Inhibitory activity of garlic (Allium sativum) extract on multidrug-resistant Streptococcus mutans.

J Indian Soc Pedod Prev Dent. 2007 Oct-Dec;25(4):164-8

Authors: Fani MM, Kohanteb J, Dayaghi M

Garlic ( Allium sativum ) extract has been known to have inhibitory activity on various pathogenic bacteria, viruses and fungi. The objective of present investigation was to study in vitro inhibitory activity of garlic extract on multidrug-resistant (MDR) strains of Streptococcus mutans isolated from human carious teeth. Filter sterilized aqueous extract of garlic was prepared and used in the present study. For isolation of S. mutans , extracted human carious teeth were cultured in Todd-Hewit broth and Mitis-Salivarius-Bacitracin agar. S. mutans was characterized by colony morphology, biochemical tests and other conventional bacteriological procedures. Disk sensitivity tests and broth dilution methods were used to determine antibiotic sensitivity profile and inhibitory activity of garlic extract on S. mutans isolated from carious teeth. Of 105 carious teeth tested, 92 (87.6%) isolates of S. mutans were recovered, among which 28 (30.4%) were MDR since they were resistant to four or more antibiotics. The highest rate of resistance was observed for tetracycline (30.4%) and least resistance (0%) to teichoplanin and vancomycin while 22.8% and 23.9% of the isolates were resistant to penicillin and amoxicillin, respectively. Chlorhexidine minimum inhibitory concentration (MIC) for MDR and non-MDR S. mutans varied from 2 to 16 microg ml-1 and from 0.25 to 1 microg ml-1 , respectively ( P S. mutans were sensitive to garlic extract with the MIC ranging from 4 to 32 mg ml-1 . Considering in vitro data obtained in the present study, mouthwashes or toothpaste containing optimum concentration of garlic extract could be used for prevention of dental caries.

PMID: 18007101 [PubMed - in process]

Comparison of antibacterial properties of two fluoride-releasing and a nonfluoride-releasing pit and fissure sealants.

J Indian Soc Pedod Prev Dent. 2007 Jul-Sep;25(3):133-6

Authors: Menon Preetha V, Shashikiran ND, Reddy VV

Occlusal pits and fissures are the most susceptible sites for the development of dental caries and prevention is difficult in the areas of occurrence. Although only 12.5% of all the tooth surfaces are occlusal, these surfaces develop more than two-thirds of total caries experienced by children. The fate of the bacteria is of significance when they are inadvertently sealed by a dental sealant. This study aimed in examining the antibacterial properties of three commercially available sealants, viz., Teethmate-F, Helioseal-F and Helioseal. Antibacterial testing was done by disc diffusion method. Selective agars were used to grow Streptococcus mutans and Lactobacillus acidophilus, which are implicated in the pathogenesis of dental caries. Statistical analysis was carried out using student's t test. The study proved that Helioseal-F and Helioseal did not possess antibacterial properties and Teethmate-F was the only sealant that showed antibacterial properties.

PMID: 17951930 [PubMed - in process]

Retention of three fissure sealants and a dentin bonding system used as fissure sealant in caries prevention: 12-month follow-up results.

Med Oral Patol Oral Cir Bucal. 2007 Oct;12(6):E459-63

Authors: Baca P, Bravo M, Baca AP, Jiménez A, González-Rodríguez MP

BACKGROUND: Bonding agents could be used as fissure sealants. This study compares the retention three fissure sealants (Delton, Delton Plus and Concise) and a filled dentin bonding system (Optibond Solo). METHODS. Fifty-six children aged 7-8 years received fissure sealants either in the four permanent first molars, in the four deciduous second molars, or in all eight of these teeth. Every child received a different sealing material in each quadrant on a random basis. Clinical evaluation at 12 months was performed by a single blind examiner, and the retention was classified as either a success (total retention) or a failure (partial retention or not present). RESULTS: There were no statistically significant differences among the four materials in permanent maxillary molars or deciduous molars. In permanent mandibular molars, Optibond Solo showed a lower percentage of retention (40.9%), significantly different (p=0.002) to that of Delton (89.5%), Delton Plus (87.5%) and Concise (76.5%). CONCLUSION: One bottle dentin bonding system used as a sealant does not improve the retention of conventional fissure sealants. CLINICAL IMPLICATION: Because of the scarcity of studies on the use of dental adhesives as sealants, further studies are warranted for the final support of that conclusion.

PMID: 17909514 [PubMed - indexed for MEDLINE]

[Sugar intake and public health]

Tidsskr Nor Laegeforen. 2007 Sep 6;127(17):2259-62

Authors: Henriksen HB, Kolset SO

BACKGROUND: Sugar is present in simple forms such as sucrose, lactose and fructose, and in the more complex forms starch and fibre. Complex carbohydrates in foods like vegetables and less refined grain products provide energy and important additions of vitamins, minerals and fibre. We have reviewed the effects of sugars on overweight, diabetes Type 2 and caries, and the intake of carbohydrates in simple and complex forms in the Norwegian population. METHOD: Literature was found in the databases PubMed and Bibsys, and in public statistics. RESULTS AND INTERPRETATION: Sugars in beverages and candy only contribute with energy that can lead to an increased amount of fat in the body. High sugar intakes contribute to development of overweight, diabetes type 2 and caries. Glucose from sucrose and starch increase blood glucose levels and stimulate insulin secretion. Lack of insulin response after fructose intake can result in adverse effects on lipid metabolism and satiety regulation. Norway is one of the countries in the world with the highest intake of sweetened beverages. Preventive health measures aimed at decreasing sugar intake in pre-school and school children must include increased availability of fruits and vegetables, water and better canteens. The increased sugar intake among adolescents requires measures from politicians and authorities.

