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PubMed1982

Caries increment in primary teeth after application of Duraphat fluoride varnish.

In order to evaluate the possible cariostatic effect of a fluoride varnish in the primary dentition, Duraphat varnish was applied twice yearly for 2 years to the teeth of 195 3 1/2-year-old children of both sexes attending nine preparatory schools in the Warsaw area. A control group of 127 children attending nine other preparatory schools was also examined. For each child a dmfs1 index (including "caries without macroscopic defect") and a dmfs2 index ("caries without macroscopic defect" excluded) were determined as well as a dmft1 and a dmft2 index. After 2 years the difference between the test and the control groups regarding the mean dmfs1 and dmft2 index increments was 9.39% (P greater than 0.1) and 24.09% (P less than 0.05), respectively. No significant differences were found, however, concerning the dmft2 and dmfs2 indices, the percentage children with new gingival caries, the number of teeth extracted on account of caries and the number of remaining teeth. A test group of 46 children treated with fluoride varnish in which a complete radiological examination could be carried out before and after the experimental period and which was treated with fluoride varnish was compared with a similar group of 27 children, which was not treated with fluoride varnish. The differences in caries increments were small, less than 15%, and were not significant. Taking into consideration the great variation between the schools it was concluded that the cariostatic effect of Duraphat application twice yearly in the primary dentition of these children was slight.

Child, Preschool↗

PubMedDate not supplied

Comparison of diagnostic methods for dental caries.

PURPOSE: The purpose of this study was to compare results of 4 different methods of diagnosing dental caries in 12-year-old children by evaluating their influence on the DMFS index and analyzing the correlation of the radiographic exam with the clinical exam. METHODS: The tools used were: 1) dental mirror; 2) dental mirror and dental explorer, both performed in an outdoor setting under natural light; 3) dental mirror; 4) dental mirror and dental explorer, both performed in a traditional dental setting under artificial light. The radiographic exam was carried out after the clinical exam. RESULTS: The dental explorer may be omitted from the clinical exam in epidemiological surveys and in clinical exams performed in dental offices. Methods 3) and 4) performed better in diagnosing dental caries than methods 1) and 2), which underestimated decay. CONCLUSIONS: In the traditional dental setting, the process of dental cleaning and drying as well as artificial light, improved the diagnosis of dental caries. The radiographic exam used for epidemiological surveys, in relation to method 2), improved the clinical exam by 4%.

Child↗

PubMed2006

The efficacy of a school-based caries preventive program: a 4-year study.

This longitudinal study aimed at testing the efficacy of a school-based caries preventive program, by comparing dental caries status of two groups, a study group (436 children) and a control group (420 children) over a period of 4 years. The study group received a preventive program which consisted of intensive oral hygiene instructions sessions, and supervised daily tooth brushing using fluoridated tooth paste in schools. The control group received only oral hygiene instructions sessions. Annual dental examination to record dental caries status, using Decayed Missed Filled Teeth Index (DMFT) and deft, was conducted for both groups over a period of 4 years. At the end of the fourth year the efficacy of the program was tested by comparing the DMFT and deft indices for the two groups using Pearson chi-square test and Cochran-Mantel-Haenzele test. The level of significance was set at P < 0.05. The results after 4 years showed that the caries status of the children in the study group was better than that of the control group. The difference was statistically significant (P-value 0.001). The estimates of relative risk values also showed that children in the control group are 3.1 and 6.4 times at higher risk of having dental caries than those in the study group for age group 12 and 6 respectively. This study proves that supervised daily tooth brushing using fluoridated toothpaste is successful in controlling dental caries in children.

Cariostatic Agents↗

PubMed2000

Dental and periodontal status of Sjögren's syndrome.

