0%, respectively. There were no statistically significant differences between the two stabilized SnF2 groups with respect to their beneficial effects on gingival health. Gingival bleeding was also reduced, relative to the control dentifrice, for both stabilized SnF2 dentifrices. However, these differences were not statistically significant at p=0.05. The stabilized SnF2 dentifrices were not significantly different from the control dentifrice in their effects on supragingival plaque. No significant differences in adverse oral soft tissue effects were observed between the test and control groups. As expected, accumulation of extrinsic tooth stain increased in the stabilized SnF2 groups. However, the difficulty in removing accumulated dental stain was similar between the control and stabilized SnF2 dentifrices. Since use of SnF2 dentifrices has been reported to produce tooth stain, gingivitis examinations were done with and without custom-made tooth covers to evaluate the potential for examiner bias. Comparable gingivitis and gingival bleeding benefits were observed when the evaluations were conducted with or without the tooth covers. Results from this study support that 0.454% stabilized stannous fluoride dentifrices can provide an important adjunct to the prevention and control of gingivitis when used in combination with regular personal oral hygiene procedures and professional care.
The clinical effects of a mouthrinse containing 0.1% octenidine.
The purpose of this three-month clinical trial was to evaluate the effects of a 0.1% octenidine mouthrinse on plaque, gingivitis, extrinsic dental stain, and the oral soft tissues. A total of 451 adult volunteer subjects was initiated into the study and given baseline dental examinations. The subjects were stratified into two balanced groups according to gender, plaque, and gingivitis scores. The subjects then received a dental prophylaxis and were provided with dentifrice, toothbrushes, and either a mouthrinse containing 0.1% octenidine dihydrochloride as the active ingredient or a similar placebo mouthrinse. Subjects were instructed to rinse with their assigned product for 30 s twice each day. Examinations were repeated at six weeks (soft-tissue assessment, gingivitis) and three months (soft tissues, plaque, gingivitis, dental stain). The results showed that the group rinsing with 0.1% octenidine had significantly less plaque (39%), gingivitis (50%), and bleeding sites (60%) than the group using the control product, but had significantly higher stain formation and experienced longer prophylaxis times to remove the stain. The oral soft-tissue examinations revealed no differences in the groups in either the numbers or types of lesions noted.
The relative plaque removal effect of a prebrushing mouthrinse.
A total of 51 adult subjects participated in a three-period crossover trial to test plaque-removal effectiveness of a prebrushing mouthrinse. Subjects refrained from brushing to allow plaque to accumulate for 24 hours before the test. The accumulated plaque was graded using Turesky's method. The subjects then used one of three treatment regimens, were retested for accumulated plaque and regraded. The three treatments tested were a commercial prebrushing mouthrinse and no toothbrushing; a commercial prebrushing mouthrinse and brushing with a dentifrice for 30 seconds; a prebrushing water rinse and brushing with a dentifrice for 30 seconds. The analysis of the data found that both groups that brushed removed significantly more plaque than the group that did not brush. However, both the prebrushing rinse group and the water rinse group achieved the same amount of plaque removal through 30 seconds of toothbrushing with a dentifrice.
Clinical effect of a sanguinaria dentifrice on plaque and gingivitis in adults.
A clinical trial was conducted to evaluate the effects of a sanguinaria-zinc chloride dentifrice on the prevention of plaque formation and gingivitis. A total of 59 young adults, 18 to 30 years of age, either performed supervised brushing with a 0.075% sanguinaria-0.05% zinc chloride dentifrice, a 0.24% sodium fluoride dentifrice, or rinsed daily with a 0.05% NaF solution. Clinical evaluations for plaque and gingivitis were performed after 7, 14, and 21 days of the test regimen. After 21 days, all subjects resumed twice daily supervised brushing and flossing and post-test evaluations were conducted after two weeks. The results showed that after 7, 14, and 21 days both groups using dentifrices had significantly less plaque and gingivitis than the group using the rinse, and there were no significant differences between the two groups using either the sanguinaria-ZnCl2 or the NaF dentifrices.
The prevalence and incidence of dental calculus in adults.
The occurrence of dental calculus is widespread with various investigators having reported evidence of calculus accumulations in a vast segment of the population. The purpose of this paper is to provide information on both the prevalence and incidence of calculus formation among adults. To determine prevalence, a total of 1,426 adult males and females were graded in Indiana for the presence of calculus using the Volpe-Manhold (VM) Index on the lingual surfaces of the six mandibular teeth. A second panel of 980 subjects was recruited in Texas to determine the incidence of calculus over a six-month period. These latter participants were given a thorough dental prophylaxis, a sufficient supply of a sodium fluoride dentifrice and toothbrushes, and were instructed to use the dentrifrice as they normally do, at least once a day. Six months after the prophylaxis, 804 participants were available and were examined for calculus accumulation using the VM Index. Results from both clinical trials indicate that males have more calculus than females and calculus formation was directly related to age for both sexes. Data are presented regarding the frequency distribution of VM Index scores by sex and age.
