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PubMed1979

Assessment of the readability of dental health education literature.

General dental practitioners have an important role in the dissemination of information to their patients and their advice is often reinforced with written health education material. Unfortunately, this written information is often of limited value for particular groups of patients because of its level of readability. This investigation of the problem was in two parts; firstly, a group of 140 secondary schoolchildren were asked to explain the meaning of a selection of words in common use in dental health education, and secondly, the readability of some current dental health education literature was assessed using the Fog Index. The results indicate that current dental health education literature reflects the reading ability of the designers rather than the ability of the potential target group. Many of the words in the dental profession's preventive vocabulary were not understood by the children. Over 80% were unsure of the meaning of fluoride tablets, gum disease, gingivitis and oral hygiene. The results of this investigation indicate that dentists should ensure that dental health education literature is not unduly complex and should take more time explaining the dental vocabulary in lay terminology.

Adolescent↗
PubMed1981

Disparities in gingival height in the mandibular central incisor region of children aged 6--12 years.

An investigation of disparate gingival heights of the mandibular central incisor region in 93 children aged from 6 to 12 years was undertaken. Unaffected paired teeth demonstrated an age-associated increase in clinical crown length, similar to previous reports, suggesting a gradual remodelling of soft tissues. Affected teeth displayed a rapid increase in clinical crown length suggesting that by age 10 years true recession had occurred. Significant associations with gingival inflammation (at the 0.1% level), and with anterior crowding (at the 0.2% level), occurred. Frenal involvement did not influence the position of the gingival margin.

Age Factors↗
PubMed1983

Gingival recession in the mandibular central incisor region of Saudi schoolchildren aged 10-15 years.

Incidence of gingival recession in the mandibular central incisor region was examined in a sample of 1336 male and female Saudi schoolchildren aged from 10-15 yr. Gingival recession was found in 9.88% with no significant difference in the affected teeth by age (p greater than 0.8361). There was a significant difference in the mean clinical crown length between the affected and adjacent teeth (p less than 0.0001). The highest significant association of gingival recession was found with inflammation (p less than 0.0001), anterior crowding (p less than 0.0009) and frenal involvement (p less than 0.0001). The results of this investigation suggest that future studies should be made to evaluate the effect of miswak as a cleansing agent for the gingival tissues among the Saudi population.

Adolescent↗
PubMed1986

Gingival recession in schoolchildren at 7, 12 and 17 years of age in Espoo, Finland.

The present study was undertaken in response to a growing concern among clinicians about an increase in gingival recession among children and adolescents. Groups of 50 boys and 50 girls aged respectively 7, 12, and 17 yr were examined at Espoo Health Centre in 1983. Gingival recession was measured on the facial and lingual aspects of all permanent teeth. Whenever the gingival margin was located on root cementum, the distance from the gingival margin to the enamel border was measured to the nearest 0.5 mm. Recession was categorized as "slight" (0.5 or 1 mm) or "extensive" (1.5-3.5 mm). The prevalence of gingival recession was 5% at 7 yr, 39% at 12 yr, and 74% at 17 yr of age. More girls than boys had recession in the two youngest age groups. At 17 yr recession was equally common in both sexes and both "slight" and "extensive" recession was most often recorded on facial surfaces of first molars, premolars and canines. The alarmingly high prevalence of gingival recession at young age warrants further study of both the reasons and the consequences of early cementum exposure.

Adolescent↗
PubMed1987

Oral health effects of smokeless tobacco use in Navajo Indian adolescents.

