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PubMed2006

Two-dimensional electrophoresis study of in vitro pellicle formation and dental caries susceptibility.

In the present study, a proteomic approach was applied to evaluate the influence of salivary protein composition on in vitro dental pellicle formation and its possible correlation with dental caries. Whole saliva, collected from caries-free and caries-susceptible subjects, was analyzed by two-dimensional electrophoresis, and protein spots were identified by mass spectrometry. Data analysis of salivary protein composition showed a statistically significant correlation between the quantity of acidic proline-rich proteins (PRPs), lipocalin, cystatin SN and cystatin S, and samples from the caries-free group of subjects [decayed, missing or filled teeth (DMFT) = 0]. Samples from subjects with a high DMFT index appear to be correlated with high levels of amylase, immunoglobulin A, and lactoferrin. In vitro pellicle-composition experiments showed the same correlations found for whole saliva. As cystatins are known physiological inhibitors of cathepsins, the higher quantities of lipocalin, and cystatins S and SN found in the samples from the caries-free subjects suggest that inhibition of proteolytic events on other salivary proteins may indirectly provide tooth protection. The correlation between higher levels of the phosphorylated acidic PRPs 1/2 with samples from the caries-free group also suggests a protective role for these proteins.

Adolescent↗

PubMed1975

Problems and proposals for recording gingivitis and plaque.

The origin of indices for recording gingivitis and plaque is reviewed. Each index seems to have been constructed for a special purpose. The development so far has been towards more and more delicately graded indices which are well suited for evaluation of short term clinical trials. The increased sensitively, though advantageous for scientific purpose, is not always practical from a public dental health point of view. It seems that at present there is a need for several different types of index systems. In order to be able to conduct his preventive programs the practicing dentist needs a simple and well defined recording system for oral hygiene and gingival inflammation. Such an index system should be as easy and natural to use as is the scoring of decayed and filled surfaces today. Instead of using individual mean scores of multi-graded plaque and gingival indices, the use of the site prevalence of a single finding is suggested. For recording of gingivitis in daily dental practice the number of gingival margins bleeding on pressure is recommended to be determined as a percentage of the sites examined (Fig. 1,2 and 3). For oral hygiene, correspondingly, the frequency of occurrence of tooth surfaces covered with clearly visible plaque could be used as a clinically relevant parameter (Fig. 4). Keeping visible plaque and gingival bleeding away is also suggested to be a clearly understandable and practical aim in the dental health education of the individual patient.

DMF Index↗

PubMed1991

Oral health among 15- and 35-44-year-olds in Sierra Leone.

In the West African country Sierra Leone a WHO-related research project has been launched, in order to evaluate oral health promoting activities for children and adolescents in an African developing country, and how primary health care workers and oral health personnel can be appropriately involved. The present report contains the main findings of an oral health survey implemented to establish the initial situation analysis. The study included 135 15-year-old secondary school children and 106 35-44-year-old persons. D3MFT of the two age groups was 2.1 and 5.3 respectively, 35% and 15% were caries-free. Only four fillings were found. Nineteen per cent of the 15-year-olds had over half of the affected surfaces in that age group. The CPITN-index showed that none in the study population were completely without periodontal disease, 9% of the students and 53% of the adults had at least one pocket of 6 mm or more. Among the students, 95% brushed their teeth every day, although relatively ineffective. Only 7% used local chewing sticks. Between 20 and 35% had manufactured sweets and/or cakes and biscuits at least twice a day. The prevalence of dental diseases found in the study is relatively high for the African region, calling for an increased emphasis on preventive strategies. However, up to now most of the dental personnel in Sierra Leone has had no traditions of oral health promotion. An action research project is being implemented in order to improve this situation.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗

PubMed1994

Factors affecting caries experience in French adolescents.

Three hundred French 14-15-yr-old adolescents were randomly selected. They were examined clinically and caries experience was determined by using the DMFS index. The aim of this investigation was to evaluate children's habits using a self-administered questionnaire, to clarify the actual influence of well-known factors such as fluoride exposure, diet, oral hygiene and socioeconomic factors on caries experience and to stress those factors of primary importance. A multiple regression analysis revealed the variables which significantly contributed to explain DMFS scores in a final model: Age, sex, frequency of sweet consumption, use of standard or high fluoride toothpastes, bleeding during toothbrushing, living in St Yorre (F- = 0.45 mg/l). At a time when caries experience is decreasing, it seems that fluoride supply, snacking and oral hygiene are still independent and significant determinants of caries experience in French adolescents.