A comparison of 3 clinical indices for measuring gingivitis.
A clinical study was conducted among 200 adult males and females to compare the intrusive gingival index (GI) for estimating gingivitis with the nonintrusive and only visually applied papillary-marginal-gingivitis index (PMGI). The GI examinations were performed by a senior examiner with long experience and a junior examiner, while the PMGI was graded by only a senior examiner with long experience. A 4th examiner was included for grading bleeding sites by gentle intrusion at the orifice of the gingival crevice. Following the baseline examination by all examiners, the subjects were randomly assigned to either a group that received an oral prophylaxis immediately or to a group that received an oral prophylaxis 6 weeks after the baseline. All subjects were regraded by all examiners 4 days after the 2nd group received a prophylaxis. This delayed prophylaxis design created a difference in the responses between treatment groups. Both the GI examiners and the PMGI examiner concluded there was significantly less gingivitis in the group receiving a prophylaxis second. There were also significantly fewer bleeding sites in the group receiving a prophylaxis second as determined by both GI examiners and the bleeding-sites examiner.
Effects of nicotine-containing chewing gum on oral soft and hard tissues: A clinical study.
A double-blind clinical trial was conducted to determine whether the use of a chewing gum containing 2.0 mg nicotine (as an adjunct to a stop-smoking program) had any effects upon oral health. A total of 193 adults who smoked cigarettes volunteered with informed consent, were given routine dental prophylaxes, and were examined for the presence of plaque, stained pellicle, gingivitis, calculus, and general oral pathosis. The subjects were then randomly assigned to use either a nicotine-containing or a placebo chewing gum. After 15 weeks the subjects were recalled and re-examined. Smoking cessation was determined through questionnaire and analysis of the carbon monoxide content of alveolar air. At the completion of the study, 79 subjects had used the placebo gum and 78 had used the nicotine gum. Data analysis indicated that the nicotine chewing gum had no significant influence on any of the oral health parameters graded, as compared to the placebo gum. The continuation of smoking, however, was associated with significant increases in gingivitis and calculus rates.
A three-year study of the effect of a sodium fluoride-silica abrasive dentifrice on dental caries.
The purpose of this study was to determine if a 0.243% sodium fluoride-silica abrasive dentifrice provides greater anticaries efficacy than a 0.4% stannous fluoride-calcium pyrophosphate abrasive dentifrice. A sample of 1,824 schoolchildren was randomly assigned to either the sodium fluoride dentifrice or the stannous fluoride dentifrice and examined clinically and radiographically for dental caries initially and after one, two, and three years of dentifrice usage. Two examiners independently examined each of the subjects for dental caries. After three years of ad libitum dentifrice usage, the results for both examiners showed that the group brushing with the sodium fluoride dentifrice had significantly lower DMF tooth and DMF surface increments than the group brushing with the stannous fluoride dentifrice. The percent reductions for DMF teeth were 14.8% and 10.5%, and for DMF surfaces 16.4% and 13.1% for the two examiners, respectively.
Dental assistants, radiology, and the Indiana Law.
This article reviews the rules, regulations, and procedures which enable dental assistants to become radiology certified in Indiana. Dental assistants must participate in an American Dental Association (ADA)-accredited program or an Indiana State Department of Health (ISDH, formerly the Indiana State Board of Health)-approved on-the-job training program to qualify for the radiology certification examination.
Is a prophylaxis really necessary prior to topical fluoride therapy?
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A clinical evaluation of the relative cariostatic effect of dentifrices containing sodium fluoride or sodium monofluorophosphate.
A three-year clinical trial was conducted to determine whether a sodium fluoride (NaF) dentifrice had greater cariostatic effects than a sodium monofluorophosphate (Na2PO3F) dentifrice. Both dentifrices contained 1100 ppm fluoride and silica abrasive systems. A panel of 3,290 children, age 6-16, received one of the two dentifrices for ad libitum home use. The subjects were examined for caries at the baseline and after 2 and 3 years. Results were analyzed both for all children and for those children age 11 years or older at the baseline. The older children were found to have about 50 percent higher new caries increments than did the entire panel of children. In the older, caries- prone children, the subjects using the NaF product experienced significantly (15 percent and 12 percent) fewer new lesions than did the subjects using the Na2PO3F product after 2 and 3 years respectively. In the panel of all children, subjects using the NaF product had numerically, but not significantly, fewer new lesions. The results for this study, showing significantly greater cariostatic benefits in caries-prone children for a sodium fluoride dentifrice with a highly compatible system, are consistent with findings of other investigators.
Considerations in diagnosing caries.
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Preventive strategies for the older dental patient.
The purpose of this article is to review preventive strategies with regards to caries, periodontal disease, xerostomia, and oral cancer which may be helpful in treating the older patient. Dramatic demographic changes projected for the older population will have a direct impact on the type and quantity of dental services delivered in the future. It will be advantageous for tomorrow's oral health professional to recognize these changes and to adapt preventive and treatment regimens accordingly.