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PubMed1978

[Oral hygiene (author's transl)].

Appropriate oral hygiene is an essential and effective prophylactic measure against caries and periodontal disease. The most important aids for this purpose are suitable multi-tufted short-headed tooth brushes with suitable plastic bristles and suitable tooth-pastes. By means of a rational technique, as for instance the rotation method, teeth and gum margin should be systematically cleaned for at least three minutes if at all possible after every meal. A certain massage effect is exerted on the gingivae at the same time. All other aids to oral hygiene such as toothpicks, dental floss, interdental stimulators, mouthwashes etc. are only additional aids which certainly have their special indications.

Dental Caries↗

PubMed1980

An outbreak of acinetobacter infection associated with the use of a ventilator spirometer.

Although respiratory therapy equipment is a well-known source of nosocomial infection, ventilator spirometers have not been previously implicated. We report 17 Acinetobacter calcoaceticus variety anitratus infections traced to contaminated spirometers. Isolates from infected patients were recovered from urine, sputum, wounds, and blood. A review of attack rates for Acinetobacter was prompted by a dramatic increase in blood culture isolates. Prospective surveillance of intensive care environment, personnel, and patients established that Bennett MA-1 spirometers constituted the major reservoir of infecting organisms. Despite daily sterilization, 30% of spirometers in use were found to be contaminated. The hands of 12% of intensive care nurses and 10% of respiratory therapists cultured were found to be colonized. In addition to the infected patients, 28 other patients on spirometer-equipped ventilators were judged to be colonized by Acinetobacter following examination of sputa and/or mouthwashings. Following discontinuation of spirometer use and following increased emphasis on proper handwashing, the incidence of Acinetobacter infections dropped dramatically. Antibiosis in the intensive care environment and a deterioration in aseptic awareness serve to make Acinetobacter an environmental opportunist of increasing importance.

Acinetobacter Infections↗

PubMed1999

Changing trends in South Wales fluoride prescription dispensing (1993-7).

OBJECTIVE: To observe patterns of fluoride preparation dispensing by primary care practitioners in a health authority. DESIGN: Observational study. SETTING: The Prescription Pricing Agency of the Welsh Health Common Services Authority (WHCSA). SUBJECTS: Individuals who had exchanged a prescription for a fluoride preparation at a pharmacy in Bro Taf Health Authority in the six months from 1 January 1997 to 30 June 1997. METHOD: Information from each prescription including a fluoride preparation, passed to WHCSA from pharmacists during the study, was entered onto a database, including the prescriber's postcode and profession, the recipient's postcode and product information. Numbers of dental prescriptions were correlated to local levels of NHS primary dental care provision and caries prevalence data. Comparisons were made with a similar study undertaken in 1993. RESULTS: 415 dentists' prescriptions were dispensed within the area, of which 38.8% originated from five dentists. At least one prescription had been made by 89 of the 253 local primary dental care providers (35%). Within the area monitored in both 1993 and 1997, dental prescribing rates had almost halved. Of the 122 doctors' prescriptions that were dispensed over the six-month period, 98 were mouthwash preparations for adult patients and four were for children. CONCLUSION: NHS provision of fluoride supplementation was low and remained related to prescribing patterns of individuals rather than to evidence on local variations in dental caries prevalence.

Adult↗

PubMedDate not supplied

Antimicrobial activity of cavity disinfectants.

The purpose of this study was to determine the antimicrobial activity of four commercially available cavity disinfectants and one prescription mouthwash as they came into contact with bacteria commonly found in the oral cavity. Streptococcus mutans, salivarius, and Actinomyces viscosus were used in the study. Zones of microbial inhibition were measured in millimeters after 48 hours. The results of this study indicate that all of the antimicrobial agents demonstrated activity against the bacteria tested. Consepsis Solution produced the largest zones of inhibition against all three of the bacteria used.

Acid Etching, Dental↗

PubMed2001

[Critical pathway for the treatment of acute myelogenous leukemia].

