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Biomedical subjects

S Twetman

Publications and source records attributed to S Twetman.

At least 19 recordsLinked to original sources
PubMed2006

Inhibition of enamel lesion formation by fluoridated milk assessed by laser fluorescence--an in vitro study.

The aim of this study was to investigate the effect of fluoridated milk on enamel lesion formation as assessed by laser fluorescence (LF). The material consisted of 18 extracted premolar teeth that were cut in mesial-distal direction and pairwise assigned to either test or control samples in an experimental caries model. The teeth were exposed to a low-pH 5% cellulose gel for 4 h, 5 days per week immediately followed by a 4-h period in either fluoridated (5 ppm, test) or nonfluoridated milk (control). In the meantime, the specimens were stored in pooled human-stimulated whole saliva in room temperature. All teeth were examined by visual inspection with a magnifying glass and by LF readings (DIAGNOdent) at baseline and after 2 and 4 weeks. The baseline LF readings ranged from 3 to 7 with a mean value of 5.6+/-0.9. The mean values increased with time in both groups but the increase was more marked in the control teeth, 8.7+/-2.3 vs 12.8+/-3.3 after 4 weeks, this difference being statistically significant (p<0.01). The visual examination could not distinguish between the test or control samples after 2 and 4 weeks, respectively. The findings indicated that fluoride added to milk may to some extent counteract enamel lesion formation as assessed by LF in an experimental caries model.

Animals↗
PubMed2006

Influence of a low xylitol-dose on mutans streptococci colonisation and caries development in preschool children.

AIM: To evaluate the effect of xylitol-containing tablets on mutans streptococci colonisation and caries development in preschool children. STUDY DESIGN: Randomised single-blind prospective design. METHODS: The material consisted of 132 healthy 2-year-old children, 71 boys and 61 girls and they were assigned to a xylitol tablet (test) group or a non-intervention control group. The mean age was 2 years + 1 month in both groups. The drop-out rate was 10.6% during the 2-year trial. The test group was given 1-2 xylitol tablets (0.5-1g) per day during 1.5 years. Mutans streptococci (MS) enumeration was performed at baseline and semi-annually in the children and at baseline or shortly after in the mothers with a chair-side technique. Caries prevalence was scored at baseline and the age of 4 years. RESULTS: No statistically significant differences in MS colonisation were disclosed between the test and control groups at baseline or any of the designated follow-ups. A statistically significant positive relationship was found between the maternal salivary MS levels and the colonisation of the children in the control group at 2.5 years, 3 years and 3.5 years (r=0.39, r=0.35; r=0.30; p<0.01, p<0.01 and p<0.05) but not in the xylitol tablet group (p<0.05). The mean caries prevalence was lower in the test group compared with the control group at 4 years of age (dmfs 0.38 +/-1.05 vs. 0.80 +/-2.60) but the difference was not statistically significant. CONCLUSION: The findings do not support a low-dose xylitol tablet program for caries prevention in preschool children.

Cariostatic Agents↗
PubMed2006

Caries in 4-year-old children after maternal chewing of gums containing combinations of xylitol, sorbitol, chlorhexidine and fluoride.

AIM: To evaluate the effect of maternal use of chewing gums containing combinations of xylitol, sorbitol, chlorhexidine and fluoride on caries prevalence in a group of mother's 4-year-old children. STUDY DESIGN: Randomised controlled trial. METHODS: After screening 416 women with newborn babies, 173 mothers with high counts of salivary mutans streptococci (MS) were randomly assigned into three experimental chewing gum groups containing A) xylitol (n=61), B) chlorhexidine/xylitol/sorbitol (n=55), and C) sodium fluoride/xylitol/sorbitol (n=57). The intervention started when each child was 6 months old, was terminated one year later. All of the mothers were instructed to chew one piece of the appropriate gum for 5 minutes, three times a day. The outcome measure was the presence of cavitated and non-cavitated (enamel) lesions in the primary dentitions of the children at the age of 4 years. RESULTS: The drop-out rate in the experimental groups was 15-20%. The mean defs, on examination at aged 4 years was 0.4 +/-1.0 in group A, 0.7 +/-1.7 in group B and 1.4 +/-3.0 in group C. The difference between group A and C was statistically significant (p<0.05). CONCLUSIONS: Less caries was observed in children of mothers who chewed gums with xylitol as the single sweetener during the time of eruption of the first primary teeth compared with those who used gums containing fluoride, sorbitol and lower amounts of xylitol.

