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PubMed1989

Effect of different carriers preventive measures in children highly infected with mutans streptococci.

The caries preventive effect of topical application of fluoride varnish (Duraphat), ferric-aluminum-fluoride solution (FeAlF) and chlorhexidine gel was compared in 2-yr clinical study. Children with more than 10(6) mutans steptococci per ml saliva were selected and a total of 189 13-yr-old children participated in the study. The children in the fluoride groups were treated every third month with either Duraphat or FeAlF-solution. In the chlorhexidine group children with more than 2.5 x 10(5) mutans streptococci per ml of saliva were treated every third month. The mean number of new decayed and filled tooth surfaces was 3.06 in the chlorhexidine group, 5.88 in the Duraphat group, 5.33 in the FeAlF group, and 6.34 in the control group. Thus supervised antimicrobial treatment can significantly reduce the incidence of dental (caries) in children with high numbers of mutans streptococci.

Adolescent↗
PubMed1991

On the prevention of caries and periodontal disease. Results of a 15-year longitudinal study in adults.

In 1971-72, a total of 375 adult subjects were recruited for a clinical trial aimed at assessing the effect of a preventive program, based on plaque control and topical application of fluoride, on the incidence of caries and periodontal disease. After a baseline examination, the volunteers were subjected to scaling, root planning and conventional caries therapy. During the course of the subsequent 6 years, they were recalled for preventive measures once every 2-3 months. After the 6-year follow-up examination, however, it was decided to extend the interval between the preventive sessions. Thus, during the next 9-year period, about 95% of the participants returned for preventive measures only 1 to 2 times per year. A small subgroup of about 15 subjects, who, during the initial 6 years had developed new caries lesions or had exhibited additional periodontal attachment loss, however, were also during the following 9 years recalled 3-6 times per year for oral hygiene control and preventive therapy. The re-examination performed in 1987 disclosed that the 317 subjects, who participated during the entire 15-year period, had a low incidence of caries and almost no further loss of periodontal tissue support. It was suggested that improved self performed oral hygiene, daily use of fluoridated dentifrice and regularly repeated professional tooth cleaning effectively prevented recurrence of dental disease.

Adult↗
PubMed1992

Assessment of quality of public oral health care on the basis of patient records.

The quality of public oral health care, especially the quality of preventive treatment in relation to patients' oral health, was investigated. The population studied consisted of 367 subjects representing the 15-yr-olds living in Helsinki in 1986. Data were taken from the patients' oral health charts, obtained from municipal dental clinics. Clinical examination of the teeth and periodontium had been adequately documented in 98% of cases. In 84% of cases, status recordings matched those recorded previously. Preventive treatment, on the whole, seemed insufficient and stereotyped. Of all patients 55%, and of those in high risk groups only 57 congruent to 60% had had a topical application of fluoride at least once during treatment. Periodontal treatment was insufficient and did not correlate with recorded clinical findings. The results indicate that the concept of prevention and its selective use had not been fully adopted as routine.

Adolescent↗
PubMed1987

A 30-month longitudinal study of the effects of some oral hygiene measures on Streptococcus mutans and approximal dental caries.

The effects of some oral hygiene measures on Streptococcus mutants and approximal dental caries were evaluated. One hundred and eighty-seven 13-year-old individuals with high levels of salivary S. mutans (greater than 10(6)/mL) were selected. They were randomly distributed into three groups. Group I initially received professional mechanical tooth-cleaning, tongue-scraping, chlorhexidine treatment, and oral hygiene instructions concentrated on the approximal surfaces most colonized by S. mutans. The treatment was given four times with intervals of two days, followed by one single treatment every six months throughout the experimental period. The initial treatment period for group II, also consisting of four visits, included the same oral hygiene instructions as for group I. The instructions were repeated every six months. Group III was maintained in the preventive program provided by the local Dental Health Office, based on mechanical plaque control and topical use of fluorides and chlorhexidine at individualized intervals. Group I showed a significant immediate reduction of S. mutans in saliva as well as an approximal tooth surfaces. After six months, there were no differences among the three groups regarding these variables. Compared with baseline, there was a significant reduction of S. mutans in all groups. There was no significant difference in caries progression among the three groups. However, the selected "high-risk" individuals in group I developed 0.25 new manifest caries lesions approximally/year, compared with 0.27 for all children of the same age group in the area. Seventeen individuals had approximal surfaces with consistently high or consistently low S. mutans levels. Forty-six percent of the surfaces with high values developed new or progressive caries, compared with 2% of the surfaces with low values.

Adolescent↗
PubMed1996

Current treatment modalities of oral problems of patients with Sjögren's syndrome: caries prevention.

Prevention of dental caries in patients with hyposalivation due to Sjögren's syndrome requires increasing host resistance and decreasing cariogenic organisms and their substrate. Although plaque control by scrupulous oral hygiene is important, particularly from a periodontal perspective, and restriction of dietary sucrose intake can limit caries, the most successful therapeutic and preventive measure has been the topical application of fluoride to the tooth surface, by the dentist, dental hygienist, dental auxiliary, and the patient. Studies on schoolchildren with normal salivary function who used fluoride dentifrices have shown that efficacy in caries prevention depends on (1) the concentration of fluoride used, (2) the frequency with which it is applied, and, to a certain extent, (3) the specific fluoride compound used. Controlled clinical studies are lacking, however, on patients with hyposalivation due to Sjögren's syndrome, and only limited data are available from patients with radiation-induced hyposalivation. Obviously it is not possible to run placebo control groups; nevertheless, there have been no head-to-head comparisons of fluoride rinses, or of stannous fluoride, acidulated phosphate fluoride, or sodium fluoride gels, and thus no single protocol can be recommended. Accordingly, different centers have used these products interchangeably--for example, selecting a rinse regimen if patients complain of gagging when using a gel applied in a tray, or if the cost of the tray is prohibitive. Recent innovations that show promise for treatment of high-caries-risk patients with hyposalivation are the use of fluoride rinses in combination with chlorhexidine rinses or gels and the professional application of high-concentration chlorhexidine varnishes to the teeth.

Cariostatic Agents↗
PubMed1989

The prevalence of fluorosis-like lesions associated with topical and systemic fluoride usage in an area of optimal water fluoridation.

The frequency of using self-applied (over-the-counter) fluoride products and prescribed supplemental fluorides, and the prevalence of fluorosis-like enamel lesions in the permanent dentitions of children living in an optimally fluoridated urban community were investigated. Subjects were selected randomly, and consent forms and questionnaires concerning fluoride usage and residency status were provided to guardians prior to examination. After a supervised tooth brushing event, 300 consenting subjects were examined by the principal investigator using Dean's index to assess levels of fluorosis-like lesions. The principal investigator was standardized with another investigator prior to the examinations to obtain an interexaminer agreement level of 97%, and an intraexaminer agreement level of 96%. Portable dental equipment was used during all examinations. Chi-square analysis indicated no statistically significant difference between the frequency of tooth brushing with a fluoridated dentifrice at an early age and the prevalence of fluorosis-like enamel lesions. However, there was a significant difference (P less than 0.05) between the prevalence of fluorosis-like lesions, and the frequency of using prescribed fluoride supplements and gels, and over-the-counter rinses.

Adolescent↗