BACKGROUND: Sjögren's syndrome (SS) is one of the most common systemic autoimmune diseases in middle-aged women. The present study had the aim to examine the dental and periodontal condition in patients with SS in comparison with disease controls and to evaluate the influence of reduced salivary flow in the periodontal tissues. METHOD: We examined 24 patients with primary or secondary SS in comparison with 27 patients who had another autoimmune disease but no signs or symptoms of SS, as well as with 29 subjects who had a subjective feeling of xerostomia or xerophthalmia without exhibiting an underlying disease. The clinical evaluation included examination of the oral mucosa, determination of missing, decayed and filled teeth, fixed or removable prosthetic appliances, plaque index, gingival index, probing pocket depth, probing attachment level, oral hygiene habits and frequency of dental visits. Statistical analysis was performed using the 2-tailed Fisher exact and Kruskal-Wallis tests. RESULTS: No significant difference was found in the dental or periodontal condition of the 3 groups. The number of teeth, feelings and distal or mesial decay lesions correlated negatively with age, while the number of fixed prosthetic appliances correlated positively. The salivary flow was statistically lower in patients with SS and exhibited a negative correlation with the number of cervical decay lesions. It was also found that SS patients had better oral hygiene habits than subjects of the control groups. CONCLUSIONS: No significant,difference could be detected concerning the dental and periodontal status of SS patients, compared with that of patients with other immune diseases as well as with that of controls who had subjective xerostomia.

Age Factors↗

PubMed1999

[Utilization of dental services--results of an oral hygiene study in Saxony].

The utilisation of dental services is a precondition for professional preventive measures. The representative oral survey "Bevölkerungsrepräsentative Studie zum zahnärztlich-prothetischen Versorgungsgrad und Behandlungsbedarf" aimed at gaining data on the frequency and motives for dental visits and the existence of barriers. The sample consisted of 714 subjects aged fifteen years and older. It was representative for the German Federal State Saxony. Socio-economic and behavioural data were collected via self-completed questionnaire. The caries history was evaluated by assessing the DMFT Index. Data collection in 1996 was carried out by three calibrated dentists. Utilisation of dental services was found to be high. Subjective barriers played no crucial role in the decision to utilise dental services. Costs as an objective barrier to dental visits had a growing importance with age. Lower rates of tooth loss and enhanced levels of restoration were found in subjects aged over 24 years who regularly utilised dental services compared to subjects with non-regular utilisation. These differences were significant for subjects over 54 years (tooth loss) and subjects aged 25-44 years and over 54 years (level of restoration). Compared to previous studies the utilisation was similar or higher in our sample. The enhanced oral health belief paves the way for professional preventive measures. In the over 64-year-olds the need for regular dental visits was obvious and this age group must definitely be given more relevant information on the subject.

Adolescent↗

PubMed2005

A prospective, randomized clinical study on the effects of an amine fluoride/stannous fluoride toothpaste/mouthrinse on plaque, gingivitis and initial caries lesion development in orthodontic patients.

The aim of this study was to examine the effect of combined use of a toothpaste/mouthrinse containing amine fluoride/stannous fluoride (AmF/SnF2; meridol) on the development of white spot lesions, plaque, and gingivitis on maxillary anterior teeth in orthodontic patients. A prospective, randomized, double-blind study with 115 orthodontic patients (42 males and 73 females, average age 14.4 years, drop outs 18) was designed. Group A (50) brushed twice daily with an AmF/SnF2 toothpaste (1400 ppm F) and rinsed every evening with an AmF/SnF2 solution (250 ppm F). Group B (47) brushed twice daily with a sodium fluoride (NaF) toothpaste (1400 ppm F) and rinsed every evening with a NaF solution (250 ppm F). Visible plaque index (VPI), gingival bleeding index (GBI) and white spot lesion index (WSL) were recorded on the six maxillary anterior teeth at bonding and after debonding, and evaluated with t tests. In group A no significant differences between bonding and debonding were recorded for WSL (1.02 +/- 0.08 versus 1.05 +/- 0.13, P = 0.14), VPI (0.10 +/- 0.21 versus 0.12 +/- 0.21, P = 0.66) or GBI (0.13 +/- 0.21 versus 0.16 +/- 0.22, P = 0.47), whereas statistically significant differences were found in group B between bonding and debonding for WSL (1.00 +/- 0.02 versus 1.08 +/- 0.17, P = 0.01), VPI (0.06 +/- 0.13 versus 0.17 +/- 0.25, P = 0.01) and GBI (0.06 +/- 0.12 versus 0.16 +/- 0.21, P = 0.01). The increase in lesions on the upper anterior teeth was 4.3 per cent in group A and 7.2 per cent in group B. It was concluded that the combined use of an AmF/SnF2 toothpaste/mouthrinse had a slightly more inhibitory effect on white spot lesion development, plaque and gingivitis on maxillary anterior teeth during fixed orthodontic treatment compared with NaF.