Adolescent↗
PubMed2006

Fluoride concentration in saliva after consumption of a dinner meal prepared with fluoridated salt.

The aim was to determine the fluoride concentration in saliva after intake of a dinner meal prepared with fluoridated salt. The investigation had a randomized cross-over design, and 10 healthy adolescents with natural fluoride content (1.06 ppm) in their drinking water participated after informed consent. After a run-in week, the subjects were served a standardized dinner of spaghetti with minced meat sauce prepared with either fluoridated salt (test arm) or non-fluoridated salt (control arm). The fluoride concentration of the test salt was 250 ppm. Samples of stimulated whole saliva was collected at baseline, directly after eating (0 min) and then after 10, 30 and 180 min. After a 1-week wash-out period, the experimental procedure was repeated with the opposite salt. Fluoride concentration in saliva was measured with a fluoride-specific electrode and the post-ingestion levels were compared with baseline using repeated-measures ANOVA. The mean baseline concentrations were 10.9 and 8.0 microg/l in the test and control arms, respectively. Immediately after the intake, the mean fluoride values increased significantly to 81.6 microg/l in the test arm and to 31.5 microg/l in the control arm (p<0.05). The fluoride levels remained elevated (p<0.05) for 30 min after ingestion of the test meal but not following the control meal. In conclusion, consumption of a dinner meal prepared with fluoridated salt increased the salivary fluoride levels for about 30 min.

Adolescent↗
PubMed2006

Xylitol concentration in saliva and dental plaque after use of various xylitol-containing products.

The study consisted of two sets of experiments, one in saliva and one in dental plaque. The xylitol concentration in saliva was determined enzymatically in 12 children (mean age 11.5 years) after a standardised use of various xylitol products: (A) chewing gums (1.3 g xylitol), (B) sucking tablets (0.8 g xylitol), (C) candy tablets (1.1 g xylitol), (D) toothpaste (0.1 g xylitol), (E) rinse (1.0 g xylitol), and (F) a non-xylitol paraffin. Unstimulated saliva was sampled 1, 3, 8, 16 and 30 min after use. The concentration in dental plaque was determined after mouthrinses with contrasting amounts of xylitol (LX = 2.0 g, HX = 6.0 g, and control) and supragingival plaque was collected and pooled after 5, 15 and 30 min. The mean xylitol concentration in saliva at baseline was approximately 0.1 mg/ml. All xylitol-containing products resulted in significantly increased levels (p < 0.05) immediately after intake and remained elevated for 8-16 min in the different groups. The highest mean value in saliva was obtained immediately after use of chewing gums (33.7 +/- 16.4 mg/ml) and the lowest was demonstrated after using toothpaste (8.2 +/- 4.9 mg/ml). No significant differences were demonstrated between chewing gums (A), sucking tablets (B), candy (C) and rinses (E). In dental plaque, the mean values were 8.6 +/- 5.4 and 5.1 +/- 4.0 mg/ml 5 min after HX and LX rinses. Concerning the higher concentration, the values remained significantly elevated (p < 0.05) during the entire 30-min follow-up. In conclusion, commonly advocated xylitol-containing products gave elevated concentrations of xylitol in unstimulated whole saliva and dental plaque for at least 8 min after intake.

Analysis of Variance↗
PubMed2005

Eating habits, smoking and toothbrushing in relation to dental caries: a 3-year study in Swedish female teenagers.