PMID: 17828323 [PubMed - indexed for MEDLINE]

[Fifty years of fluoridation of public water supplies in Brazil: benefits for the control of dental caries]

Cien Saude Colet. 2007 Jul-Aug;12(4):1057-65

Authors: Ramires I, Buzalaf MA

Fluoridation of public water supplies is among the most important public health measures for control of dental caries. Through a review of the literature, this study intends to reaffirm the importance and scope of fluoridation for caries control, as this is acknowledged as one of the most effective ways of ensuring the constant presence of fluoride in the oral cavity, which is vital for controlling caries. Water fluoridation is rated as an important factor for reducing caries, meaning that it should be maintained and also monitored, ensuring adequate fluoride levels for controlling caries while avoiding dental fluorosis.

PMID: 17680164 [PubMed - indexed for MEDLINE]

[Influence of immigration on the bucco-dental health of a school population in Reus]

Aten Primaria. 2007 Jul;39(7):381-2

Authors: Manso Mora J, Collado Cuco A, Palau Galindo A, Sánchez Sánchez L, San Miguel San Martín J

PMID: 17669327 [PubMed - indexed for MEDLINE]

Dental enamel around fixed orthodontic appliances after fluoride varnish application.

Braz Dent J. 2007;18(1):49-53

Authors: Gontijo L, Cruz Rde A, Brandão PR

Poor oral hygiene has been considered one of the main problems routinely faced in the orthodontic treatment. Orthodontic appliance creates an environment that provides mineral loss from the dental enamel. Such condition is clinically seen as white spot lesions and cavitations in the most severe cases. The aim of this study was to evaluate the effects of a fluoride varnish application as a caries prevention method for clinical orthodontics. The experiment analyzed dental enamel adjacent to orthodontics accessories after treatment. In addition, it was observed the calcium, phosphorus and fluoride contents on enamel treated with a fluoride varnish. The results showed that fluoride varnish application is a simple and fast technique that could be useful in preventing enamel demineralization associated to orthodontic treatment. Scanning electron microscopy revealed significant amount of calcium fluoride-like material deposited on enamel and energy dispersive x-ray analysis demonstrated a large incorporation of calcium and fluoride to the enamel of the treated specimens. It was concluded that fluoride varnish could indeed be considered an efficient preventive method to enhance enamel resistance against the cariogenic challenges during orthodontic therapy.

PMID: 17639201 [PubMed - indexed for MEDLINE]

Isolation and characterization of the mutans streptococci from the dental plaques in Koreans.

J Microbiol. 2007 Jun;45(3):246-55

Authors: Yoo SY, Park SJ, Jeong DK, Kim KW, Lim SH, Lee SH, Choe SJ, Chang YH, Park I, Kook JK

Mutans streptococci have been implicated as cariogenic bacteria in dental caries because they can produce high levels of dental caries-causing lactic acid and extracellular polysaccharide. The aim of this study was to isolate and characterize the mutans streptococci from the dental plaque obtained from Koreans. The dental plaque samples were collected from the anterior and molar teeth of both jaws in 155 subjects (aged 2 to 33.2 years, average age 13.7+/-4.7 years). The samples were diluted by 100-fold in 1x PBS and plated on mitis-salivarius bacitracin (MSB) agar plates. The mutans streptococci grown on MSB plates were screened by polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) targeting dextranase gene (dex). The mutans streptococci were identified at the species level using a 16S rDNA sequencing comparison method. The biochemical tests were carried out to biotype the mutans streptococci. Ninety-five strains of the mutans streptococci out of 358 colonies, which were derived from 141 subjects, were isolated. Of them, 77 strains and 18 strains were Streptococcus mutans and Streptococcus sobrinus, respectively. The biotyping data showed that 62, 1, 20, 10, and 2 strains were biotypes I, II, IV, V and variant, respectively. Of the two strains of variant biotype, one strains was similar to biotype IV except that it was positive to the arginine hydrolysis test. We considered this one strain a new biotype, and classified it as biotype VII. In conclusion, S. mutans and its biotype I was most frequently isolated in Korean dental plaque. The mutans streptococci strains isolated in this study might be useful for the study of the pathogenesis and the prevention of dental caries.

PMID: 17618231 [PubMed - indexed for MEDLINE]

Simultaneous determination of fluoride, chloride, sulfate, phosphate, monofluorophosphate, glycerophosphate, sorbate, and saccharin in gargles by ion chromatography.

J Zhejiang Univ Sci B. 2007 Jul;8(7):507-11

Authors: Zhang YZ, Zhou YC, Liu L, Zhu Y

Simple, reliable and sensitive analytical methods to determine anticariogenic agents, preservatives, and artificial sweeteners contained in commercial gargles are necessary for evaluating their effectiveness, safety, and quality. An ion chromatography (IC) method has been described to analyze simultaneously eight anions including fluoride, chloride, sulfate, phosphate, monofluorophosphate, glycerophosphate (anticariogenic agents), sorbate (a preservative), and saccharin (an artificial sweetener) in gargles. In this IC system, we applied a mobile phased gradient elution with KOH, separation by IonPac AS18 columns, and suppressed conductivity detection. Optimized analytical conditions were further evaluated for accuracy. The relative standard deviations (RSDs) of the inter-day's retention time and peak area of all species were less than 0.938% and 8.731%, respectively, while RSDs of 5-day retention time and peak area were less than 1.265% and 8.934%, respectively. The correlation coefficients for targeted analytes ranged from 0.999 7 to 1.000 0. The spiked recoveries for the anions were 90% approximately 102.5%. We concluded that the method can be applied for comprehensive evaluation of commercial gargles.

