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PubMed2005

Oral and dental manifestations in diabetic and nondiabetic uremic patients receiving hemodialysis.

OBJECTIVE: The aim of this study was to examine the dental condition and oral manifestations in diabetic and nondiabetic uremic patients undergoing hemodialysis. STUDY DESIGN: A total of 128 patients undergoing hemodialysis therapy were classified into the diabetic and nondiabetic groups and examined for uremic oral manifestations, dental caries, and the periodontal status. All the patients received predialytic salivary pH examination. In the diabetic group, the correlation between oral findings and glycemic controlled levels, which was collected based on Hb A1C values, were further studied. RESULTS: The diabetic group exhibited significantly higher prevalence of caries and more severe dry mouth, taste change, and mucosa pain than the nondiabetic group. The diabetic group tended to have lower predialytic salivary pH, and patients with poor glycemic control (ie, Hb A1C > 9%) showed higher incidence of dry mouth, mucosal pain, and tongue coating. However, the DMFT and CPI index were not associated with glycemic control in the diabetic group. CONCLUSIONS: This study reveals that diabetic uremic patients undergoing maintained hemodialysis exhibited a potentially higher risk for dental decay and xerostomia. Lower salivary pH and poor glycemic control may affect oral manifestations. Further research is needed to clarify the combined influence of diabetic nephropathy on oral health.

Adult↗

PubMed2004

Oral health in Nigeria.

Most oral health surveys in Nigeria have been sporadic and based on convenience samples. Periodontal disease with deep pocketing occurs in Nigerians at an early age, the prevalence being 15-58% in those aged above 15 years. Caries experience has been reported to vary between very low and low in most studies, but is moderate in some urban communities. Although mean DMFT is below 4 in most communities, the restorative index is extremely low, most carious teeth remaining unrestored. The higher caries prevalence in second than first permanent molars that has been reported is most likely due to a change from traditional to Western-type diet. Other oral health problems include malocclusion, truamatised teeth, dental fluorosis, and oral tumours. The scanty oral health services available in the country are mainly in urban areas. There is, therefore, a need to develop sustainable strategies for national preventive and therapeutic oral health services in Nigeria.

Adolescent↗

PubMed1999

Disturbances in oral and dental structures in patients with pediatric lymphoma after chemotherapy: a preliminary report.

OBJECTIVE: The purpose of this study was to evaluate the effects of chemotherapy on oral and dental structures and craniofacial growth in 30 survivors of childhood lymphoma. STUDY DESIGN: Eruption status, root malformations, premature apexification, agenesis, crown anomalies, soft tissue abnormalities, gingival and periodontal status, enamel defects and discolorations, and craniofacial growth status of the subjects were documented and compared with findings in 20 healthy children who served as controls. RESULTS: Statistically significant (P < .05) differences between the study and control groups were found for plaque index, enamel hypoplasias, discolorations, and agenesis. CONCLUSIONS: The results of the study suggest that antineoplastic therapy and/or childhood cancer can result in a higher prevalence of various malformations in teeth. Children treated in the early years of their lives displayed the most severe dental defects, suggesting that immature teeth are at a greater risk of developmental disturbances than fully developed teeth.

Adolescent↗

PubMed2002

Synergistic enhancement of the antitumor effect of taxol by the bioreductive compound NLCQ-1, in vivo: comparison with tirapazamine.