Adolescent↗

PubMed2004

Changes in caries experience among Australian public dental patients between 1995/96 and 2001/02.

OBJECTIVE: Health Card holders are a financially disadvantaged group and are the target population eligible for public-funded dental care. The aims of this study were to describe the oral health status of public-funded dental patients by age, sex, type of care and geographic location, and to compare trends over time. METHODS: Patients were sampled randomly by State/Territory dental services in 1995/ 96 and 2001/02. Dentists recorded oral health status at the initial visit of a course of care using written instructions. The samples were weighted in proportion to the numbers of public-funded dental patients for each State/Territory. RESULTS: Multiple linear regression analysis indicated that caries experience measured by the DMFT index increased across older age groups (p<0.05). For male compared with female patients mean numbers of decayed teeth were higher (beta=0.74), and filled teeth lower (beta=-1.16). For emergency compared with general care, mean numbers of decayed and missing teeth were higher (beta=0.52 and beta=0.76), and filled teeth lower (beta=-1.08). For major city compared with regional/remote patients, mean numbers of decayed (beta=-0.35) and missing teeth were lower (beta=-0.34). Between 1995/96 and 2001/02 numbers of decayed teeth were higher (beta=0.81) while numbers of filled teeth were lower (beta=-0.55). CONCLUSIONS: There was variation in oral health among public dental patients by sex, type of care and location, and there was a trend towards lower numbers of filled teeth but higher numbers of decayed teeth and higher overall caries experience over time. IMPLICATIONS: Despite population trends towards improved oral health, levels of untreated decayed teeth have increased among public dental patients.

Adolescent↗

PubMed2000

Evaluation of school-based dental health activities including fluoride mouth-rinsing in Hiraizumi, Japan.

School-based dental health activities conducted in Hiraizumi over the past 20 years have remarkably improved the dental health status of schoolchildren. For example, DMFT index of 12-year-old children decreased to 1.5 in 1998, one-half that of the national average. School dental health activities, which were focused on dental health education, resulted in an increase of filled teeth rates, a decrease in the number of missing teeth, and a decline in incisor caries (1979-1986). In addition, the introduction of a school-based fluoride mouth-rinsing program (1986 - ) showed a positive effect on the prevention of dental caries; a significant decrease was observed in the overall prevalence of dental caries, particularly in the molars. In Japan it seems advantageous to promote the dental health of schoolchildren by school-based programs that combine dental health examination, dental health education and fluoride mouth-rinsing program. Especially, to prevent dental caries in the mandibular first molars more effectively, it is recommended to start fluoride mouth-rinsing at age 5.

Adolescent↗

PubMed2004

Dental injury among Brazilian schoolchildren in the state of São Paulo.

To describe the distribution of dental trauma in Brazilian schoolchildren and its association with demographic, environmental and clinical factors. A random sample of 73 243 schoolchildren's oral examination records from private and public units, selected from 131 cities within the state of São Paulo, Brazil, was analysed. Trauma was assessed based on international methodological standards prescribed by the World Health Organization for Oral Health Surveys (1997). Proportions obtained were compared between urban and rural schools, as well as between private and public units. Oral health status indices were estimated based on the decayed, missing and filled teeth (DMFT) index - the average number of decayed, missing and filled teeth; the proportion of caries-free 5-year-old schoolchildren and anterior maxillary overjet among 12-year-old schoolchildren. The prevalence of dental trauma in anterior dentition was of 2.4, enrolling average 1.2 teeth per child. A rate of 2.4 impaired anterior teeth per thousand was obtained, upper central incisors being those that were most affected - 7.7 in every 10. Among 8- to 11-year-old children, the rates grew regularly. The proportion of dental trauma was significantly higher in boys than in girls (P < 0.01), and gender prevalence ratio was of 1.58 for boys. The results showed positive associations between dental trauma and caries-free 5-year-old schoolchildren (P = 0.003), anterior maxillary overjet > or =3 mm (P < 0.001), and private school as a socio-economic proxy indicator (P = 0.048).