PMID: 17610331 [PubMed - indexed for MEDLINE]

Feasibility and costs of water fluoridation in remote Australian Aboriginal communities.

BMC Public Health. 2007;7:100

Authors: Ehsani JP, Bailie R

BACKGROUND: Fluoridation of public water supplies remains the key potential strategy for prevention of dental caries. The water supplies of many remote Indigenous communities do not contain adequate levels of natural fluoride. The small and dispersed nature of communities presents challenges for the provision of fluoridation infrastructure and until recently smaller settlements were considered unfavourable for cost-effective water fluoridation. Technological advances in water treatment and fluoridation are resulting in new and more cost-effective water fluoridation options and recent cost analyses support water fluoridation for communities of less than 1,000 people. METHODS: Small scale fluoridation plants were installed in two remote Northern Territory communities in early 2004. Fluoride levels in community water supplies were expected to be monitored by local staff and by a remote electronic system. Site visits were undertaken by project investigators at commissioning and approximately two years later. Interviews were conducted with key informants and documentation pertaining to costs of the plants and operational reports were reviewed. RESULTS: The fluoridation plants were operational for about 80% of the trial period. A number of technical features that interfered with plant operation were identified and addressed though redesign. Management systems and the attitudes and capacity of operational staff also impacted on the effective functioning of the plants. Capital costs for the wider implementation of these plants in remote communities is estimated at about $US 94,000 with recurrent annual costs of $US 11,800 per unit. CONCLUSION: Operational issues during the trial indicate the need for effective management systems, including policy and funding responsibility. Reliable manufacturers and suppliers of equipment should be identified and contractual agreements should provide for ongoing technical assistance. Water fluoridation units should be considered as a potential priority component of health related infrastructure in at least the larger remote Indigenous communities which have inadequate levels of natural fluoride and high levels of dental caries.

PMID: 17555604 [PubMed - indexed for MEDLINE]

Antibacterial activity of red and white wine against oral streptococci.

J Agric Food Chem. 2007 Jun 27;55(13):5038-42

Authors: Daglia M, Papetti A, Grisoli P, Aceti C, Dacarro C, Gazzani G

Wine contains a number of biologically active compounds with beneficial effects on human health. The antibacterial action of commercial red and white wines against oral streptococci responsible for caries development and against S. pyogenes responsible for pharyngitis was studied. Its postcontact effect against S. mutans was also studied. Both wines displayed activity. The compounds responsible for such activities were succinic, malic, lactic, tartaric, citric, and acetic acid. The synthetic mixtures of the organic acids tested at the concentrations found in wine had greater antibacterial activity than the beverages, indicating that in wine they are inhibited by other components. Wine polyphenols displayed no activity against oral streptococci or S. pyogenes. Findings show that wine is active against oral streptococci and S. pyogenes and suggest that it enhances oral health.

PMID: 17547418 [PubMed - indexed for MEDLINE]

[An epidemiological investigation of deciduous dental caries among 5375 preschool children aged between 3 to 6 years in Shenyang City]

Shanghai Kou Qiang Yi Xue. 2006 Dec;15(6):596-600

Authors: Cheng RB, Zhang XF, Zhang Y, Pan L, Tao W

PURPOSE: To investigate the status of dental caries of deciduous teeth among preschool children in Shenyang city. METHODS: According to the criteria recommended by the World Health Organization and The Second National Oral Health Investigation, the deciduous caries of 5375 preschool children aged from 3 to 6 years were clinically examined. The mean dmft and the prevalence of dental caries for each age group were calculated. The results were analyzed using SPSS11.0 software package for t test (to compare the difference between the two sample groups), one way ANOVA (to compare the differences among three and more sample groups) and chi2 test (to compare the rate of each group). RESULTS: The prevalence of dental caries was 71.29%. The mean dmft score was 3.88. The prevalence of dental caries and mean dmft increased gradually as the children were growing up (P < 0.05).Dental caries of the upper teeth was significantly more common than that of the lower teeth (P < 0.01). Most caries were minor in degree of severity, and mostly lie in the occlusal and proximal surface. The filling rate was 10.82%.As the age increase, the filling rate increased, too. CONCLUSION: Deciduous dental caries of preschool children was an important problem in Shenyang city, and the filling rate was very low. Necessary methods for early prevention of dental caries must be taken into consideration. Supported by Scientific Research Fund for College and University from Liaoning Provincial Education Bureau (Grant No. 20201316).

PMID: 17533710 [PubMed - in process]

Comparative evaluation of the marginal sealing ability of Fuji VII and Concise as pit and fissure sealants.