Adolescent↗

PubMed1994

Dental caries risk in relation to dietary habits and dental services in two industrial populations.

OBJECTIVES: Environmental hazards contribute to the poor oral health in many occupations. Among the earliest occupations mentioned are those of the baker and confectionery worker. To determine appropriate ways of promoting oral health in places of work, factors affecting caries susceptibility were studied. METHODS: Dental caries status, dietary and dental health behaviors, and salivary microbiologic findings in 338 confectionery and 101 shipyard workers were compared. A caries risk index based on salivary findings was used in log-linear models where the effects of sex, diet, use of dental services, and work environment were studied. RESULTS: Caries experience was found to be high in both populations. Dietary habits were the most important factor affecting caries occurrence and susceptibility. Similar dietary behaviors were found in both groups. CONCLUSIONS: The confectionery industry did not seem to be an exceptionally hazardous environment for dental health in general. However, the screening of high-risk workers should be organized. Reimbursement of costs had no major effect on use of dental services or caries risk. Oral health promotion should be integrated with existing occupational health services to improve oral health in industrial populations.

Adult↗

PubMed2000

The effects of a break in water fluoridation on the development of dental caries and fluorosis.

Durham, NC, fluoridated since 1962, had an 11-month cessation of fluoridation between September, 1990, and August, 1991. The purpose of this study was to assess the effects of this break on the development of caries and fluorosis in children. Study participants were continuously-resident children in Kindergarten through Grade 5 in Durham's elementary schools. There were 1696 children, 81.4% of those eligible, for whom a questionnaire was completed and clinical data recorded. Age cohorts were defined by a child's age at the time that fluoridation ceased. Caries was recorded in children in the Birth Cohort through Cohort 3, and fluorosis for children in Cohorts 1 through 5. Caries was assessed in the primary first and second molars according to the decayed-filled index; fluorosis on the labial surfaces of the upper permanent central and lateral incisors was assessed by the Thylstrup-Fejerskov (TF) index. Mother's education was associated with caries; higher education of the mother had an odds ratio of 0.53 (95% CI 0.40, 0.76) for caries in the child. No cohort effects could be discerned for caries. Overall prevalence of fluorosis was 44%. Prevalence in Cohorts 1, 2, 3, 4, and 5 was 39.8%, 32.3%, 33.0%, 62.3%, and 57.1%, respectively. These cohort differences remained statistically significant in regression analysis. It was concluded that while the break had little effect on caries, dental fluorosis is sensitive to even small changes in fluoride exposure from drinking water, and this sensitivity is greater at 1 to 3 years of age than at 4 or 5 years.

Age Factors↗

PubMedDate not supplied

Prevalence of dental caries and enamel defects in Connecticut Head Start children.

PURPOSE: The aim of this study was to determine the prevalence of dental caries and enamel defects in a sample of predominantly African American and Hispanic children from an inner city Head Start program located in Connecticut. METHODS: A total of 517 children were examined for dental caries and enamel defects. Children's caries experience was described using the dmfs/t indices, and dental defects were described using a modified developmental defects of enamel index. RESULTS: The mean dmfs was 3.0, and 38% of the children had caries. The prevalence of enamel defects was 49%. When analyzed by race/ethnicity no significant differences in dmfs scores or the prevalence of defects were observed. The majority of defects were located on anterior teeth, and the type of defect varied with the location. On the buccal surface of canines, hypoplasia accounted for 70% of the lesions. On maxillary anterior teeth, linear opacities accounted for 50% of the lesions. A positive association between enamel defects and caries was observed. CONCLUSIONS: The prevalence of caries and defects in these Head Start children was high, with most defects located on anterior teeth. Enamel defects were associated with an increased caries incidence.

Chi-Square Distribution↗

PubMed2006

Periodontal status and IOTN interventions among young hemophiliacs.

Fifty-two young individuals suffering from severe haemophilia A and B volunteered to be compared with school- and college-going students for oral health status description and subsequent management. A total of 244 students (84.42% boys and 15.58% girls) with the age group of 13-23 years were divided into two groups, A and B (controls). The purpose of this study was to increase awareness about evidence-based dental practices by oral examinations followed by comparisons of periodontal health and prevalence of malocclusions among medically compromised students and healthy controls. Results described the oral health in severe haemophilic population to be compromised with combined simplified health index score of 0.50 and Decayed/Modified/Filled Teeth (DMFT) index score of 2.07 when compared with 0.42 and 0.95, respectively, among group B. Although prevalence of malocclusion and orthodontic treatment needs among group A were higher, yet it was not confirmed as a reason for degraded dental and periodontal status. However, spontaneous and/or toothbrush (trauma)-induced gingival bleeding episodes among group A could be explained as factors discouraging oral hygiene maintenance, particularly self-administered measures. Four haemophiliacs presented with symptoms of Temporomandibular Joint Dysfunction Syndrome (TMPDS). Evidence-based oral medicine and clinical practices need to be encouraged and applied to enhance the quality of life among haemophiliacs, particularly in developing world. Dental treatment needs of haemophilic population appear to be greater and maybe incorporated in routine dental practices, at institutional and individual levels.