The antitumor effect of taxol was investigated in combination with the bioreductive compounds NLCQ-1 or tirapazamine (TPZ), in vivo. The EMT6/BALB/c and SCCVII/C3H murine tumor models were used. All drugs were given by IP injection: NLCQ-1 at 10 mg/kg (28% of its LD50), TPZ at 30 or 23 mg/kg (38% or 28% of its LD50, respectively), and taxol up to 25 mg/kg. Dose modification factors (DMF) were calculated at the optimal administration intervals for potentiation of taxol by NLCQ-1/TPZ, by using the in vivo-in vitro assay as the endpoint. Bone marrow toxicity studies were performed in parallel by using a modified CFU-GM assay. A schedule-dependent potentiation of taxol was observed with either hypoxic cytotoxin and in both tumor models. The percentage of tumor cells, P, that were killed beyond additivity was 59.2 and 29.5 when NLCQ-1 was administered 1-3 h after, and TPZ 3 h before taxol, respectively, in the EMT6/ BALB/c model. The P values in the SCCVII/C3H model were 31.0 and 24.6 for NLCQ-1 and TPZ, respectively, when either of them was administered ca. 2 h after taxol. At the above time schedules, therapeutic indexes [ThI = DMF(T)/DMF(BM), where DMF(T) and DMF(BM) are the DMF values for the antitumor effect and bone marrow toxicity, respectively] of 2.5 and 2.0 were obtained by NLCQ-1 in the EMT6 and SCCVII tumors, respectively, whereas a ThI of 1.2 was obtained by TPZ in both type of tumors. These results suggest a potential clinical use of NLCQ-1 as a potentiator of taxol againstsolid tumors possessing hypoxic regions.

Animals↗

PubMed2004

Oral health and habits in children with asthma related to severity and duration of condition.

AIM: This study was designed to examine the oral health status of asthmatic children and to compare the oral health condition and habits of different groups of asthmatic children. METHODS: 140 asthmatic children were involved in the present study. Of those, 30 were younger than 7 years of age, 73 were between 7 and 12, 37 were older than 12. Dental caries was scored according to the guidelines of the BASCD. No radiographs were taken. The gingival health and the amount of plaque were assessed using the bleeding index described by Mühleman and Son [1971] and the plaque index of Silness and Löe [1964] respectively. To differentiate between the asthmatic children three explanatory variables were used: the time the asthmatic symptoms had lasted, the exposure time to the medication and the severity of the asthmatic condition. Finally the parents and children were asked to fill in a questionnaire referring to oral health habits. RESULTS: The mean dmft was 1.99 (SD+/-2.74) and the mean DMFT was 1.10 (SD+/-1.98). Non-parametric correlation and multiple logistic regression analyses showed no significant difference between the caries (dmft/s, DMFT/S), the gingival health (bleeding index) and plaque indices and the three explanatory variables. The impact of possible compensatory factors as oral hygiene and dietary habits was of no significant importance. CONCLUSION: This analysis revealed that neither the period (of the disease and the medication) nor the severity of the asthma had a significant influence on the risk of caries and gingivitis in asthmatic children. No reported oral health and dietary habits could explain this lack of correlation.

Adolescent↗

PubMedDate not supplied

[Salivary tests and clinical indexes in selection of caries risk groups. Critical review of the literature].

The Authors briefly illustrate some recent findings about the selection of high caries risk groups. The aim of this study is to review some of the main contributes of the literature of the last years. The attention has been mainly focused on the used experimental design. From this review it can be concluded that it is necessary a better comparability of the results among the different groups of researchers working on this problem. It could also be suggested an improvement of the predictive value of the tests by their combined use.

DMF Index↗

PubMed1984

Dental health in a group of drug addicts attending an addiction-clinic.

The present study was undertaken to investigate the dental health of a group of parenteral drug addicts. The study population comprised 134 persons with a mean age of 25 yr (min. 18, max. 37) examined in 1977-81. Mean DMFT was 18.3 and mean DMFS was 50.2, approximately twice as much as found in comparable age groups in Denmark. Even free smooth surfaces were often involved. The oral hygiene was measured by the use of the Visible Plaque Index (VPI) and the Bleeding Index (BI). Both indices were high, mean VPI = 77.4 and mean BI = 71.3. 12-40% of the teeth selected had a loss of periodontal attachment of more than 4 mm. It is suggested that not only drug abuse, but also factors like low social status, low education and different barriers towards receiving dental treatment should be considered in a multifactorial cause-effect relationship. The effect of offering a free dental care system for this high-risk group will be dealt with in another paper.

Adult↗

PubMed2006

Oral hygiene and the need for treatment of the dependent institutionalised elderly.