J Contemp Dent Pract. 2007;8(4):10-8

Authors: Ganesh M, Shobha T

AIM: The anatomical pits and fissures of the teeth have long been recognized as susceptible areas for the initiation of dental caries. The extreme vulnerability to decay of these pits and fissures on the occlusal surfaces has prompted dental scientists to seek methods of caries prevention. Motivated by the role of pit and fissure sealants in caries prevention, the aim of this study was to compare the efficacy of Fuji VII glass ionomer sealant and Concise resin-based sealant. METHODS AND MATERIALS: An in vitro study was undertaken using forty premolars extracted for orthodontic reasons. The teeth were divided into two groups and sealants were applied. One was an experimental group using Fuji VII as a pit and fissure sealant and the other a control group using Concise. The teeth were kept in gentian violet dye for 24 hours, the sectioned samples were observed for the extent of dye penetration, and scores were based on established scoring criteria. RESULTS: The comparison of the performance of the two groups showed a statistically significant difference. CONCLUSION: The Concise resin-based sealant performed better in terms of sealing ability than did the Fuji VII glass ionomer sealant.

PMID: 17486182 [PubMed - indexed for MEDLINE]

Comparison of salivary fluoride levels following use of dentifrices containing different concentrations of fluoride.

J Indian Soc Pedod Prev Dent. 2007 Mar;25(1):20-2

Authors: Nagpal DI, Damle SG

Many industrialized countries have reported a decline in caries prevalence over the past few decades. These reductions have been related to the regular use of fluoride dentifrices. Fluoride dentifrices are the most cost-effective and efficient means of caries prevention. However, there have been concerns regarding the risk of fluorosis in children due to the ingestion of dentifrices. This has led to the use of dentifrices with low concentration of fluoride. Salivary fluoride levels after tooth-brushing have been shown to be related to the anticaries efficacy of fluoride dentifrices. The present study was designed to evaluate the effect of the concentration of fluoride in the dentifrice, on the salivary fluoride level in children. Twenty children in the age group of five to six years were randomly selected and divided into two groups using, either 500ppm or 1000ppm fluoride dentifrice (sodium monofluorophosphate). Salivary fluoride levels at 0, 15, 30, 45, 60, minutes after brushing were estimated. The data collected was statistically evaluated using the unpaired t-test. The results showed that salivary fluoride levels following use of 500ppm fluoride dentifrice were significantly lower than 1000ppm fluoride dentifrice. The low salivary fluoride levels may thereby reduce the anticaries efficacy. Hence, the pros and cons of recommending a low fluoride concentration dentifrice must be judiciously considered.

PMID: 17456962 [PubMed - indexed for MEDLINE]

Fighting the silent epidemic of poor oral health.

Am Fam Physician. 2007 Feb 15;75(4):475-6

Authors: Wessel L, Rhee K, Wolpin S

PMID: 17323708 [PubMed - indexed for MEDLINE]

[External control over the fluoridation of the public water supply in Bauru, SP, Brazil]

Rev Saude Publica. 2006 Oct;40(5):883-9

Authors: Ramires I, Maia LP, Rigolizzo Ddos S, Lauris JR, Buzalaf MA

OBJECTIVE: To assess the fluoridation of the public water supply and compare these results with previous data. METHODS: The study was carried out from March 2004-2005 in Bauru, a city of Southeastern Brazil. Every month, on dates established randomly, 60 water samples were collected from the 19 supply sectors of the city, totaling 737 samples. The fluoride concentration in the water samples was determined in duplicate, using an ion-specific electrode (Orion 9609) coupled to a potentiometer. Following analysis, the samples were classified as acceptable or unacceptable according to their fluoride concentration. Descriptive statistical analysis was utilized. RESULTS: The mean fluoride concentration observed in the different collection months ranged from 0.37 to 1.00 mg/l. Around 85% of the samples were classified as acceptable. CONCLUSIONS: One year after implementing external control, an improvement in the water fluoridation conditions was observed in comparison with previous results obtained in the city. The implementation of water supply fluoridation monitoring by means of surveillance systems must be stimulated: this is fundamental for controlling dental caries.

PMID: 17301911 [PubMed - indexed for MEDLINE]

Dental management of low socioeconomic level patients before radiotherapy of the head and neck with special emphasis on the prevention of osteoradionecrosis.

Braz Dent J. 2006;17(4):336-42

Authors: Bonan PR, Lopes MA, Pires FR, Almeida OP

Head and neck cancer patients need to receive dental care previously to radiotherapy. Even patients who regularly visit dental offices need special attention including prophylactic and curative treatments. The purposes of this study were to evaluate the dental status of Brazilian head and neck squamous cell carcinoma patients with low socioeconomic level as well as to discuss the dental treatment performed and the oral side effects of radiotherapy. Forty patients with head and neck squamous cell carcinoma received dental care and dental extractions prior to radiotherapy and were were followed up for a mean period of 28.7 months after the cancer treatment. Before radiotherapy, 28 patients were dentulous and 12 edentulous, and all of them had poor oral health and hygiene. The most common treatment performed were dental extraction and 23 patients had 8.6 teeth extracted on average. One out of 9 (11.1%) patients developed radiation caries and 5 out of 23 cases (21.3% - Group I) developed osteoradionecrosis, being only 1 case associated with previous dental extraction. Brazilian low-socioeconomic level patients with head and neck cancer were submitted to multiple dental extractions due to poor dental conditions and inadequate oral care. The dental treatment did not prevent osteoradionecrosis, which presumably presented a multifactorial etiology in most cases.

PMID: 17262149 [PubMed - indexed for MEDLINE]

Knowledge and attitude on infant oral health among graduating medical students in Kerala.