Adolescent↗

PubMed1977

Oral health status in relation to socioeconomic and ethnic characteristics of urban adults in the U.S.A.

Nearly 1,300 adult members of a prepaid medical group plan in New York City were screened through automated multiphasic health testing in a series of test stations including a dental station, during 1971-1973. Oral status indicators were developed including a number of missing teeth, scores to measure levels of gingival and periodontal disease, Simplified Oral Hygiene Index scores, and ratios of decayed teeth. Ratios of filled teeth were calculated to measure levels of restorative care. The present paper examines the interrelationships of economic status, education and ethnic origin with each of the above oral status measures. It was found that variations in ratios of decayed and of filled teeth were primarily due to economic status while variations in a number of missing teeth, oral hygiene levels and levels of gingival and periodontal diseases were primarily due to screenees' educational level. Ethnic group differences could be explained in part by differences among these groups in economic and and educational levels. There were no consistent ethnic patterns, however, and while some differences could be explained by controlling for education and economic status, others persisted.

Adult↗

PubMed2002

Oral findings in patients with primary Sjögren's syndrome and oral lichen planus--a preliminary study on the effects of bovine colostrum-containing oral hygiene products.

Bovine colostrum is rich in antimicrobial substances and growth factors. The purpose of this open study was to examine and compare the interventory effects of daily use of bovine colostrum-containing oral hygiene products (CHP) on oral symptoms and findings in 20 patients with primary Sjogren's syndrome (pSS) and 20 age-matched patients with oral lichen planus (OLP). Objective oral measures and self-assessment of oral symptoms and general health were conducted before and after 90 days' use of CHP. The pSS patients had more systemic diseases, medication intake, oral dryness, poorer general health and lower salivary secretion than the OLP patients, who had the highest plaque index (PI) and the most mucosal soreness. Oral dryness and soreness were correlated to general health. In both patient groups. unstimulated whole saliva flow rate (UWS) had increased, PI and periodontal pocket depth (PPD) were reduced, and general health and oral dryness and soreness had improved after using CHP. A decrease in hyphae was found in candida smears from both groups and in blastospores in OLP smears. A reduction in the extension of the mucosal lesions was observed in 15 OLP patients. Results suggested beneficial effects of intervention with CHP on oral symptoms, general health, UWS, PI, PPD and candidal load in two patient groups--pSS and OLP--representing different oral symptomatology.

Adult↗

PubMed1991

[The oral health of an East German population of a large city. The basic research of the Dresden prevention study on 2500 16- to 35-year-olds].

Oral health behaviour, oral health state, dental care effectiveness and preventive-curative care needs were subject of a basic examination using 2500 randomly selected patients aged 16-35 years in 6 Dresden state health services in 1988. The spectrum of methods included extended anamnesis, plaque index according to Silness & Löe, DMF/T index and DMF/S index according to WHO criteria without X-ray diagnostics, GPM/T index, CPITN, as well as assessment of gingival recessions, acute and chronic trauma and the prosthetic status. Considering a mean DMF/T of 9.88, DMF/S of 17.93 and GPM/T of 11.9 in patients being 16-19 years and a DMF/T of 15.21, DMF/S of 40.94 and GPM/T of 12.9 in patients being 30-35 years, as well as the insufficient dental care, the majority of patients was in need of preventive care measures. Filling therapy and gingivitis treatment were necessary from the curative point of view. Early chronic tooth surface loss required early preventive-curative intervention. The key for an effective care in the early and middle adult age is a functioning individual concept with preventive emphasis which should include a basic and a risk strategy.

Adolescent↗

PubMed2002

Oral condition, chemistry of saliva, and salivary levels of Streptococcus mutans in thalassemic patients.