OBJECTIVE: To assessing the oral hygiene and treatment needs of a geriatric institution in southern France. BACKGROUND: For various reasons, the care demand from elderly people is low and difficult to determine, whereas their oral status would need long and complicated treatments. MATERIALS AND METHODS: From 2003 to 2004, a cross-sectional study of 321 elderly patients was conducted at several geriatric services of Montpellier, France. The clinical evaluation of dental status was recorded together with medical information. Dental and prosthetic hygiene, status of dentures, caries experience, dependence conditions and treatment needs were evaluated. RESULTS: The prevalence of edentulism was 27%, with no gender difference (23% of the men and 29% of the women). Among them, 16.7% (upper jaw) and 18.1% (lower jaw) were totally edentulous with no denture. The mean number of decayed and missing teeth was 3.7 for men and 2.8 for women and 21.5 for men and 21.0 for women, respectively. The mean number of filled teeth was 0.8 for men and 1.3 for women, with no statistical difference according to gender for the three indexes. Most of the subjects needed prostheses (53%), 45.1% extractions and 30.6% conservative treatments. Only 2.4% did not need any treatment. CONCLUSION: The prevalence of edentulism was relatively low, while the need for prosthodontic rehabilitation, especially for men, was still very high. The dental hygiene was globally inadequate. This evaluation emphasises the care demand and the need for help in oral hygiene procedures for the dependent institutionalised elderly.

Aged↗

PubMedDate not supplied

Nitric oxide concentrations in saliva and dental plaque in relation to caries experience and oral hygiene.

The aim of the study was to determine the correlation of the antibacterial substance nitric oxide (NO) with dental caries in vivo. Salivary and dental plaque NO concentrations were analyzed by the Griess method in 11 subjects with high DMFT index and simplified oral hygiene index (OHI-S), 11 with low DMFT and OHI-S. Subjects with high DMFT and OHI-S had significantly higher NO concentrations in saliva (71.5 microM) and plaque (83.5 microM) than those with low DMFT and OHI-S (33.2 and 61.1 microM in saliva and plaque, respectively). Plaque NO concentrations were significantly higher than in saliva in both groups. NO production might be a host defense mechanism when dental caries increases or oral hygiene deteriorates.

Adolescent↗

PubMed1990

Correlation between caries prevalence (DMFS) and periodontal condition (CPITN) in more than 2000 patients.

The CPITN (Community Periodontal Index of Treatment Needs) and DMFS (Decayed-Missing-Filled Surfaces) index were evaluated simultaneously to provide information on the mutual influences of periodontal disease and caries. With the aid of an electronic database system the data of the caries index and periodontal index of more than 2000 patients aged between 18 and 80 years were stored and calculated. As expected, the CPITN and DMFS values increased with age. When the CPITN was selected as a reference the DMFS was found to change with increasing CPITN. With the examination method used in this study no correlation could be established between the prevalence of caries and periodontal condition, although both conditions have a common aetiological factor: microbial plaque.

Adolescent↗

PubMedDate not supplied

[The status of the oral cavity and results of the use of fluorine-containing preparations in preventing dental caries in children].

Stomatologic examinations of 1370 children aged 7, 12, and 15, determination of hygienic indexes in them, and anonymous questionnaires distributed among 154 parents and 64 pupils, as well as study of the efficacies of fluorine lacquer and gel have lead the authors to a conclusion that the level of dental caries intensity is low in children, but shows a tendency to growth. This necessitates introduction of a program of measures for the prevention of dental diseases and local administration of fluoride drugs, fluoride gel being the most effective of them.

Adolescent↗

PubMed1994

Pattern of caries experience among an elderly population in south India.

A study was carried out among a population aged 60 years or over in South India. The caries experience, as expressed by the DMFT index, was found to be a mean of 13.51, of which the 'missing' component was 10.98. The sample population had an average of 18.42 teeth present but not one of the 300 individuals interviewed and examined had a tooth filled. Details are given of the teeth most commonly carious and missing. Data are also provided on habits and oral hygiene measures and their effect on the oral health of the elderly in this region.

Age Factors↗

PubMed1995

Effectiveness of two school-based caries preventive programmes.