OBJECTIVES: The aims of the present study were to describe eating, toothbrushing and smoking habits in a cohort of Swedish female adolescents, and to relate the findings to dental caries increment. DESIGN: The research took the form of a longitudinal study. SUBJECTS AND METHODS: The study sample consisted of a cohort of 162 girls under regular dental care, aged 12 years at baseline, who were followed for 3 years, from the sixth to the ninth grade. Eating, oral cleaning and smoking habits were self-reported three times per year through a questionnaire, and caries data at baseline and after 3 years were collected from dental records. RESULTS: The results showed significantly (P < 0.05) impaired eating habits during the study period and that adherence to regular main meals diminished. In the eighth grade, one-third of the girls skipped breakfast before school and only 50% had their free school lunch daily. The omission of breakfast and irregular main meals, as well as smoking were significantly associated with caries (decayed, missed and filled surfaces) increment in the eighth grade (odds ratio = 4.1-4.9, P < 0.05). Snacks, light meals, soft drinks and sweets were already frequently consumed at baseline and continued to be so over the years. Although > 95% of subjects reported that they brushed their teeth at least once a day, approximately 20% did not do it every evening, and this figure remained stable over the study period. However, snacks, soft drinks and sweets, and toothbrushing habits had no significant influence on caries development. CONCLUSION: Dietary advice for caries prevention in adolescent girls should focus on the importance of retaining regular main meals, and especially, not skipping breakfast.

Adolescent↗
PubMed2005

Caries risk assessment as a predictor of metabolic control in young Type 1 diabetics.

AIMS: To investigate the relationship between caries risk and glucosylated haemoglobin and to evaluate the use of a computerized caries risk assessment program as a predictor of metabolic control in schoolchildren with Type 1 diabetes mellitus. METHODS: The material consisted of 64 young Type 1 diabetes mellitus patients (8-16 years) attending an outpatient paediatric clinic. Within 2 weeks after the onset of diabetes, a caries risk assessment was carried out with the aid of a computer-based program (Cariogram) and data on the level of metabolic control were collected from the medical records at the 3-year check-up. Caries increment was registered at recall clinical examinations. RESULTS: A statistically significant positive relationship between caries risk and metabolic control was found (r = 0.51; P < 0.01), with a sevenfold increased risk of impaired metabolic control after 3 years in those assessed with high caries risk at onset (OR 7.3; P < 0.01). When the Cariogram was used as a predictor for the metabolic state of the disease, the sensitivity and specificity was 75% and 71%, respectively. The negative predictive value was 91%. CONCLUSIONS: Our data suggested that a caries risk assessment at the diagnosis of diabetes mellitus in children may be a good indicator of overall health care that can provide useful prognostic information on the level of metabolic control after 3 years.

Adolescent↗
PubMed2004

Effects of furosemide and bendroflumethiazide on saliva flow rate and composition.

Aim of this study was to evaluate the effect on saliva flow rate and composition and on perceived xerostomia. The study used a Latin square design, all subjects being once daily (at 7.00 a.m.) taking the bendroflumethiazide (2.5 mg), furosemide (40 mg), or placebo, in a randomised order. Each treatment period of 7 days was separated by wash-out periods of 14 days. Unstimulated and paraffin chewing stimulated whole saliva, and 3% citric acid stimulated parotid and submandibular-sublingual secretion were collected twice daily, at 7.30 a.m., with the patients in a fasting condition (morning values), and at 10.30 a.m., about 2 h after intake of a standard breakfast (lunchtime values), on day 0 (baseline), day 1 (acute treatment), and day 7 (chronic treatment). Saliva flow rates were measured and all four secretions were analysed for the concentration of sodium, potassium, chloride, and total protein. Xerostomia was assessed by means of a Visual Analogue Scale. Statistical analysis used the Wilcoxon signed rank test. For flow rate, only that of submandibular-sublingual secretion was affected, significantly so in the morning during chronic treatment with both drugs. In resting whole saliva the output of both sodium and chloride tended to decrease especially during treatment with bendroflumethiazide, while in submandibular-sublingual secretion the output of all the electrolytes was decreased, especially for potassium and chloride and during treatment with furosemide. Further, xerostomia tended to increase during treatment with furosemide, statistically significant at lunchtime during chronic treatment. In conclusion, this study has demonstrated a modest effect on salivary flow rate and a more pronounced effect on saliva composition, especially in submandibular-sublingual secretion during treatment of healthy volunteers with therapeutic doses of two different diuretics, encouraging clinical studies in hypertensive patients and basic research as to the presence of a thiazide sensitive Na-Cl cotransporter in human salivary glands.