J Indian Soc Pedod Prev Dent. 2006 Dec;24(4):173-6

Authors: Kumari NR, Sheela S, Sarada PN

Providing dental and oral health care to all children in Kerala remains a thorny challenge. Lack of community water fluoridation, dental workforce shortages and geographical barriers all aggravate oral health and access problems. Children from low-income and minority families and children with special needs are at particular risk. Family centered disease prevention strategies are needed to reduce oral health disparities in children. Oral health promotion can take place in a primary care practitioner's office, but medical providers often lack relevant training. Present study was conducted to evaluate knowledge and attitude of graduating medical students towards infant oral health qualitative methods were used to evaluate the program.

PMID: 17183179 [PubMed - indexed for MEDLINE]

One in a million: the first community trial of water fluoridation.

Bull World Health Organ. 2006 Sep;84(9):759-60

Authors: Lennon MA

PMID: 17128347 [PubMed - indexed for MEDLINE]

Dental caries risk in the U.S. Air Force.

J Am Dent Assoc. 2006 Nov;137(11):1582-91

Authors: Bartoloni JA, Chao SY, Martin GC, Caron GA

BACKGROUND: This study describes the dental caries risk in the active duty U.S. Air Force population from October 2000 through September 2004. METHODS: The authors used data collected from two Air Force databases (personnel and dental files) by cross-referencing Social Security numbers from both databases with date. RESULTS: During the study period, the percentages of people at high and moderate risk of developing caries decreased by 31 percent and 12 percent, respectively, while the percentage of people at low risk of developing caries increased by 9 percent. Among Air Force members who were enrolled continuously during the study period, the percentages at high and moderate risk of developing caries decreased by 57 percent and 18 percent, respectively, while the percentage at low risk of developing caries increased by 14 percent. The authors observed improvement in caries risk in 83 percent and 73 percent of the people at high and moderate caries risk, respectively, for those continuously enrolled. High caries risk was related inversely to age, rank, education and years in service. Also, tobacco users had an elevated risk of developing caries. CONCLUSIONS: The Air Force Dental Service has made great strides in improving the oral health of the Air Force population. The results of this study suggest that caries risk is decreasing in the Air Force population, but oral health disparities still exist and require further evaluation. CLINICAL IMPLICATIONS: This investigation suggests that a caries risk assessment can be conducted successfully, and caries risk can be reduced by using a comprehensive population-based prevention program. This caries risk assessment also can identify factors associated with dental caries disparities in a large-scale population.

PMID: 17082285 [PubMed - indexed for MEDLINE]

Clinical evaluation of an ionic tooth brush on oral hygiene status, gingival status, and microbial parameter.

Indian J Dent Res. 2006 Apr-Jun;17(2):74-7

Authors: Deshmukh J, Vandana KL, Chandrashekar KT, Savitha B

It has long been recognised that the presence of dental plaque leads to gingivitis and periodontal disease, as well as dental caries. Today tooth brushing is the most widely accepted method of removing plaque. Hence this present clinical study was undertaken to evaluate the effectiveness of an ionic toothbrush on oral hygiene status. For this study, 20 dental students in the age group of 18-20 years were included. All the subjects after undergoing dental prophylaxis were then provided with ionic toothbrushes, either active (equipped with lithium battery) or inactive (without lithium battery). Plaque index and gingival bleeding index were examined at 7th, 14th, and 21st day. Microbial assessment was done for detection of colony forming units (CFU) from the plaque samples which were collected on 0 day and 21st day, both before brushing and after brushing. Results shown a significant reduction in all the parameters and the reduction was more significant in active and inactive ionic toothbrush users. It was concluded that both active and inactive ionic toothbrushes reduced the plaque index and gingival bleeding index scores significantly and active ionic tooth brushes were more effective as compared to inactive ionic toothbrushes. There was no soft tissue trauma following the use of both type of toothbrushes, which showed that ionic toothbrushes were equally safe for regular long-term use.

PMID: 17051872 [PubMed - indexed for MEDLINE]

The effectiveness of school dental screening: a cluster-randomized control trial.

J Dent Res. 2006 Oct;85(10):924-8

Authors: Milsom K, Blinkhorn A, Worthington H, Threlfall A, Buchanan K, Kearney-Mitchell P, Tickle M

Dental screening of children in schools is undertaken in many countries. There is no evidence that this activity is effective. The objective of our study was to determine if school dental screening of children reduces untreated disease or improves attendance at the population level. A four-arm cluster-randomized controlled trial was undertaken in the northwest of England. In total, 16,864 children aged 6-9 years in 168 schools were randomly allocated to 3 test groups, which received screening according to different models, and a control, which received no intervention. There were no significant differences in caries increment in the primary and secondary dentitions or in the proportions of children attending a dentist after screening between the control group and the 3 intervention arms. School dental screening delivered according to 3 different models was not effective at reducing levels of active caries and increasing attendance in the population under study.

PMID: 16998133 [PubMed - indexed for MEDLINE]

Laser-fluoride effect on root demineralization.

J Dent Res. 2006 Oct;85(10):919-23

Authors: Gao XL, Pan JS, Hsu CY

Although the individual cariostatic effects of laser and fluoride have been shown, the combined effect of CO(2) laser and fluoride on root demineralization remains uncertain and was the main aim of this study. By using a pH-cycling system and Polarized Light Microscopy, we demonstrated the synergistic effect of fluoride combined with CO(2) laser treatment on reducing root demineralization. The mean lesion depths (in microm) for each group were 160 +/- 14 (Control), 113 +/- 8 (Laser treatment alone), 111 +/- 6 (Fluoride treatment alone), and 25 +/- 7 (Fluoride followed by laser treatment). A significant laser-enhanced fluoride uptake, characterized by the ToF-SIMS analysis, was revealed by the 37% and 400% increments in loosely and firmly bound fluorides (both p < 0.002) in laser-irradiated areas, compared with the non-irradiated controls. In conclusion, there is a significant synergistic effect of combined CO(2) laser and fluoride treatment on the inhibition of root demineralization, possibly due to laser-enhanced fluoride uptake in the root.

