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At least 721 records · Page 40Linked to original sources
PubMed2003

Sugars and dental caries.

A dynamic relation exists between sugars and oral health. Diet affects the integrity of the teeth; quantity, pH, and composition of the saliva; and plaque pH. Sugars and other fermentable carbohydrates, after being hydrolyzed by salivary amylase, provide substrate for the actions of oral bacteria, which in turn lower plaque and salivary pH. The resultant action is the beginning of tooth demineralization. Consumed sugars are naturally occurring or are added. Many factors in addition to sugars affect the caries process, including the form of food or fluid, the duration of exposure, nutrient composition, sequence of eating, salivary flow, presence of buffers, and oral hygiene. Studies have confirmed the direct relation between intake of dietary sugars and dental caries across the life span. Since the introduction of fluoride, the incidence of caries worldwide has decreased, despite increases in sugars consumption. Other dietary factors (eg, the presence of buffers in dairy products; the use of sugarless chewing gum, particularly gum containing xylitol; and the consumption of sugars as part of meals rather than between meals) may reduce the risk of caries. The primary public health measures for reducing caries risk, from a nutrition perspective, are the consumption of a balanced diet and adherence to dietary guidelines and the dietary reference intakes; from a dental perspective, the primary public health measures are the use of topical fluorides and consumption of fluoridated water.

Adolescent↗
PubMedDate not supplied

A comparison of Fluroshield with Delton fissure sealant: four year results.

PURPOSE: The purpose of this study was to evaluate the retention rate and the caries increment differences between a light cured, F releasing filled fissure sealant and a non-F nonfilled one. METHODS: The two different fissure sealants (Fluoroshield, Delton) were placed on all 4 caries-free first permanent molars of 112 children aged 7-8 years, under a half-mouth experimental design. All the children were seen in 6 month intervals where a preventive program, including regular topical fluoride application was applied. The sealants were not reapplied if they had been lost between examinations. RESULTS: After 48 months 162 teeth in the F sealant group and 162 in the conventional sealant group were evaluated. Regarding sealant retention, 124 teeth (77%) in the first group and 144 (89%) in the second were fully sealed, and 23 (14%) compared to 9 (6%) were partly sealed (P = 0.01). Regarding caries development, 14 teeth (9%) had developed caries in the first group and 19 (10%) in the second (P > 0.1). CONCLUSION: In a regular biannual preventing program including topical gel application, F-releasing filled sealant (Fluroshield) appears to have a declined full retention rate, after four years, when compared with a non-F nonfilled one (Delton). However, total sealant loss and caries increment was similar in both groups.

Bisphenol A-Glycidyl Methacrylate↗
PubMed1991

Decline in dental caries and public oral health care of adolescents.

The adequacy and appropriateness of the oral health service were evaluated from patient records of 15-year-olds in Helsinki in 1976 and 1986. The subjects selected for the study represented the whole age group participating in public oral health service in the 2 years in question. During the 10 years, substantial decreases were seen in the mean numbers of dental visits (from 4.0 to 2.4) and fillings (from 2.9 to 1.2). The greatest decrease was seen in the number of fillings made in incisors. Slightly fewer preventive measures were carried out in 1986 than 10 years earlier, but no focusing on risk patients was seen. In the 2 years studied, 15-year-olds in the high-risk group received applications of topical fluorides and instructions on oral hygiene as often as those in the low-risk group. A major problem seemed to be the increasing number of unfinished courses of treatment among high-risk patients. We conclude that patients with a higher risk of caries should receive more attention with regard to both the preventive treatment given and ways of motivating them to complete their treatment courses.

Adolescent↗
PubMed2005

Erosion--chemical and biological factors of importance to the dental practitioner.

The intrinsic and extrinsic aetiology factors responsible for dental erosion are well understood as are the chemical events leading the initial mineral dissolution, softening and eventual loss of the dental surface. Of greatest importance are the pH, titratable acidity, phosphate and calcium concentration, fluoride content of the erosive challenge which determines the degree of saturation with respect to the tooth mineral, and thus the driving force for its dissolution. Of the biological modifying factors affecting the erosion process, the protective properties of saliva and its contribution to pellicle formation are considered of greatest importance. Unstimulated salivary flow rate and buffering capacity have been directly associated with dental erosion. The acquired pellicle has been shown to have a protective effect against acid erosion by acting as a diffusion barrier. There is considerable overlap between the aetiology of dental erosion and that of dentinal hypersensitivity. Patient education on the causes and prevention of dental erosion are essential to prevent progression. In addition to reducing or eliminating exposure to acidic soft drinks and juices, modified acid beverages with reduced potential to cause erosion can be recommended to patients. Frequent application of high concentration topical fluoride may be of some benefit in preventing further demineralisation and increase the abrasion resistance of erosion lesions.

Calcium↗
PubMedDate not supplied

Whole salivary flow rates following submandibular gland resection.