Adult↗
PubMed2004

Fluoride levels in saliva and dental plaque after consumption of snacks prepared with fluoridated salt.

AIM: To determine the concentration of fluoride in saliva and supragingival dental plaque at designated time intervals after consumption of snacks prepared with a standardised amount of fluoridated salt. STUDY DESIGN: The investigation had a single blind prospective crossover design. METHODS: A group of 11 healthy young adults volunteered to participate after verbal and written information and consent. After a 1-week fluoride depletion period, the subjects consumed popcorn prepared with either fluoridated (250 mg/kg) or non-fluoridated salt during 30 minutes. Unstimulated whole saliva and samples of supragingival plaque were collected before consumption (baseline) and at 30, 60 and 120 minutes after the intake. Fluoride concentration was determined with a fluoride-specific electrode and the post-ingestion levels were compared with baseline by ANOVA. RESULTS: In saliva, the mean fluoride concentrations at baseline ranged from 0.021 to 0.027 mg/L and after the 30 minutes consumption of fluoride prepared snacks a 15-fold increase (p<0.001) was found. The same pattern was disclosed in the plaque samples. In both saliva and plaque, the fluoride levels remained significantly elevated after 2 hours (p<0.001 and p<0.05, respectively). CONCLUSION: Consumption of snacks prepared with fluoridated table salt resulted in significantly increased fluoride levels in saliva and supragingival plaque for a period of at least two hours.

Adult↗
PubMed2002

Prevalence of salivary Streptococcus mutans in mothers and in their preschool children.

OBJECTIVES: To establish the prevalence and possible relationship of oral Streptococcus mutans colonization in mother-child pairs. DESIGN AND SETTING: An analytical cross-sectional study was carried out at a well-baby evaluation clinic held at the Public Dental Clinic, Varberg, Sweden. SAMPLE AND METHODS: Two hundred preschool children, 100 of which were 18 months old and the remaining 100 were 3 years old, and their mothers attended the clinic. All mothers were interviewed and their children's medical history, oral hygiene routines and dietary habits established. All children were clinically examined. The presence and level of S. mutans was estimated in the mother-child pairs with the aid of the Strip mutans chair-side test. RESULTS: Nearly 50% of mothers exhibited high levels of salivary S. mutans, prevalence among the 18-month- and 3-year-olds was 30% and 42%, respectively. A statistically significant (P < 0.01) mother-child relationship was found; a greater presence in mothers led to a higher number of children found harbouring the bacteria. Logistic regression analysis found that high maternal S. mutans levels (P < 0.001), daily sweet intake (P < 0.01) and sugary drinks in feeding bottles (P < 0.05) were significant factors for S. mutans colonization in children. Absence of daily toothbrushing and use of feeding bottles at night failed to fit into the model. Caries prevalence (initial and manifest decayed surfaces) was significantly related to S. mutans colonization (P < 0.01). CONCLUSION: The results support the concept of vertical transmission (mother-child), emphasizing the importance of the dietary component, and justifying a primary preventive approach with targeted action directed at mothers with high levels of S. mutans colonization.

Adult↗
PubMed2001

Effect of an antibacterial varnish on lactic acid production in plaque adjacent to fixed orthodontic appliances.