PMID: 16998132 [PubMed - indexed for MEDLINE]

Immunogenicity and persistence of a targeted anti-caries DNA vaccine.

J Dent Res. 2006 Oct;85(10):915-8

Authors: Xu QA, Yu F, Fan MW, Bian Z, Chen Z, Fan B, Jia R, Guo JH

We have previously reported that a targeted anti-caries DNA vaccine, pGJA-P, induced accelerated and increased antibody responses compared with a non-targeted anti-caries DNA vaccine. Recently, pGJA-P/VAX, a new targeted anti-caries DNA vaccine for human trials, was constructed by replacing the pCI vector used in the construction of pGJA-P with pVAX1, the only vector authorized by the US Food and Drug Administration in clinical trials. Here, we report on our exploration of the kinetics of the antibody responses generated following pGJA-P/VAX immunization and the persistence of pGJA-P/VAX at both the inoculation site and the draining lymph nodes. Intranasal vaccination of mice with pGJA-P/VAX induced strong antibody responses that lasted for more than 6 months. Furthermore, pGJA-P/VAX could still be detected at both the inoculation site and the draining cervical lymph nodes 6 months after immunization. Thus, the persistent immune responses are likely due to the DNA depot in the host, which acts as a booster immunization.

PMID: 16998131 [PubMed - indexed for MEDLINE]

Reasons for permanent tooth extractions in Japan.

J Epidemiol. 2006 Sep;16(5):214-9

Authors: Aida J, Ando Y, Akhter R, Aoyama H, Masui M, Morita M

BACKGROUND: There has been no nationwide study in Japan on reasons for extraction of permanent teeth. This survey was aimed to determine the reasons for extraction of permanent teeth in Japan. METHODS: Five thousand, one hudred and thirty-one dentists were selected by systematic selection from the 2004 membership directory of the Japan Dental Association. The dentists selected were asked to record the reason for each extraction of permanent teeth during a period of one week from February 1 through 7, 2005. Reasons for tooth extraction were assigned to five groups: caries, fracture of teeth weakened by caries or endodontics, periodontal diseases, orthodontics, and other reasons. RESULTS: A total of 2,001 dentists (response rate of 39.1%) returned the questionnaires, and information on 9,115 extracted teeth from 7,499 patients was obtained. The results showed that caries and its sequela (totally 43.3%, 32.7% and 10.6%, respectively) and periodontal disease (41.8%) were the main reasons for teeth extraction. Extraction due to caries or fracture was commonly observed in all age groups over 15 years of age, whereas periodontal disease was predominant in the groups over 45 years of age. CONCLUSIONS: Most of the permanent teeth were extracted due to caries and its sequela and periodontal disease. Prevention and care for dental caries for all age groups and periodontal disease for over middle age groups are required.

PMID: 16951541 [PubMed - indexed for MEDLINE]

Assessing patients' caries risk.

J Am Dent Assoc. 2006 Sep;137(9):1231-9

Authors: Fontana M, Zero DT

BACKGROUND: Caries management historically has focused on the removal of cavitated carious tissue and restoration of the tooth. OVERVIEW: Assessing a patient's risk of developing caries is a vital component of caries management. A comprehensive caries assessment should consider factors such as past and current caries experience, diet, fluoride exposure, presence of cariogenic bacteria, salivary status, general medical history, behavioral and physical factors, and medical and demographic characteristics that may affect caries development. A caries risk assessment also should consider factors that may challenge the patient's ability to maintain good oral hygiene (for example, crowded dentition, deep fissures, wide open restorative margins or placement of oral appliances). CONCLUSIONS: and Practical Implications. The authors review the importance of caries risk assessment as a prerequisite for appropriate preventive and treatment intervention decisions and provide some practical information on how general practitioners can incorporate caries risk assessment into the management of caries.

PMID: 16946427 [PubMed - indexed for MEDLINE]

[Study on the frequency of caries and associated factors in type 1 diabetes mellitus]

Arq Bras Endocrinol Metabol. 2006 Jun;50(3):515-22

Authors: do Amaral FM, Ramos PG, Ferreira SR

Subjects with diabetes mellitus (DM) are more prone to certain disturbances of oral cavity but there are controversies concerning caries. This cross-sectional study investigated the frequency of caries and associated factors, in a sample of population with or without type 1 DM, including non-diabetic (53 women, 31 men) and 30 diabetic subjects (19 women, 11 men) aged 17-28 years. Diagnosis of dental caries was based on the DMF-T index (D= decay; M= miss; F= fill; T= teeth); in addition, a plaque control record (PCR) was obtained. A preponderance of female sex was found within the groups studied but such proportions did not differ when comparing diabetic and non-diabetic groups. Mean ages were 21.0 +/- 2.2 and 19.5+/-1.8 years, respectively for subjects without and with DM (p< 0.05). Education level was higher in the non-diabetic group as well as the DMF-T index (10.5 +/-5.8 vs. 6.7+/-5.7, p< 0.01). Linear regression analysis (n= 114) showed significant associations of DMF-T with age, sucrose intake, daily frequency of tooth brushing, of dental floss use, PCR and of visits to the dentist. By ANOVA model with age as a covariate the non-diabetic condition (p= 0.047), sucrose index and PCR (r(2)= 0.820) were independently associated with the DMF-T. In the diabetic-specific model, with only the diabetic subjects included and sucrose index as a covariate, DM duration, fundus abnormality and PCR were significantly associated with the presence of caries (r(2)= 0.816). The sample of type 1 diabetic subjects suggest that they are less prone to caries than non-diabetics, despite having a higher frequency of meals, less tooth brushing and dental floss use. We speculate that DM duration may contribute to the occurrence of caries and restricted sucrose consumption to lower frequency of caries in diabetic subjects.