Recent reports have suggested that the use of smokeless tobacco is increasing in adolescents, and is particularly high in Native Americans, causing concern about possible effects on oral health. In this study, 226 Navajo Indians, aged 14-19, were interviewed regarding their use of smokeless tobacco (ST), cigarettes, and alcohol. Midbuccal and mesiobuccal sites on all fully erupted permanent teeth (excluding third molars) were examined for the presence of gingival bleeding, gingival recession, calculus, and loss of periodontal attachment. The oral mucosa was examined for evidence of leukoplakia. 64.2% (145) of the subjects (75.4% of the boys and 49.0% of the girls) were users of ST. Of these, over 95% used snuff alone or in combination with chewing tobacco. 55.9% used ST one or more days per week. 52.2% consumed alcohol, usually beer or wine, and 54.0% smoked cigarettes. 25.5% (37) of the users and 3.7% (3) of the non-users had leukoplakia. The duration (in years) and frequency of ST use (days per week) were highly significant risk factors associated with leukoplakia. However, the concomitant use of alcohol or cigarettes did not appear to increase the prevalence of these lesions. No consistent relationship was observed between the use of ST and gingival bleeding, calculus, gingival recession, or attachment loss, either when comparing users to non-users or when comparing the segment where the tobacco quid was habitually placed to a within-subject control segment. In view of these results, there is little doubt that smokeless tobacco is significantly related to the etiology of leukoplakia. As some evidence exists that smokeless tobacco use is a significant risk factor associated with oral carcinoma, intervention programs to discourage the use of smokeless tobacco by adolescents should be a public health priority.

Adolescent↗
PubMed1989

Visual and tactile observational error: comparative probing reliability with recession and cementoenamel junction measurements.

Probing error may arise from several sources, including visual observations and tactile detection of the cementoenamel junction (CEJ). This study examined two types of probe scale in relation to measurements of recession and CEJ from a flexible stent, and two types of probe design in addition, in relation to CEJ detection. 492 sites were studied in six patients with untreated periodontitis. Following stent construction, patients attended for measurement of recession and probing depth. This was repeated after 1 h, and then calculus was scaled in the vicinity of the CEJ. One week later, patients attended for CEJ measurements, which were similarly repeated. Measurements with an offset scale (between marks) were more reproducible in general, though no significant difference was detected between recession scores. The most reproducible detection of the CEJ was with a modified Cross calculus probe with an offset scale. A curious feature of the results was a bias affecting 9% of the recession measurements. It is possible that edematous enlargement of the gingiva occurred after the first measurement of probing depth, and was occasionally sufficient to alter the recession score.

Bias↗
PubMed1981

Development of rampant dental caries, and composition of plaque fluid and saliva in irradiated primates.

Co-60 gamma irradiation of the salivary glands of Macaca mulata monkeys fed a cariogenic diet led to the rapid onset of dental caries resembling that in irradiated human patients. Plaque fluid and saliva were sampled from irradiated monkeys, nonirradiated controls and a group of animals fed a noncariogenic diet in order to look for changes which might occur in inorganic composition related to the caries development and to dietary differences. Salivary calcium and phosphate levels were not markedly changed after irradiation: iodide levels were raised, while thiocyanate levels fell. In plaque fluid, calcium concentrations were not affected by irradiation, but were higher in animals fed a noncariogenic diet. Phosphate levels were higher with a cariogenic diet and further increased in irradiated animals. Magnesium levels were occasionally higher than those of calcium. Other differences in plaque fluid composition may be related to secondary effects of the concomitant gingival disease. The results do not point clearly at a specific change in the quality of the saliva produced by the residual gland tissue after irradiation which precipitates the rampant caries. It is more likely that the great reduction in the quantity of saliva with its protective constituents is responsible.

Animals↗
PubMed1985

Effects of smokeless tobacco on the periodontal, mucosal and caries status of adolescent males.