BACKGROUND: Patients with head and neck neoplasms receive therapeutic neck dissections which may include the submandibular gland unilaterally or bilaterally. The clinical consequences of salivary gland resection could be reduced salivary output, altered cariogenic microflora, and increased incidence of dental caries. METHODS: This investigation evaluated whole salivary flow rates of patients who had received unilateral (n = 29) or bilateral (n = 8) submandibular gland resections and compared them with noncancer control subjects (n = 29). RESULTS: Unstimulated and stimulated (paraffin) flow rates were significantly lower in both resection groups compared with those of the noncancer group, ranging from p < .002 to p < .02. Although flow rates were lower in the bilateral group than in the unilateral group, the differences between these two groups were statistically significant (p < .02) only for stimulated saliva. Xerostomia was reported by one third of the resection subjects. CONCLUSION: In view of the significantly lower flow rates observed in the resection groups (especially for unstimulated saliva), topical fluoride therapy should be considered for those patients whose past caries activity would indicate an increased caries risk associated with partial loss of salivary function.

Adult↗
PubMed1975

Remodeling of teeth by grinding.

Pulp and dentin reactions to extensive grinding of human teeth were studied clinically and histologically. The facial portions of forty-eight premolars to be extracted for orthodontic reasons were reshaped to "lateral incisors" using diamond instruments and abundant water cooling. Following grinding and polishing with sandpaper discs and pumice, topical fluoride was administered. The patients were asked to report any increased sensitivity reactions. The teeth were extracted at 0, 1, or 3 weeks or 3 to 5 months and examined histologically. No significant discomfort was reported by the patients except for an initial period of a few days during which there was increased sensitivity to temperature changes. The histologic findings indicated that extensive remodeling of young permanent teeth is possible with no or only minor pulp and dentin reactions. Some initial localized effects in terms of aspiration of odontoblast nuclei, hyperemia, absence of a cell-free zone, and slight cellular infiltration were sometimes observed, but the long-term observations indicated that these reactions were transient. Secondary dentin formation was not registered. It is important that gentle grinding techniques with abundant water spray be used and that smooth and self-cleansing surfaces which allow hypermineralization of the ground enamel and dentin be prepared. In a few teeth in which proximal retention areas were unintentionally prepared, caries developed and marked pulp reactions occurred. Therefore, great care must be taken not to introduce proximal steps when mesiodistal tooth width adjustments are performed. The present study has provided histological and clinical evidence to indicate that even extensive recontouring by grinding may not be harmful to the teeth. This should encourage orthodontists to remodel teeth by grinding to improve the final occlusal and esthetic results in a number of different cases.

Bicuspid↗
PubMed1992

An evaluation of smear layer with various desensitizing agents after tooth preparation.

According to hydrodynamics, any agent blocking the dentinal tubules reduces the flow of fluids and diminishes hypersensitivity. The properties of the desensitizing agents that sponsor tubular occlusion and the barrier efficiency resulting from the interaction of the smear layer with test materials were examined with the scanning electron microscope and energy-dispersive x-ray microanalysis. Selected dentinal desensitizing was accomplished with burnishing procedures, cavity varnish, calcium hydroxide, and topical fluoride. Subjective evaluations were also recorded clinically after tooth preparation. This investigation indicated that the smear layer did not protect against zinc phosphate cement, and that cavity varnish prevented the formation of the smear plugs. The smear layer and plugs were basically composed of calcium and phosphorus, the major ingredients of dentin.

Adult↗
PubMed2005

Dental hygiene participation in managing incipient and hidden caries.

With the advent of new caries detection devices that allow early detection, dental hygienists can intervene in the demineralization process and work with the patient toward remineralization through patient self-care procedures and the professional application of topical fluorides. The focus of this article is on caries detection devices, caries risk assessment, agents used to prevent dental caries, and the development of self-care plans for patients that include prevention, intervention, and therapeutic components.

Dental Care↗
PubMed1998

Effects of pulsed Nd:YAG laser irradiation on root canal wall dentin with different laser initiators.

The effects of pulsed Nd:YAG laser irradiation with different laser initiators on the permeability and ultrastructure of the root canal wall dentin were investigated in vitro. Forty extracted human single-rooted teeth were randomly assigned to four groups. Group 1 teeth were not lased as a control. Group 2 specimens received four 10-s duration laser exposures for a total exposure of 40 s/canal. In group 3 specimens, the root canals were painted with black ink and then lased by the same method as group 2 teeth. In group 4 specimens, root canals were treated with 38% Ag(NH3)2F and then lased by the same method as group 2 teeth. Laser parameters were set at 2 W, 20 pps. After being placed in 0.6% rhodamine B solution for 48 h, the teeth were sectioned for study by stereoscope and scanning electron microscopy. Statistical analysis showed there were significant differences (p < 0.05) in dentin permeability in the apical areas between groups 3 and 1, 4 and 1, and 4 and 2. Scanning electron microscopic examination showed that laser treatment alone had no obvious effects on the root canal wall. The root canal surfaces prepared for by laser irradiation with black ink or 38% Ag(NH3)2F revealed melting, smear layer evaporation, and open dentinal tubules. Black ink was more effective than 38% Ag(NH3)2F as a Nd:YAG laser initiator.