PMID: 16936993 [PubMed - indexed for MEDLINE]

The in vitro effect of fluoridated milk in a bacterial biofilm--enamel model.

Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub. 2006 Jul;150(1):63-9

Authors: Arnold WH, Forer S, Heesen J, Yudovich K, Steinberg D, Gaengler P

OBJECTIVES: The purpose of this study was to investigate the effect of milk and fluoridated milk on bacterially induced caries-like lesions. SAMPLE AND METHODS: Extracted impacted human molars were cut in half and covered with a varnish leaving a 4*4 mm window. The samples were coated with biofilm of S. sobrinus and were further divided into three experimental groups of S. sobrinus, S. sobrinus and milk and S. sobrinus and fluoridated milk. As negative controls served teeth incubated in saline. Of twenty tooth halves serial ground sections were cut through the lesions and investigated with polarization light microscopy (PLM) and scanning electron microscopy (SEM) and EDX element analysis. The PLM photographs were used for 3D reconstruction, volumetric assessment and determination of the extension of the lesion zones. Of eight tooth halves the biofilm on the enamel surface was studied with SEM and EDX element analysis. RESULTS: Volumetric assessment showed a statistically significant difference in the volume of the body of the lesion and the translucent zone between the milk group and fluoridated milk group. Quantitative element analysis demonstrated significant differences between sound enamel and the superficial layer in the fluoridated milk group. The biofilm on the enamel surface showed an increased Ca content in the milk group and fluoridated milk group. CONCLUSIONS: Milk as a common nutrient seems to play a complex role in in-vitro biofilm--enamel interactions stimulating bacterial demineralization on one hand, and, as effective fluoride carrier, inhibits caries-like demineralization.

PMID: 16936902 [PubMed - indexed for MEDLINE]

Dentifrices, mouthwashes, and remineralization/caries arrestment strategies.

BMC Oral Health. 2006;6 Suppl 1:S9

Authors: Zero DT

While our knowledge of the dental caries process and its prevention has greatly advanced over the past fifty years, it is fair to state that the management of this disease at the level of the individual patient remains largely empirical. Recommendations for fluoride use by patients at different levels of caries risk are mainly based on the adage that more is better. There is a general understanding that the fluoride compound, concentration, frequency of use, duration of exposure, and method of delivery can influence fluoride efficacy. Two important factors are (1) the initial interaction of relatively high concentrations of fluoride with the tooth surface and plaque during application and (2) the retention of fluoride in oral fluids after application.Fluoride dentifrices remain the most widely used method of delivering topical fluoride. The efficacy of this approach in preventing dental caries is beyond dispute. However, the vast majority of currently marketed dentifrice products have not been clinically tested and have met only the minimal requirements of the FDA monograph using mainly laboratory testing and animal caries testing. Daily use of fluoride dental rinses as an adjunct to fluoride dentifrice has been shown to be clinically effective as has biweekly use of higher concentration fluoride rinses. The use of remineralizing agents (other than fluoride), directed at reversing or arresting non-cavitated lesions, remains a promising yet largely unproven strategy. High fluoride concentration compounds, e.g., AgF, Ag(NH3)2F, to arrest more advanced carious lesions with and without prior removal of carious tissue are being used in several countries as part of the Atraumatic Restorative Treatment (ART) approach.Most of the recent innovations in oral care products have been directed toward making cosmetic marketing claims. There continues to be a need for innovation and collaboration with other scientific disciplines to fully understand and prevent dental caries.

PMID: 16934126 [PubMed]

Dental plaque as a biofilm and a microbial community - implications for health and disease.

BMC Oral Health. 2006;6 Suppl 1:S14

Authors: Marsh PD

Dental plaque is a structurally- and functionally-organized biofilm. Plaque forms in an ordered way and has a diverse microbial composition that, in health, remains relatively stable over time (microbial homeostasis). The predominant species from diseased sites are different from those found in healthy sites, although the putative pathogens can often be detected in low numbers at normal sites. In dental caries, there is a shift toward community dominance by acidogenic and acid-tolerating species such as mutans streptococci and lactobacilli, although other species with relevant traits may be involved. Strategies to control caries could include inhibition of biofilm development (e.g. prevention of attachment of cariogenic bacteria, manipulation of cell signaling mechanisms, delivery of effective antimicrobials, etc.), or enhancement of the host defenses. Additionally, these more conventional approaches could be augmented by interference with the factors that enable the cariogenic bacteria to escape from the normal homeostatic mechanisms that restrict their growth in plaque and out compete the organisms associated with health. Evidence suggests that regular conditions of low pH in plaque select for mutans streptococci and lactobacilli. Therefore, the suppression of sugar catabolism and acid production by the use of metabolic inhibitors and non-fermentable artificial sweeteners in snacks, or the stimulation of saliva flow, could assist in the maintenance of homeostasis in plaque. Arguments will be presented that an appreciation of ecological principles will enable a more holistic approach to be taken in caries control.