Based on analysis of data from 10 patients newly diagnosed as having acute myelogenous leukemia (AML), we developed a critical pathway (CP) to prevent infection and thus shorten the period of hospitalization. This CP shows laboratory test results, vital signs, chemotherapy regimen, concomitant supportive care and oral medications, gargling with antiseptic mouthwash, other anti-infection measures, diet, room conditions, patient education in anti-infection measures, outcome, and variance on the vertical axis and time on the horizontal axis. After introduction of the CP, 9 of the newly diagnosed AML patients did not experience severe treatment-related complications during a mean hospitalization of 29 days until remission and 95 days until discharge. These results suggest that the present CP makes it possible to shorten the hospital stay, reduce treatment costs, and improve the quality of life of AML patients.

Acute Disease↗

PubMed2001

Adjunctive use of chlorhexidine in oral candidoses: a review.

Oral candidosis is by far the commonest human fungal infection and manifests in a variety of clinical guises. The main reason for its high incidence appears to be the multiplicity of predisposing factors, which facilitate the conversion of oral commensal Candida to a parasitic existence. Despite the availability of a number of effective antimycotics for the treatment of oral candidoses, failure of therapy is not uncommon owing to the unique environment of the oral cavity where the flushing effect of saliva and the cleansing action of the oral musculature tend to reduce the drug concentration to sub-therapeutic levels. For these and other reasons chlorhexidine is widely prescribed in dentistry both as an antiseptic mouthwash and a denture disinfectant in order to supplement other antifungals. Chlorhexidine has a broad spectrum of antimicrobial activity including Candida albicans and other common non-albicans yeast species. In this review we outline the utility of chlorhexidine as an adjunct to conventional antimycotic therapy in the management of oral Candida infections.

Anti-Infective Agents, Local↗

PubMed2001

Preventive dental care for children and adolescents.

Preventive dental care for children and adolescents requires a good understanding of the dental caries process and the particular relationships that exist throughout childhood and young adulthood. Only when these relationships are understood can they be used to diagnose dental caries risk and apply appropriate preventive therapies and restorative care that is effective. The need to diagnose risk when applying preventive care is as important for individual patients as it is for population groups. At the individual level, the aim is to aid the development of a healthy functioning dentition for life. This applies in the population group level but the cost benefits also become important in justifying the funding to carry out preventive practices. Risk can be determined by general factors including the socioeconomic status, access to optimally fluoridated drinking water and age. Specific factors include the microbiology of the dental plaque, dietary practices, oral hygiene practices, individual fluoride use and previous dental caries history. Once the risk has been diagnosed and the related factors identified, the best preventive approach can be selected. This may include oral hygiene, dietary change, fluoride recommendations, restorative care using fluoride releasing materials or antibacterial mouthwashes. The dentist may play several roles in preventive dental care. The first is as the giver of advice and care for the individual child patient; the second is as an advocate to help the child get the care by getting the consent and support of the parents; and the third may be to lobby for the appropriate funding to obtain this care in publicly funded programs.

Adolescent↗

PubMedDate not supplied

Oral-disease prevention in children with cancer: testing preventive protocol effectiveness.

UNLABELLED: Mucositis, gingivitis, herpetic stomatitis and candidiasis are a potential source of systemic infection in patients undergoing chemotherapy. Their severity and incidence may be reduced with procedures based on the prevention and elimination of sources causing oral infection and irritation. OBJECTIVE: The purpose of this investigation was to evaluate the effectiveness of an Oral Disease Preventive Protocol in children with cancer, subjected to chemotherapy and prior to application of dentobacterial infection control. MATERIAL AND METHODS: A controlled clinical test was run, with random assignations, on twelve 5-to-12-year-old patients diagnosed with Acute Lymphoblastic Leukemia (ALL) or Lymphoma, evaluated for twelve months, with a total of 154 evaluations. Five patients were boosted with oral physiotherapy, with non-alcoholic 0.05% fluoride mouthwashes, with topical application of myconazole oral gel; seven patients were given instructions on oral physiotherapy. RESULTS: There were no significant differences between the groups under evaluation (p>0.05). Of the oral complications evaluated, gingivitis registered the highest percentage (60%), followed by mucositis (18%) and candida albicans infection (7%). Most affected were the submandibular and cervical ganglions (59% and 41%, respectively). CONCLUSIONS: Prior control of sources causing oral infection and irritation effectively prevents complications during non-surgical cancer therapy.