Dental Pulp Cavity↗
PubMed1990

The prevalence of clinically undetected occlusal dentine caries in Scottish adolescents.

During the third examination of a 3-year anti-caries dentifrice study, bitewing radiographs were read to detect occlusal, as well as approximal caries lesions in 2623 subjects aged 14-15 years. These analyses showed that 1.4% of 2107 upper molars and 7.2% of 2288 lower molars (P less than 0.001), previously scored as clinically 'sound', were carious at a radiographic Grade '3' score (dentinal involvement), and 0.2% had radiographic pulpal lesions. However, for teeth which had been deemed as having a 'suspicion' of caries clinically, but which a 0.6 mm blunted probe would not enter, 29.1% of lower molars had definite radiographic evidence of dentinal caries as compared to only 7.6% of upper molars (P less than 0.001), and a further 0.5% exhibited pulpal extension. In addition, 23.9% of lower premolars also showed dentinal involvement in this group. Overall, 12.1% of lower molars and 3.1% of upper molars showed definite radiographic evidence of occlusal caries in the absence of a firm clinical indication. Thus, the use of bitewing radiographs would appear to be a most helpful adjunct to clinical caries diagnosis, not only of approximal lesions, but also for the detection of early occlusal caries, in these days of generally available topical fluoride.

Adolescent↗
PubMed2004

3D X-ray microscopic study of the extent of variations in enamel density in first permanent molars with idiopathic enamel hypomineralisation.

OBJECTIVE: To measure mineral concentration distributions within teeth with idiopathic enamel hypomineralisation, a condition in which developmental defects are seen in first permanent molars, and/or incisors. DESIGN: X-ray microtomographic and 3D x-ray microscopy. SETTING: UK University, 2001. MATERIALS AND METHODS: X-ray microtomographic measurements of the extent of hypomineralisation in two affected molars and two contralateral controls extracted from the same patient. RESULTS: The control molars were visibly normal. The affected molars showed hypomineralised yellow opaque enamel with regions of breakdown. X-ray microtomographic images showed; a 20% reduction in mineral concentration of affected enamel (most cases involved full enamel thickness); hypomineralised enamel had a mineral concentration gradient opposite to that of normal enamel; regions of hypomineralisation distributed randomly throughout affected teeth, (apart from cervical region which was less severely affected). CONCLUSIONS: The pattern of mineral concentration suggests a disturbance during the maturation process. Differences in susceptibility of the ameloblasts during different stages of dental development may explain the asymmetric distribution of the defects. Topical fluoride applications may help promote post eruption maturation of the surface layer in these teeth. The use of fissure sealants and adhesive materials appears to prevent further breakdown.

Child↗
PubMed1995

Prognosis of overdenture abutments in elderly patients with controlled oral hygiene. A 5 year study.

The effect of controlled oral hygiene was studied in 31 elderly overdenture patients involving 72 abutments over a period of 5 years. Intensive instruction and motivation in oral hygiene care were carried out prior to prosthodontic treatment and two to four times yearly during the study period. The initial dental and periodontal conditions were very poor, with a mean loss of proximal bone adjacent to the abutments of 61%. During the study period, it was possible to maintain mean plaque index scores of 0.45-0.73 and mean gingival index scores of 0.89-0.95 adjacent to the abutments. There was no relationship between the patients' initial plaque index score and the oral and denture hygiene observed during the study. There was spontaneous regression of 4-5 mm periodontal pockets, whereas deeper pockets persisted. Seven abutments were extracted due to periodontal complications. Caries was a minor problem which could be controlled by hygienic measures, topical fluoride or fillings. The present study has shown that it was possible to maintain teeth as overdenture abutments to a large extent in elderly patients initially having a poor dental and periodontal status.

Aged↗
PubMed1980

Economic aspects of a caries preventive program.

Cost-benefit and cost-effectiveness analyses (CBA and CEA) have been done on a preventive program. The program included professional toothcleaning, dietary and oral hygiene instruction, topical fluoride application and sealing of pits and fissures in 9--12-year-old children over 2 years. All measures were delivered by a specially trained dental nurse. In spite of a marked reduction in caries activity both CBA and CEA indicated that the preventive program was highly uneconomic compared to traditional dental care (3.73/1). However, when comparing the cost per completely treated child and year in the trial clinic continuing to use the preventive measures described, with that in dental clinics with no special preventive programs the cost seemed to be lower in the trial clinic now markedly interested in prophylaxis.

Child↗