The purpose of this investigation was to determine the oral status in a group of patients with thalassemia major (TM). Eighteen TM patients (15 M, three F) and 18 healthy controls randomly matched for age and sex were examined for dental caries using the decayed, missing, and filled teeth (DMFT) index and for oral hygiene conditions using the oral hygiene index (OHI)-S. Spontaneous saliva was collected from each subject, and the biochemical composition (calcium, phosphorous, potassium, sodium, urea) was determined. Furthermore, salivary Streptococcus mutans levels were evaluated. Statistical analysis (Student's t-test) were performed for means comparison, while independence among categorical variables was assessed using the chi(2) test. Fisher's exact test was used when expected cell values were less than 5. Dental status (DMFT index) was almost equal in the two groups (10.3 in TM vs 9.4 in controls, P=0.34). The occurrence of plaque (OHI-S 2) was higher in the control group, but no statistically significant association was observed between oral hygiene conditions in the two groups (Fisher's exact test 0.47, P=0.79). Biochemical saliva composition was very similar in the two groups; only the urea concentration was lower in TM, and this difference was statistically significant ( P=0.002). The TM patients had an increased presence of mutans streptococci at detectable levels. Our findings confirm that, although no substantial differences were found between the two observed groups, further investigations are needed to determine the theoretical risk of oral diseases in thalassemic patients.

Adult↗

PubMed2004

Measuring inequalities in the distribution of dental caries.

OBJECTIVES: To evaluate different measurements of prevalence and inequality in the distribution of dental caries as to their partial collinearity, and ability in expressing associations with the supply of fluoridated tap water, indices of socioeconomic status and provision of dental services. METHODS: The DMFT, the Significant Caries (SiC) Index, the proportions of children with high- (DMFT > or = 4) and rampant- (DMFT > or = 7) caries experience, caries-free children (DMFT = 0), the Gini coefficient and the Dental Health Inequality Index (DHII) were the dental outcomes appraised in a sample comprising 18 718 oral examination records for 11- and 12-year-old schoolchildren in 131 towns of the state of São Paulo, Brazil. Spatial data analysis assessed the association between aggregate figures of dental indices and several covariates. RESULTS: The DMFT, the SiC Index and the proportions of children with high- and rampant-caries experience presented strong linear associations (Pearson r near or higher than 0.95), and an analogous profile of correlation with indicators of socioeconomic status, dental services and access to fluoride tap water. The same was observed for the DHII, the Gini coefficient and the proportion of caries-free children. These observations involve the perception of variables in each set as interchangeable tools for ecological studies assessing factors influencing, respectively, prevalence levels and inequality in the distribution of dental disease. CONCLUSION: An improved characterization of the skewed distribution of caries experience demands the concurrent estimation of figures of prevalence and inequality in dental outcomes. This strategy may contribute to the design of socially appropriate programmes of oral health promotion.

Brazil↗

PubMed2000

Oral health status, oral microflora, and non-surgical periodontal treatment of renal transplant patients receiving cyclosporin A and FK506.

OBJECTIVES: To determine the oral health status, oral microflora and the effect of non-surgical periodontal treatment on gingival overgrowth of renal allograft recipients receiving either cyclosporin A (CsA) or FK506 (Tacrolimus) as an immunosuppressant. MATERIALS AND METHODS: A total of 47 patients receiving CsA (mean age 43.1 years) and 10 receiving FK506 (mean age 40.1 years) were included in the study. Stone casts were taken for measurement of gingival overgrowth. An oral rinse technique was used to investigate the prevalence of yeasts, and aerobic and facultatively anaerobic Gram-negative rods (AGNR). RESULTS: The CsA and FK506 patients exhibited a Gingival Overgrowth Index (GOI) of 45.2%, and 25.1%, respectively (p < 0.05). The CsA patients had a GOI of 15.2% after one year of non-surgical periodontal treatment. The difference between pre- and postoperative gingival overgrowth indices was significant (p < 0.0001). Candida albicans and Klebsiella pneumoniae were the most notable yeast and AGRN found. CONCLUSIONS: Renal transplant patients, being immunocompromised, constitute a high-risk group for gingival overgrowth. However, the FK506 regime appeared to ameliorate this effect, compared with CsA. Non-surgical periodontal treatment was effective in reducing established gingival overgrowth in both CsA and FK506 patients (p < 0.05). Adequate pre- and post-transplant oral health care is recommended, for these patients, irrespective of the drug regime.

Adult↗

PubMed1977

Relationships between fluoride in enamel, DMFT index and fluorosis in high- and low-fluoride areas in South Africa.