Antineoplastic Agents↗

PubMed2001

[Dentistry in antiquity].

The Etruscan gold dental appliances to women of means were a remarkable start of the application of inserted teeth. The Romans that followed paid great attention to the dental system and the poet Martialis is one of the first Roman writers who speaks clearly of artificial teeth. Celcus, with his medical writings in eminent Latin, made a nice contribution to dental surgery and some of the prescriptions and remedies of Scribonius Largus were fairly effectual. Dioskorides distributed a most comprehensive pharmacological guide presenting a great number of medical applications - some related to teeth and gums. Plinius collected a celebrated encyclopaedia on medicine and natural science crammed with all sort of facts - some absurd. The passages concerning teeth and gums has thus got a miscellaneous description of current folklore and more reliable treatments. Galenos, after Hippocrates the greatest physician of ancient times, was a prolific writer. He produced medical reference books covering all medical branches that became authoritative for nearly two thousand years and the portions of dental treatments are detailed. The Romans had a widespread interest of mouth-care with toothpicks, mouthwashes, pain relieving remedies, the use of instruments and in some cases constructions of false teeth - but no real explanation of caries.

Dentistry↗

PubMed2002

[The preventive effect of allopurinol spray on stomatitis induced by anti-cancer drugs].

The present study was conducted to evaluate the effect of allopurinol spray on stomatitis induced by chemotherapy for esophageal cancer. The chemotherapeutics used consisted of 5-FU + CDDP (FC) given to 40 patients and 5-FU + ND (FN) given to 9 patients. Allopurinol solution for spray was prepared using a gelatin agent as base. The allopurinol spray was used 3-5 times daily before and after chemotherapy. The Japan Society for Cancer Therapy's criteria for stomatitis were used. With FN-therapy, no stomatitis was observed. With FC-therapy, 9 of 40 patients developed stomatitis of grade 1 (8 patients) or grade 2 (1). The incidence of stomatitis was 18.4% with all therapies and 22.5% with FC-therapy. The average graded toxicity was 0.20 for all therapies and 0.25 for FC-therapy. These results suggest that allopurinol spray is markedly effective for the prevention of stomatitis induced by chemotherapy. In addition, allopurinol spray is portable and convenient, and resulted in less nausea or vomiting than mouthwash.

Aerosols↗

PubMedDate not supplied

Evaluation of non-invasive treatment applied to occlusal surfaces.

The purpose of this study was to evaluate the efficacy of non-invasive methods of treatment for active incipent occlusal caries. Anamnesis, professional prophylaxis, and visual inspection were used to classify 250 Brazilian pre-school-children. First permanent decayed molars (n=98) from thirty-one subjects (6 years+ 6 months) were selected and divided into three groups. Group 1: fissure sealants with resin-modified glass ionomer - Vitremer (n=29); Group 2: fluoride varnish -Duraphat (n=36) and control group: tooth brushing and 0.2 percent NaF weekly mouthwashes (n=33). Four clinical evaluations were carried out over three, six, nine, and twelve months. Caries activity and progression were observed through clinical and radiographic evaluation. The results were analyzed by Fisher=s Exact test. After twelve months, the results showed 100 percent of arrestment of caries activity for Group 1, 83.3 percent for group 2, and 72.7 percent for control group. At the same time, the results showed 0 percent of caries progression for group 1, 5.5 percent for Group 2, and 6.1 percent for control group. Group 1 showed a better inactivation property than the other groups (p<0.05). There were no statistically significant differences in caries progression among these groups (p>0.05). It was concluded that this non-invasive methods were able to arrest the progression of occlusal caries, but fissure sealant showed better results in controlling caries activity.