The effect of an antibacterial varnish on lactic acid concentration in suspensions of early supragingival plaque collected adjacent to fixed orthodontic brackets was evaluated in 25 adolescents using a double-blind split-mouth design with a placebo varnish control. The test varnish contained 1% chlorhexidine and 1% thymol as active ingredients. Both varnishes were applied on two occasions within 3 days and plaque was subsequently collected at 3, 7 and 30 days after the first treatment. The samples were evaluated for total viable counts (TVC) and the proportion of mutans streptococci. Acid fermentation in suspensions was induced by glucose and L(+)-lactic acid concentrations were determined enzymatically after a 30-min incubation period. The test varnish did not affect TVC but reduced the proportion of mutans streptococci significantly at the 7-day follow-up (P<0.05). The concentration of lactic acid was reduced by approximately 20% on the 3- and 7-day follow-ups (P<0.05). The results suggest that the chlorhexidine/thymol-containing varnish may to some extent reduce the viability and metabolic activity of susceptible oral bacteria in suspensions of early supragingival plaque.

Adolescent↗
PubMed2001

Application of quantitative light-induced fluorescence to monitor incipient lesions in caries-active children. A comparative study of remineralisation by fluoride varnish and professional cleaning.

The aim of this study was to apply the quantitative light-induced fluorescence (QLF) method in a randomised controlled study, comparing treatment with fluoride varnish and professional tooth cleaning for remineralisation of white spot lesions in caries-active adolescents. In the fluoride varnish group (n = 13; 32 lesions), professional tooth-cleaning was followed by application of fluoride varnish at the beginning of the study, after 1 wk, and then once every 6 wk for 6 months. The other group (n = 18; 30 lesions) underwent professional tooth-cleaning once every 6 wk for 6 months. Enamel fluorescence was measured at baseline and at each visit. In the fluoride varnish group there was a significant change over time (baseline: 6 months) for both lesion area: and average change in fluorescence (decreased lesion area and increased fluorescence radiance). The corresponding changes in the professional tooth-cleaning group were not significant. There was a significant difference in average change in fluorescence between the two test groups. For lesion area, there was no significant difference, but a tendency towards a difference between the test groups. It was concluded that (a) the QLF method is a sensitive method, suitable for longitudinal quantification of incipient caries lesions on smooth surfaces; and (b) that repeated fluoride applications had a favourable effect on the remineralisation of white spot lesions as measured after 6 months.

Adolescent↗
PubMed2001

Effect of a school-based preventive program with salivary lactobacillus counts as sugar-motivating tool on caries increment in adolescents.

The caries preventive outcome of a school-based program with salivary; lactobacillus counts as sugar-motivating tool was evaluated in six cohorts of totally 936 adolescents in a comprehensive school in Sweden. Students from a neighboring district with similar socioeconomic structure but with no corresponding dental health-promoting activities were selected as reference. The program started in the beginning of the 7th grade (13 years) and was terminated at the end of the 9th grade (16 years). Salivary lactobacilli were evaluated semi-annually with a dip-slide method and used for individual counseling. Dental caries was scored from the dental records and bitewing radiographs of each 4th participant at baseline and at 16 and 19 years of age. The number of salivary lactobacilli decreased significantly (P< 0.05) in all cohorts but one during the program. There was no significant difference in the increment of caries (DFS) between the participants from the study and reference schools, either at the end of the program or at 19 years of age. The increment of proximal enamel caries was slightly lower in the study group compared with the reference group (P< 0.05) at the final registration. Considering the time and efforts spent, the results did not seem to justify a school-based intervention with lactobacillus counts as a sugar-motivating tool in an adolescent low-caries population.

Adolescent↗
PubMed2000

Acid formation in sucrose-exposed dental plaque in relation to caries incidence in schoolchildren.