The DMFT Index, degree of fluorosis (DEGF), and enamel fluoride concentration (F) were determined in 88 children living in a high- and 79 children living in a low-fluoride area in South Africa. The following interrelationships between these parameters were found: in both areas there was a significant negative correlation between log F and age; in the high-fluoride area there was a significant positive correlation between log F and DEGF; and in the combined data from the two areas there were significant correlations between log F and area, log F and age, and log F and DEGF, and a significant association between DEGF and area. There were no significant correlations between DMFT and log F and between DMFT and DEGF.

Adolescent↗

PubMed1998

Dental caries prevalence and treatment need in Chiriqui Province, Panama.

A pathfinder pilot survey was conducted in rural Chiriqui Province, Panama, using standard WHO methodology, in order to estimate dental caries prevalence and treatment need. Examinations for caries and treatment need were performed by six trained, experienced examiners. From a convenience sample of 2,597 subjects, a stratified cluster sample was constructed using index ages 12 and 15 years and age groups 35-44 and 65-74 years. The results showed a mean Decayed, Missing and Filled Teeth index (DMFT) of 4.08 for 12 year olds, 6.40 for 15 year olds, 13.20 for the 35-44 age group, and 18.88 for the 65-74 age group (P < 0.001). No statistically significant differences by gender were found. These findings rank rural Panama with Mexico and Haiti when compared to the results of other Central American community studies. The percentage of caries free 12 year olds was 6.8 per cent. Of the total sample, 74.7 per cent of individuals would require one or multiple surface restorations and 47.9 per cent would require at least one extraction. Restorative need was greatest in the 15 year olds. The severity of dental caries in this sample was moderately severe and the treatment need extraordinarily high.

Adolescent↗

PubMed2006

Oral health in postmenopausal Turkish women.

UNLABELLED: The most common condition affecting all women is menopause and most women spend one third of their lives after the menopause. Menopause is accompanied by a number of characteristic physical changes, some of which are manifested in the oral cavity. PURPOSE: The objective of this study was to evaluate the oral health status of a group of menopausal women who visited a menopause clinic in Ankara, Turkey. MATERIALS AND METHODS: A total of 348 women, aged 44-65 (mean 52.17+/-4.67), who spontaneously attended the menopause clinic at Hacettepe University Hospital, Ankara, Turkey, (between 1998 and 2000) were interviewed and examined by a trained dentist over a two-year period. Their oral status was determined by the same dentist by using the follwing indices on the basis of WHO criteria: Decayed, Missing and Filled Teeth (DMFT); Decayed, Missing and Filled Teeth Surfaces (DMFS); Root, Decayed, Filled (RDF); and Community Periodontal Index (CPI). Oral complaints and denture status was also assessed. The data were analysed by means of difference between groups. RESULTS: A total of 23% of the women were using hormones and 77% were not. The most significant symptom was oral dryness with 48.8% in the hormone users and 68.3% in the non-users (p < 0.05). A total of 36.3% of the hormone users and 39.5% of the non-users were edentulous (p > 0.05). DMFT, DMFS and CPI values of non-users were higher than the hormone users (p < 0.001). RDF values did not show any significant difference between hormone users and non users (p > 0.05). CONCLUSIONS: These data suggest that menopause might play a role in the oral status of women. The use of hormones seemed to affect oral health positively.

Adult↗

PubMed2000

Caries experience among publicly-funded dental patients in Australia, 1995-96: type of care and geographic location.

Health card holders are a financially disadvantaged group and are the target population eligible for publicly-funded dental care. While their health status is generally worse compared with other Australians, there is also considerable variation among card holders. The aims of this study were to describe the oral health status of publicly-funded dental patients by type of care, geographic location and age, and to compare trends over time against other Australian studies. Patients were sampled randomly, based on date of birth, by State/Territory dental services in 1995-96. Dentists recorded oral health measures at the initial visit of a course of care using written instructions, but there was no formal calibration. The 6109 patients sampled were weighted in proportion to the numbers of publicly-funded dental patients for each State/Territory. Multiple linear regression analysis indicated that caries experience measured by the DMFT index increased across older age groups (p < 0.05). For rural compared with urban patients, mean numbers of decayed and filled teeth tended to be higher. For emergency compared with non-emergency care, mean numbers of decayed and missing teeth were higher, and filled teeth lower. The findings of this monitoring survey document high levels of previous disease and treatment and indicate variation between subgroups of users of publicly-funded dental care. This included an uneven geographic distribution of oral health and disease, and variation in unmet treatment needs by type of course of care. Temporal comparisons indicate publicly-funded patients have experienced the population trend towards lower levels of tooth loss over time but have higher levels of untreated decayed teeth compared with the general population.

Adolescent↗