Cariostatic Agents↗

PubMed2002

Dry mouth and nose in the older patient. What every PCP should know.

Dry mouth and dry nose are common complaints among the older population. Dry mouth can be attributed to medical conditions and other underlying causes, whereas dry nose is usually associated with age-related changes in nasal physiology and structure. In both cases, medications can contribute to dryness, so a proper evaluation includes a careful drug review. Management of dry mouth includes hydration and use of mouthwash, sugarless gum, candy, and saliva substitutes. Dry nose can be managed with nasal sprays that moisten the nasal cavity.

Aged↗

PubMedDate not supplied

Glass ionomer cements in pediatric dentistry: review of the literature.

Glass ionomer cement systems have become important dental restorative and luting materials for use in preschoolers, children and teenagers. These materials form chemical bonds to tooth structure, are biocompatible, release fluoride ions for uptake by enamel and dentin, and are able to take up fluoride ions from dentifrices, mouthwashes, and topically applied solutions. Unlike early glass ionomers, the new cement systems are easy and practical to use. Resin-modified glass ionomer cements not only have improved physical characteristics, but the photopolymerizable resin component reduces initial hardening time substantially. This article reviews the development and history of glass polyalkenoate cement systems and their ongoing role in dentistry for children.

Adolescent↗

PubMed1999

Effect of amine fluoride-stannous fluoride containing toothpaste (Meridol) on plaque and gingivitis in adults: a six-month clinical study.

Treatments that aim to reduce the accumulation of bacteria on dental surfaces are considered today as the most efficient way of treating gingivitis and the resultant destruction of periodontal tissues. Mechanical plaque removal was found to be very effective in the control of gingival inflammation for most patients, but the supplement of toothpastes and mouthwashes with anti-plaque properties may benefit individuals with unperfected plaque control. The aim of the present study was to investigate the long-term effect of amine fluoride/stannous fluoride (AmF/SnF2) toothpaste on plaque levels and gingivitis in adults, as an additional measure to standard oral hygiene. One hundred and three adult subjects with gingivitis were divided into two randomised groups. One group used NaF toothpaste (control) and the second group AmF/SnF2 (Meridol) toothpaste. The subjects were examined every two months under double-blind conditions. The recorded parameters were plaque index (PlI), gingival index (GI) and bleeding on probing. The differences in PlI between baseline and the end of the study were statistically significant for both treatments, and no significant differences were found between the two treatment groups. There was a significant drop in GI between baseline and the concluding examination only for the AmF/SnF2 group, but the differences between the two treatment groups were not significant. A significant reduction in the percentage of bleeding sites during the six-month study period was found in the AmF/SnF2 group, but not in the control group. The results of the present study suggest that the long-term use of AmF/SnF2 toothpaste in adults may be of benefit to gingival health.

Adult↗

PubMed2003

[Drug related taste disturbances: emphasis on the elderly].

BACKGROUND: Taste disturbances are common among the elderly due to physiologic changes, diseases, and medications. As many as 11% of elderly persons using multiple drugs report taste aberrations. The main danger of taste decline and disturbance in the old is food-anhedonia, causing loss of body weight via decreased calorie and nutrient intake. GOALS: To overview drug related taste disturbances emphasizing the elderly. METHODS: Review of Hebrew and English medical literature. RESULTS: Taste-disturbances can be divided into hypogeusia [diminished sense of taste], ageusia [absence of taste], and the 2 types of dysgeusia [taste distortion]: aliageusia [food related] and phantogeusia [taste illusions]. The mechanisms by which drugs impair taste are numerous, and may be related to drug chemical structure. The treatment of taste disturbances is empiric and has limited success. Treatments include: shifting drugs within the same class, zinc replacement (proven to enhance taste sensation for sweet, bitter and salty flavors), palliative measures (use of mints, sugarless chewing-gums, and bicarbonate mouthwashes), niacin and vitamin A ameliorate hypo and dysgeusia. CONCLUSIONS: Disturbed taste sensation is common among the elderly, and should be considered whenever unexplained nutritional decline is present. Scrupulous drug screening is mandatory, and other intervention modalities can be beneficial.