Age Factors↗

PubMed2003

Dental caries and fluorosis in low- and high-fluoride areas in Turkey.

OBJECTIVE: The aim of this study was to investigate the caries prevalence of children living in either low- or high-fluoride areas and to relate caries experience to the severity of dental fluorosis. METHOD AND MATERIALS: A total of 278 12- to 14-year-old schoolchildren, 149 in a low-fluoride area (LFA) and 129 in a high-fluoride area (HFA), were included in the study. The naturally occurring fluoride concentrations in the drinking water were 0.30 to 0.40 ppm in the LFA, 1.42 to 1.54 ppm in the HFA1, and 1.55 to 1.66 ppm in the HFA2. Dental caries was recorded with the World Health Organization criteria, and dental fluorosis was measured using the Tooth Surface Index of Fluorosis. RESULTS: The percentages of children who had an average TSIF > or = 1 were 0%, 29%, and 77% in the LFA, HFA1, and HFA2, respectively. The mean decayed, missing, and filled permanent teeth (DMFT) and decayed, missing, and filled permanent surfaces (DMFS) were 0.84 +/- 0.98 and 1.58 +/- 2.24 in LFA, 1.30 +/- 1.46 and 1.78 +/- 2.52 in HFA1, and 1.26 +/- 1.42 and 1.97 +/- 2.60 in HFA2, respectively. There was no significant difference in caries prevalence among children living in low- and high-fluoride areas when evaluated with an analysis of covariance model, including the frequency of toothbrushing. Toothbrushing frequency had a significant effect on the decayed teeth, decayed surfaces, DMFT, and DMFS. In high-fluoride areas, there was no relationship between caries prevalence and severity of fluorosis. CONCLUSION: Increasing water fluoride levels were associated with higher prevalence and severity of dental fluorosis and had no influence on caries experience in children with poor oral hygiene.

Adolescent↗

PubMed1998

Oral hygiene as a risk indicator of enamel and dentin caries.

UNLABELLED: Dental researchers have postulated that the risk factors for enamel and dentin caries may not be the same. A review of the literature ascertained that data to support this theory are lacking. OBJECTIVES: To evaluate the risk indicators of enamel and dentin caries of the permanent dentition in a study group who had limited access to fluorides and made limited use of dental services. METHODS: The study was conducted in Goa, India. Data came from a cross-sectional survey of 1189 seventh grade children, which consisted of a clinical dental examination and a self-administered questionnaire to their parents. The cavitated and non-cavitated criteria were used to score for caries, and the Silness-Loe index for plaque. RESULTS: The mean age of the children was 12.2 years. The percentage of children caries free in the permanent dentition was 22.2%, the mean+/-s for dmfs, enamel and dentin lesions were 4.20+/-5.10, 2.59+/-2.89 and 1.61+/-3.30 respectively, and the mean plaque score was 1.00+/-0.48. Results of regression analyses showed that the risk indicators of prevalence and severity of caries differed depending on lesion type. The only variable that was consistently a risk indicator of presence and severity of both dentin and enamel caries was poor oral hygiene. Mother's highest level of education and presence of fluorosis were also risk indicators of enamel and dentin caries. The presence of decayed primary teeth was a risk indicator of enamel caries; and fluorosis severity, use of fluoride toothpaste at the time of the survey, and toothbrushing frequency were risk indicators of dentin caries. The observed caries-oral hygiene association seen is explored further.

Cariostatic Agents↗

PubMed1995

Caries prevalence and patterns in 3-6-year-old Beijing children.

A total of 400 Beijing children, 3-6-yr-old, equally distributed by age and sex, were examined for dental cares. Results were analyzed with the traditional dmfs/t index and with the Caries Analysis System. The system differentiated between caries patterns and examined the percentage of affected children (Prevalence), the degree to which these children were affected (Severity), and the proportion of total caries each disease pattern represented (Distribution). Over 67% of the children experienced caries, a level comparable to other reports from China and other developing countries, but 50% greater than those seen in United States preschool children. Nearly all children with caries experienced fissure caries. In 3-yr-olds maxillary anterior caries was the next most prevalent pattern with 43% affected, whilst in the 6-yr-olds, posterior proximal caries was the second most prevalent pattern with 68% affected. Since maxillary anterior caries was so prevalent, and because the presence of this pattern has been shown to be a risk factor for future caries, preventing the maxillary anterior pattern may markedly reduce caries in this population.