The use of smokeless tobacco (ST) products, such as snuff and chewing tobacco, was investigated in a school population of 565 males with a mean age of 13.8 years. All students completed a tobacco usage questionnaire and were given intraoral examinations by a team of dentists to determine the possible relationship of ST usage to the presence of gingivitis, gingival recession, mucosal pathology and caries. The overall prevalence of ST usage was 13.3%, which was much higher than the 1.4% prevalence of cigarette smoking. Pairwise chi square analysis revealed that there was no relationship between ST usage and the prevalence of gingivitis, but that the prevalence of gingival recession was significantly elevated in ST users, P less than 0.001. The odds of having gingival recession were 9 times greater in the students using smokeless tobacco as compared to healthy, non-user cohorts. ST usage did not affect the prevalence of gingival recession in students without gingivitis. The frequency of occurrence of soft tissue pathology was significantly elevated, about 6-fold in students who used smokeless tobacco, as compared to non-users, P less than 0.01. This was principally due to the increased prevalence of white mucosal lesions in smokeless tobacco users. However, there was no attributable risk for mucosal pathology in ST users who were free of gingivitis. Similarly, the use of smokeless tobacco was associated with a 1.6-fold elevation in mean DMF in students with gingivitis, P less than 0.001, but this increase in caries experience was not seen in ST users who were free of gingivitis. In summary, in students with clean mouths that were free of gingivitis, the use of smokeless tobacco was not associated with a change in the prevalence of gingival recession, mucosal pathology, or in the mean DMF score. In contrast, smokeless tobacco usage was a significant risk factor in individuals with co-existing gingivitis, associated with a marked increase in the prevalence of gingival recession, mucosal pathology and caries experience.

Adolescent↗
PubMed1997

Histochemical and immunohistochemical localisation of elastic system fibres in focal reactive overgrowths of oral mucosa.

Eight specimens each of the following groups were investigated: gingival pyogenic granuloma, fibrous epulis, calcifying fibrous epulis, peripheral giant cell granuloma, giant cell fibroma (four gingival, four non-gingival), denture-irritation hyperplasia and fibroepithelial polyp. These lesions have diverse histopathological appearances but the composition of their connective tissue is poorly defined. The elastic system consists of a complex mixture of glycoproteins that in normal oral mucosa form three differentially distributed fibre types; oxytalan, elaunin and elastic. The elastic system was investigated by Verhoeff's haematoxylin stain, aldehyde fuchsin staining and an anti-elastin monoclonal antibody. Elastin was identified in all fibroepithelial polyps and denture-irritation hyperplasias, but in none of the other lesions. In particular, this identified a distinct difference in the extracellular matrix between the giant cell fibroma and fibroepithelial polyp. Many of the epulides included only oxytalan fibres, but the presence of oxytalan fibres did not follow any pattern within either a single lesion group, or between different lesions. However, the presence of oxytalan fibres in the absence of elastin does not necessarily support a periodontal ligament origin for reactive epulides.

Antibodies, Monoclonal↗
PubMed2005

Peripheral odontogenic tumor: a clinicopathologic study of 30 cases. General features and hamartomatous lesions.

BACKGROUND: Peripheral odontogenic tumors (POT), either neoplastic or hamartomatous, are rare. This study briefly summarizes the general features of POT and selectively reviews the histomorphologic spectrum of under-recognized hamartomatous lesions that we have designated peripheral odontogenic hamartomas (POH) in order to shed more light into the pathogenesis of POT. METHODS: Archival material accessioned at our institutions between 1970 and 2004 was systematically searched to identify examples of POT/POH. RESULTS: Among 39 660 biopsies, we retrieved 25 cases of 'classical' POT and five cases of 'unique' POH. Odontogenic fibroma and ameloblastoma were by far the most common. Of POH, two purely epithelial lesions showed multiple strands of basaloid rests [odontogenic gingival epithelial hamartoma (OGEH)] and a conglomerate of polyhedral epithelium, ghost cells and concentric calcifications (calcifying epithelial odontogenic tumor-like hamartoma), respectively. OGEH and peripheral squamous odontogenic tumor (PSOT) deserve to be a related entity. In two types of mixed POH, ectomesenchymal elements appeared juxtaposed to the squamous lining (gingival cyst-like organoid hamartoma) and ghost cells aggregated in the enamel organ of a microdont (peripheral odontoma). None of POH exhibited continuity with the surface epithelium. CONCLUSION: On the basis of this relatively limited series of cases, POH, to conceptualize a unified histogenetic source, are speculated to arise from the soft-tissue remnants of dental lamina. Gingival rests of Serres seem to retain the ability to pursue epithelial-ectomesenchymal interactions that are necessary leading to odontoma formation.