Aged↗

PubMed1992

Quantitation and morphotyping of Candida albicans from healthy mouths and from mouths affected by erythematous candidosis.

Imprint culture and a mouthwash method were used to determine if quantitative differences exist between isolates of Candida albicans from individuals with healthy oral mucosa and from patients with erythematous candidosis (EC). The C. albicans isolated were differentiated by morphotyping. No quantitative difference in yeast isolations was observed with either technique irrespective of tobacco smoking status, the presence of a prosthesis, or EC. Multiple morphotypes were isolated from smokers with upper dentures and from smokers and non-smokers with EC, whilst a single morphotype was isolated from non-smokers with a healthy oral mucosa.

Adult↗

PubMed2003

Dentistry in the British Isles.

This wide-ranging and in-depth study of dental practice in the British Isles reveals the origins and education of practitioners in the context of the political and economic background and that of their medical colleagues. The nature and costs of treatments offered are examined, as well as the marketing of other products such as toothache cures and mouthwashes. The significance of advertising, especially in connection with the need for migration and mobility of practitioners to secure a living is discussed. The second half of the chapter looks at individual practitioners in selected areas of England, Scotland and Ireland, the types of treatment they offered and their professional travels.

Dentists↗

PubMed1992

[Chewing gum and dental health. Literature review].

Clinical studies have demonstrated the caries promoting effects of sugar based gum when compared with non sugar chewing controls. Sucrose gum has been shown to stimulate plaque growth and increase its adhesivity. Acid produced in plaque and mixed saliva whilst chewing sugar gum is counteracted by the buffering action of mastication induced saliva. However the vast majority of studies measuring plaque pH has demonstrated acidification of plaque during use of sugar gum into the decalcifying zone (pH < or = 5.5), or after the gum is taken out. Sugar gum causes a more pronounced fall in plaque pH in individuals with an increased caries risk compared to the pH drop in more caries resistant individuals. Sorbitol, by itself or in combination with mannitol is slowly converted to acids by the plaque microorganisms. Chewing gums sweetened with these sugar alcohols do not cause a critical acidification of the plaque and appear not to promote caries in the clinical trial. Twelve weeks use of sorbitol chewing gum has been shown to induce a plaque more adapted to form acids from this sugar alcohol. This adaptation has been shown to persist for up to twelve weeks after cessation of the use of the sorbitol gum. Xylitol has generally been considered non-cariogenic because of its non-fermentability by most important plaque microorganisms. Plaque pH and pH of mixed saliva is increased during and following the use of xylitol based chewing gum. Prolonged use of xylitol or xylitol containing chewing gum reduces Streptococcus mutans counts in plaque and saliva, at the same time fostering remineralization of early caries lesions. Regular use of xylitol reduces the acidogenic potential of the plaque as well as its adhesiveness, at the same time increasing its mineral content. No adaptive changes in plaque metabolism resulting in the fermentation of xylitol have been reported, not even after long term, intense use. Xylitol chewing gum therefore is eminently suited to be used as part of a caries preventive regimen notably for high caries risk patients and those suffering from xerostomia. Adding mineral salts to sugar based chewing gum has been demonstrated to significantly inhibit caries development. Possible additional caries preventive benefits of mineral compounds added to sugar-free chewing gum have, so far not been reported. Sugar-free chewing gum has been shown to be an excellent vehicle for Fluoride. The plaque-growth retarding properties of Chlorhexidine-containing chewing gum have been shown to equal that of a Chlorhexidine mouthwash. Ureum added to a sugar-free chewing gum helps to neutralize plaque acids by liberating basic ammonia.

Adolescent↗