The aim was to investigate the composition and concentration of organic acids produced by plaque bacteria in vivo and its possible relation to caries development in schoolchildren. Sucrose-exposed pooled plaque from 25 healthy teenagers was collected and the levels of Streptococcus mutans and lactobacilli were estimated. The acid anions were analysed with isotachophoresis. The prevalence and incidence of dental caries during a 2-year period was recorded. Depending on the amount of plaque collected, the subjects were divided into a low (n = 12) and a high (n = 13) plaque weight group. The dominating anions in sucrose exposed plaque were lactate, acetate and propionate. For the entire study group, no association was found between the total acid concentration and caries development but for the participants with low plaque weight a positive relationship (P < 0.01) was disclosed. No correlation was found between the concentrations of acids and the number of lactobacilli or Streptococcus mutans. The present results did not suggest that the acidogenicity of sugar-exposed pooled plaque samples was a suitable indicator of caries activity in teenagers.

Acetates↗
PubMed2000

Fluoride concentration in plaque in adolescents after topical application of different fluoride varnishes.

The aim of the study was to measure the fluoride (F) concentration in plaque after a single topical application of different fluoride varnishes with contrasting levels of F. Thirty adolescents (12-17 years) with fixed orthodontic appliances were randomly assigned to one of three groups: Bifluoride (6% F), Duraphat (2.23% F) and Fluor Protector (0.1% F). The varnishes were applied after professional cleaning in one upper quadrant, leaving the opposite quadrant untreated according to the split-mouth technique. Pooled plaque samples from each quadrant were collected at baseline and 3 days, 7 days and 30 days after the varnish treatment, and fluoride was analysed by microdiffusion. All fluoride varnishes increased the fluoride concentration in plaque compared with baseline, and the mean values varied between 23 and 138 ng F/mg after 3 days, depending on varnish F concentration. Compared with the control quadrant, statistically significant elevations were recorded for Bifluoride after 3 days and 7 days and Duraphat after 3 days, while no significant differences were revealed in the Fluor Protector group. The fluoride concentration in plaque was back to baseline levels for all participants in the Duraphat group after 7 days, while some individuals in the Bifluoride and Fluor Protector groups still registered slightly increased levels after 30 days. The results suggest that fluoride varnish treatments resulted in elevated fluoride levels in plaque adjacent to fixed orthodontic appliances for a period of up to 1 week, although different patterns was disclosed for the various brands.

Adolescent↗
PubMed2000

Decreasing prevalence of salivary lactobacilli in Swedish schoolchildren 1987-1998.

The prevalence and number of salivary lactobacilli was determined in all schoolchildren starting the 7th grade (12-13 yr; n = 1,578) in comprehensive school located in Kumla, Sweden between 1987 and 1998. Whole saliva samples were collected and transferred to dip-slides (Dentocult-LB) and incubated in room temperature for 7 d. Caries data were collected from the dental records and from bitewing radiographs. Both the number of lactobacilli and the prevalence of manifest caries and restorations exhibited a decreasing tendency and were significantly lower in 1998 than in 1987. The mean caries prevalence (DFS) declined from 5.2 to 1.8. In 1987, 45% of the children harboured high or very high lactobacilli counts ( > or =10(5) CFU/ml) in their saliva compared to approximately 10-15% at the later examinations. The proportion of children with no detectable counts varied between 4-29% during the study period, while children with low counts (10(3)-10(4) CFU/ml saliva) constituted a clear majority at the recent samplings. With such low levels in the population, the use of lactobacilli counts as a didactic tool in dietary counselling must be called into question.

Adolescent↗
PubMed2000

Infant oral health.

According to the United Nations' Convention on "The Rights of the Child," articles 2 and 24, all children should have the same rights and have right to health and medical service. Early childhood caries is a lifestyle disease with biologic, behavioral, and social determinants. An early screening of all children at around 1 year of age is an excellent opportunity for early detection of risk factors and risk indicators that may increase the possibilities for its prevention. The caries risk evaluation should form the base for appropriate recommendations of preventive measures. The preventive care must be coordinated with an eventual operative care and should be based on education of prospective and new parents as well as professional and home-based measures. The various interventions must be developed further and evaluated in prospective studies in terms of effectiveness and efficiency for this specific age group. This is an urgent task for dental professionals and all societies with the ambition of providing good dental care for all young children.

Child↗