Ameloblastoma↗
PubMed1983

Histopathology of benign gingival fibroblastic lesions with special reference to odontogenic fibroma and recurrence rates.

Histopathologic and clinical reexamination of 84 cases diagnosed as peripheral odontogenic fibroma showed 56 cases with no evidence of recurrence, 12 with possible single recurrence and 16 with verified single or multiple recurrences. An effort was made to correlate the histopathologic appearance with the recurrence rate. Three different types of lesions could be identified: fibrous epulis, calcifying fibroblastic granuloma and various types of "fibroma", also showing a high recurrence rate. Our findings show that neither histomorphology nor recurrence rate can be used as a definite criterium to separate neoplasia such as odontogenic fibroma from other gingival fibrous overgrowths.

Adult↗
PubMed1996

Plaque fluoride and mutans streptococci in plaque and saliva before and after discontinuation of water fluoridation.

Our aim was to compare plaque fluoride and the level of mutans streptococci in saliva and plaque before and 1 and 2 years after discontinuation of water fluoridation in Kuopio, Finland. For comparison, a low-fluoride community was included in the study. Pooled plaque and saliva were collected from a random sample of 12-year-olds in both communities (n = 139). Enumeration of mutans streptococci in plaque was made on MSB agar and the level of salivary mutans streptococci was measured using the Strip mutans method. Fluoride was analyzed using a fluoride specific electrode. Caries, gingival status, fluoride varnish applications and self-reported oral health habits were recorded at baseline. Before discontinuation of fluoridation, the level of mutans streptococci in saliva was significantly lower in the fluoridated than in the non-fluoridated community. The difference in plaque mutans streptococci was not statistically significant. After discontinuation of water fluoridation, there was a significant shift towards elevated values of salivary mutans streptococci in the fluoridated community, but the level of mutans streptococci in plaque remained at the baseline level. There was no significant difference between the communities in the fluoride content of plaque either before or after discontinuation of fluoridation. From the background factors, only caries scores (higher in the non-fluoridated community) and oral hygiene (better in the non-fluoridated community) were significantly different between the communities.

Chewing Gum↗
PubMedDate not supplied

Periodontal and other soft tissue considerations in esthetic dentistry.

Esthetic considerations are playing a greater role in the treatment planning of dental care, especially in the restoration of anterior teeth. Much attention has been paid to both operative and prosthodontic techniques that are available in esthetic restorative dentistry. Less attention has been given to soft tissue esthetics, the shape of the face and position of the lips, and the contours, color, and overall appearance of the gingiva and associated soft tissues. This article reviews a basic approach to soft tissue esthetics, the appearance of the gingiva, the interrelationship of the gingiva, teeth, and restorations, and outlines several common soft tissue problems and their management.

Alveolar Ridge Augmentation↗
PubMed1984

The gingival health of eight-year-old Nigerian children.

A total of 860 eight-year-old schoolchildren in Lagos Nigeria, were examined between April 1981 and March 1982: 409 from private schools and 451 from government schools. Half were boys and the other half were girls. The mean Gingival Index score for children in private schools is 0.4 and 0.5 in the government schools. The GI score was slightly higher for boys than for girls in each group. The prevalence of calculus (24.7 percent) and gingivitis (46.5 percent) in the private schoolchildren is significantly lower than that found in the government schoolchildren (59.6 percent and 61.6 percent respectively) (p values less than 0.002). The mean OHI-S score is lower in the private schools (0.8 for boys and 0.7 for girls) than in the government school (1.1 for both boys and girls). These findings suggest better oral hygiene habits in the higher socioeconomic group of private schoolchildren. Among the boys, 47.3 percent had calculus and 52.2 percent had gingivitis while 38.7 percent of the girls had calculus and 56.6 percent had gingivitis. Overall, 43 percent of the children examined had calculus, 54.4 percent had gingivitis. The mean GI Score was 0.4 and the mean OHI Score was 1.0. The results indicate a trend toward a lower prevalence of gingivitis and better oral hygiene among Nigerian children now when compared with studies reported two decades ago.

Child↗