Although the efficacy of school-based preventive programmes is well established, their effectiveness under conditions prevailing in the community require further exploration. A longitudinal study was conducted to assess the community effectiveness of two school-based caries preventive programmes. A group of 150 primary school pupils, 10-15 years old were randomly selected from each of three primary schools (Dagbreek, Vergesig, De Villiers) in the Boland town of Robertson. The sample comprised 75 10-12 year-olds and 25 in each of the 13, 14 and 15 year age groups. The 75 (10-12 year-olds) constituted the experimental cohort, which was to be followed up over a period of 3 years and compared to the 13-15 year-olds, the control or baseline cohort. The experimental cohort in Vergesig was exposed to a daily toothbrushing programme with a fluoride dentifrice, the Dagbreek children were exposed to the same regimen plus a weekly 0.2 per cent fluoride rinse and the De Villiers cohort acted as a control group for contamination and co-intervention. The DMFT index (WHO, 1987) was used as a caries measure. Dagbreek showed a reduction of 0.96 DMFT (14.2 per cent) and Vergesig of 1.85 DMFT (24.5 per cent). The difference is attributed to a higher baseline DMFT at Vergesig. The weekly fluoride rinse did not confer any additional benefit. Although the caries reduction was lower than that generally found in clinical trials, the two intervention programmes were cost-effective.

Adolescent↗

PubMed1999

A time-series analysis of caries status among adolescents in relation to socioeconomic variables in Göteborg, Sweden.

The aim of this study was to detect, using time-series analysis methods, whether measurable socioeconomic adjustments for the time period 1986-96, as presented by caries index values, could be related to a new trend in caries status development for specific age groups leaving the free state-organized dental care system. In the study, Göteborg was divided into four districts. The study showed a favorable development in dental health for the 15-19 age group. However, the caries incidence index DSa (decayed approximal surfaces) values showed no or only negligible signs of lower mean values. During the study period, the study showed an unfavorable trend concerning the socioeconomic variables related to health care. However, the incongruity for the different districts between the trend results of the caries index values and the contemporaneous socioeconomic variable development indicated few signs of relationship. In relation to general discussions of environmental questions, the idea of sustainable development was discussed when applied to the field of dental care. The results of this study indicate that dental health, in times of major economic adjustments and lack of resources for health care for the 15-19 age group in Göteborg--as interpreted by the caries indices used is an example of sustainable dental health development.

Adolescent↗

PubMed2000

Rampant early childhood dental decay: an example from Italy.

OBJECTIVES: This study sought to estimate the prevalence and related prediction factors for dental caries in 3- to 5-year-old children in Rome, Italy. METHODS: From a sample of 2,025 children, 1,494 (73.8%) were included in the analysis. Children with at least two primary maxillary incisors showing evidence of caries experience were considered affected by rampant early childhood dental decay (RECDD). Behavioral and socioeconomic variables, mutans streptococci counts, diet, and nutritional status were investigated for their association with RECDD using regression analysis. RESULTS: The prevalence of any caries was 27.3 percent, and was 7.6 percent for RECDD. Among all children, mean dft and dt scores per person were 1.1 (SD = 2.4) and 0.9 (SD = 2.3), respectively; among those classified as having RECDD, scores were 6.9 (SD = 4.2) and 6.7 (SD = 4.3), respectively. Children with RECDD had 56 percent of all the decayed teeth in the sample. Low and medium social classes, use of a baby bottle filled with sweetened beverages, high salivary mutans streptococcal levels, and malnutrition were directly associated with RECDD; milk and yogurt consumption and low Plaque Index scores were inversely associated with the condition. CONCLUSIONS: The high prevalence of RECDD suggests that the implementation of preventive programs should be a priority for dental public health. Because of its high prevalence among children as young as 3 years of age, preventive measures targeted toward pregnant women and toddlers should be developed and tested, while kindergarten students could be used for monitoring RECDD prevalence and for detection of communities at risk.

Animals↗

PubMed2002

Elderly Canadians residing in long-term care hospitals: Part II. Dental caries status.