Age Distribution↗

PubMed1996

Prevalence of incisor trauma in persons 6-50 years of age: United States, 1988-1991.

Traumatic injuries to the teeth are among the most serious of dental conditions, yet little is known about the prevalence of tooth or dental trauma at the national level. The National Institute of Dental Research (NIDR) modified existing indices for specific use in national epidemiologic studies of tooth trauma among both children and adults. The NIDR index was developed not only to track the status of the tooth from sound (no evidence of trauma) through missing due to trauma, but also to reflect selected sequelae of trauma. The index is based on clinical, non-radiographic evidence of tooth inujury and treatment received in the eight permanent incisors, including a positive history of injury obtained from the subject. The trauma assessment index was applied immediately following the caries examination for dentate participants ages 6-50 years old (n=7,707) in Phase 1 of the NHANES III oral examination. This article reports the first national overall and age-specific population-based prevalence of dental trauma among gender, racial, and ethnic groups. There is a higher prevalence of incisal trauma, of both maxillary and mandibular incisors, in males than females, in both the younger and older age groups. The prevalence of incisal trauma of both maxillary and mandibular incisors in whites and blacks in both younger and older age categories is similar. The study found that half of the individuals with trauma had only one incisor tooth classified as having trauma. Males and older age groups showed larger numbers of traumatized teeth. Further study and examination of methodological issues are desirable for additional understanding of incisal trauma in the general population .

Adolescent↗

PubMed2005

Efficiency of a schoolchildren program for oral care.

The aim of this investigation was to evaluate the efficiency of an oral school program, applied during 3 years. DMFT index, the component D and CTNI of a sample of 590 children (Group I, aged 12.0 +/- 1.1 years) which received regular oral treatment during 3 consecutive years were compared with the same indicators of 586 children (Group II, aged 12.6 +/- 1.0 years) without treatment. The cost-benefit ratio of the current required treatments in both groups was calculated. Results revealed: (a) in Group I the component D of DMFT was 0.9 +/- SEM = 0.3, and in Group II, 5.5 +/- SEM = 1.5; and (b) the cost-benefit ratio of the required treatment for Group I ranged from 1.5 to 7.5 times lower than that required for cumulative pathology resolution in groups lacking preventive coverage. It seems advisable to introduce management strategies to change spontaneous demand into programmed care with a strong preventive component. The accomplishment of this regular school program appears to contribute to strengthen equity and could reduce the differences in oral health care among schoolchildren at different social risk.

Child↗

PubMed2003

Oral health condition in southern Chinese after radiotherapy for nasopharyngeal carcinoma: extent and nature of the problem.

OBJECTIVE: To measure the oral health status of southern Chinese nasopharyngeal carcinoma (NPC) survivors 1-4 years after radiotherapy. SUBJECTS AND METHODS: A total of 109 subjects participated in this cross-sectional study. Thirty-eight subjects were NPC survivors, 40 subjects were patients newly diagnosed with NPC and 31 were healthy subjects. Verified clinical examination techniques were used to assess limitation of jaw opening, the presence of mucositis, candidiasis, dental caries, periodontal disease [community periodontal index (CPI)] including attachment loss (ALoss) and prosthetic status/need. Differences among three groups were tested by chi-squared and Kruskal-Wallis tests. Relationships between selected clinical variables and radiation parameters were analysed using Spearman's rank correlation coefficients. RESULTS: The NPC survivors attended for dental treatment more frequently than the other groups (P < 0.01). NPC survivors had significant xerostomia (92%, P < 0.01), trismus (29%, P < 0.01), a higher prevalence of clinical candidiasis (24%, P < 0.01), a greater DMFT (16.4 +/- 7.0, P < 0.01), more decay/filled roots (2.1 +/- 2.9, P = 0.01) compared with new NPC patients and controls. No difference was found in CPI, ALoss, prosthetic status and need between groups. Dry mouth and tooth hypersensitivity were the most common oral problems perceived by the NPC survivors. CONCLUSION: Despite having regular dental follow-ups, oral health was compromised in NPC survivors 1-4 years postradiotherapy.

Candidiasis, Oral↗

PubMed1997

Caries prevalence and treatment needs of 7- to 10-year-old schoolchildren in southwestern Germany.

The caries status of 1784 children aged 7 to 10 years was examined in a cross-sectional, epidemiological study in the Rhine-Neckar-District. Results showed that 30.5% of the children had caries-free primary and 65.2% had caries-free permanent teeth. The d(m)ft index was 2.68, and the D(M)FT averaged 0.76. As in previous studies, a high risk caries group was found, with 10% of all children showing more than 50% of all carious and filled teeth in the permanent dentition. Overall, 45.6% of the children's primary teeth and 16.3% of their permanent teeth needed treatment. As indicated by higher dt:ft (DT:FT) ratios in younger age groups, dentists preferred treating older children. Apart from a higher caries prevalence in primary teeth in males, no significant sex differences were found. Children of rural origin had a higher caries experience. The results confirm previous data showing considerable improvements with a declining caries experience in the young population. But the caries status of German pre-teenage children is still moderately high according to WHO criteria. For further improvements, considerable efforts have to be made with special emphasis on prevention in high risk caries groups.

Age Factors↗

PubMedDate not supplied

[Prevalence of dental caries, gingivitis and periodontal disease in pregnant diabetic women].

OBJECTIVE: To determine the difference in the prevalence of dental caries, gingivitis, and periodontal disease among non-diabetic, type-II diabetic and pregnant diabetic women. MATERIAL AND METHODS: In the period from June 1993 to January 1994, a cross-sectional study was carried out at the Instituto Nacional de Perinatología among 160 pregnant women; eighty non-diabetic women were included in the control group, while 40 type-II diabetic and 40 gestational diabetic women conformed the study group. In each patient the following variables were recorded: age, week of pregnancy, the Simplified Oral Hygiene Index, the Decayed, Missing and Filled Teeth Index, the Gingival Index, and the Extent and Severity Index. Statistical analysis was carried out using Analysis of Variance and the Multiple Range Test, with a 95% confidence internal. RESULTS: All of the groups had similar prevalences of dental caries (100%). Type-II diabetic women showed a higher prevalence of gingivitis (42.5%) than non-diabetic (36.25%) and gestational diabetic (10%) women, but the differences were not statistically significant between the non-diabetic and type-II diabetic women. Type-II diabetic women had a statistically significant higher prevalence of periodontal disease (12.5%) than the women in the other groups. CONCLUSIONS: It is very important to establish proper metabolic control and a fitting oral hygiene in pregnant diabetic women, since type-II diabetes was shown to be associated with a higher prevalence of periodontal disease. Besides, gestational diabetes is likely to pose a high risk of periodontal disease in the absence of preventive measures.

Adult↗

PubMed2001

Influence of repeated chlorhexidine varnish applications on mutans streptococci counts and caries increment in patients treated with fixed orthodontic appliances.

The occurrence of new carious lesions is among the most detrimental side effects in subjects undergoing orthodontic therapy with fixed appliances. The present study evaluated the efficacy of repeated applications of a 40% chlorhexidine varnish in this patient group with regard to long-term suppression of elevated mutans streptococci levels and the frequency and location of new carious lesions. Thirty-three prospective orthodontic patients age 11 to 18 harboring more than 10(5) mutans streptococci per ml saliva at the initial examination participated in the study. At baseline the previous carious involvement in each subject was recorded using the DMFS index, and extensive information on caries prevention was given. Using a random assignment 18 subjects were included in the test group while the remaining 15 subjects were assigned to the placebo group. From the time of banding until removal of the fixed appliances (median: 21 months) salivary mutans streptococci counts were recorded once every 8 weeks in both groups. At the same appointments all teeth and introaral appliances in the test group were coated with a 40% chlorhexidine varnish. Subjects in the placebo group were treated in the same way, using a placebo varnish with the same varnish base. After debanding, the DMFS score of each participant was recorded again. Analysis of the data revealed that mutans streptococci counts in the test group were only temporarily suppressed and were restored almost to baseline levels by the end of the study. In both groups a clinically relevant increase in the average DMFS score was recorded. Inter-group differencies were not significant.

Adolescent↗