BACKGROUND: Dental caries has been identified as a significant problem for elderly residents of long-term care (LTC) hospitals in developed countries, yet little recent information is available for the Canadian population. OBJECTIVE: To document the caries status of elderly dentate residents of intermediate and extended LTC hospitals in Vancouver and surrounding communities. METHODS: A dentist examined the teeth of 369 elderly dentate hospital residents (coronal and root surfaces) for caries. The medical, dietary, oral microbial, oral hygiene and dental status of the same subjects are documented and discussed in a companion article. RESULTS: Two hundred and ninety (78.6%) of the subjects had at least one carious lesion; 186 (50.4%) had coronal caries and 254 (68.8%) had root caries. On average, each subject had 3.8 carious teeth. The residents of extended LTC hospitals had significantly more carious coronal surfaces. Lactobacillus scores were correlated with the DMFS (decayed, missing, filled surfaces), the number of carious coronal lesions, the number of carious surfaces and the plaque index, but Streptococcus mutans scores were correlated only with DMFT (decayed, missing, filled teeth). CONCLUSIONS: Overall, the prevalence of dental caries among the elderly residents of LTC hospitals in this study was high, although almost half of the subjects had visited community dentists within the previous 5 years. Caries prevention strategies (specifically diet, oral hygiene and antimicrobial agents) rather than treatment alone may be needed to control caries in this susceptible population.

Aged↗

PubMed1995

Dental caries experience and use of prescription medications among people aged 60+ in South Australia.

Medication has long been implicated as a potential risk factor for dental caries among elderly people, although epidemiological studies have reported inconsistent associations between medication usage and dental caries experience. This paper aimed to describe the frequency of medication usage, and to examine associations between medication usage and dental caries experience among non-institutionalized persons aged 60+ years in South Australia. A cross-sectional survey design was used to collect interview data about prescription medication usage from 1,650 people. Oral examinations were conducted among 848 people to obtain information about coronal and root canes experience. The number of prescribed medications taken ranged from 0 to 17, and the mean number taken was 1.8 (sd, 1.9). This was higher in older subjects and females. Four medication categories accounted for almost three-quarters of the medications taken; of those, cardiovascular drugs (including diuretics) accounted for three, with analgesics the only non-cardiovascular class. Subjects taking 3 or more prescription medications had a higher Root Caries Index (RCI, mean = 14.43; P < 0.01) than those taking one or two (mean = 11.50), and those who were taking none (mean = 12.02). Examination of particular medication types revealed that people who took antidepressants and antiulcer drugs had significantly higher RCI values (P < 0.05). There was only a moderate association between medication usage and root caries experience which may be attributable to xerogenic effects of medication, or non-causal associations with underlying medical conditions.

Aged↗

PubMed1976

How to deliver a comprehensive preventive dentistry service that dental insurance carriers can underwrite.

The successful practice management of preventive dentistry requires that it be comprehensive and include both chairside and counseling procedures. The chairside clinical procedures are a prophylaxis, topical application of fluorides, application of pit and fissure sealants, and fabrication of mouth-guards and space maintainers. The counseling procedures include plaque control and nutritional guidance. The caries activity test can be used as a means of monitoring excessive sugar intake. It is the responsibility of the dentist to determine the preventive dentistry needs of his patient based on the latter's caries score, periodontal, gingival, and plaque indexes, and diet evaluation. Since patients are prone to certain dental problems during particular age periods, the preventive management procedures must consider the existing and anticipated dental problems on the basis of the patient's age. Each of the preventive services is objective in nature because it involves either chairside or counseling procedures. During the counseling service,worksheets and clinical case notes are kept as part of the patient's dental record. The progressive effectiveness of the home-care preventive dentistry counsling procedures can be measured by scores and indexes. The frequency of repeating the service depends on proven clinical merit and the individual needs of the patient. The delivery of preventive dentistry services can be monitored by dental insurance carriers through peer review of clinical services, data sheets, case notes, a preventive dentistry record, and by patient questionnaire. A method for managing, measuring, and monitoring an objective, comprehensive preventive dentistry service has been presented so that the insurance carrier can underwrite this type of coverage as part of its dental insurance plan.

Colorimetry↗