PMID: 16934115 [PubMed]

Biotech and biomaterials research to reduce the caries epidemic.

BMC Oral Health. 2006;6 Suppl 1:S1

Authors: Slayton RL, Bryers JD, Milgrom P

The goal of this workshop is to develop a consensus within the biomaterials/bioengineering community for a research agenda focused on creating technologies that will address the current dental caries pandemic. The workshop will bring together expertise from academia, industry, and the NIH institutes in the areas of oral biofilm microbiology and innovative biomaterials. The rationale for the workshop is that science and technology have not produced sufficient practical tools for public health practitioners and the private delivery system to address the pandemic in dental caries that exists for children and adults from families with low incomes and for numerous ethnic minority and racial groups. Moreover, it is unclear whether the barriers are remediable bioengineering and technical problems or fundamental science questions. Nevertheless, the obligation to address the gap between scientific research and practical application is especially relevant today. The U.S. and state governments bear the majority of the cost of trying to control this pandemic through Medicaid, the Public Health Service, Indian Health Service and other similar programs. These costs continue to escalate as continued applications of existing technology are unlikely to markedly reduce disparities. The mainstays of caries prevention, topical and systemic fluorides and pit and fissure sealants, are technologies developed in the 1950s and 1960s.

PMID: 16934110 [PubMed]

Dental fluorosis in Brazil: a systematic review from 1993 to 2004.

Cad Saude Publica. 2006 Sep;22(9):1809-16

Authors: da Cunha LF, Tomita NE

The current article proposes a reflection on several aspect pertaining to dental fluorosis in Brazil, based on a systematic review of epidemiological surveys. The authors assess the prevalence and degrees of severity found in different studies and show that in methodological terms, there is a need for progress in procedures for population-based studies on fluorosis. Despite the different data collection approaches, there is some consensus among the different studies as to the limited severity of fluorosis in Brazil, as well as its association with the independent variables age and socioeconomic status. The authors also highlight the importance of adding subjective aspects to the normative diagnosis as a contribution to public health policy decisions, since the use of exclusively clinical criteria gives dental fluorosis more space than society ascribes to it. There is a lack of empirical evidence to reassess the fluoride content in public water supplies, a method that is known to be necessary to improve dental caries epidemiological indicators.

PMID: 16917577 [PubMed - indexed for MEDLINE]

Oral healthcare for elderly: identifying the needs and feasible strategies for service provision.

Indian J Dent Res. 2006 Jan-Mar;17(1):11-21

Authors: Goel P, Singh K, Kaur A, Verma M

The aim of the present study was to assess the oral health practices, status and treatment needs of the rural elderly in national capital territory of Delhi. An effort was also made to identify patterns of utilization of dental services and test alternate strategies for service provision. A total of 96 elderly subjects (47 males and 49 females) in 5 rural areas were interviewed and clinically examined using Basic Oral Health Survey criteria of W.H.O. This was followed by a community trial in which the 5 villages were divided into control and test groups. Results of the survey found that both traditional as well as modern oral health practices co-exist in the rural community. Dental services were available to a majority (mostly through private sector), and edentulousness was a condition of primary concern among the elderly as a result of unmet treatment needs for dental caries and periodontal diseases. Age was a variable that was statistically significantly associated with edentulousness (p=0.005). Results of the community trial showed that higher utilization of care can be achieved by providing on-site dental care as compared to referring cases to tertiary care centers. Nevertheless provision of treatment alone is not a suitable policy recommendation since many elderly did not avail care even at on-site community dental health programmes that were operated free of cost. This emphasizes the need of health education over treatment in order to empower the elderly, especially the non-ambulatory patients, to practice prevention and develop favourable attitudes towards accepting prompt treatment at primary health care level.

PMID: 16900890 [PubMed - indexed for MEDLINE]

Grills, 'grillz' and fronts.

J Am Dent Assoc. 2006 Aug;137(8):1192

Authors:

PMID: 16873337 [PubMed - indexed for MEDLINE]

Professionally applied topical fluoride: evidence-based clinical recommendations.

J Am Dent Assoc. 2006 Aug;137(8):1151-9

Authors:

BACKGROUND: With the dramatic increase in the amount of scientific information available about oral health, an evidence-based approach to oral health care and the practice of dentistry is necessary. There is a need to summarize, critique and disseminate scientific evidence and to translate the evidence into a practical format that is used easily by dentists The evidence-based clinical recommendations in this report were developed by an expert panel established by the American Dental Association Council on Scientific Affairs that evaluated the collective body of scientific evidence on the effectiveness of professionally applied topical fluoride for caries prevention. The recommendations are intended to assist dentists in clinical decision making. TYPES OF STUDIES REVIEWED: MEDLINE and the Cochrane Library were searched for systematic reviews and clinical studies of professionally applied topical fluoride--including gel, foam and varnish--through October 2005. RESULTS: Panelists were selected on the basis of their expertise in the relevant subject matter. The recommendations are stratified by age groups and caries risk and indicate that periodic fluoride treatments should be considered for both children and adults who are at moderate or high risk of developing caries. Included in the clinical recommendations is a summary table that can be used as a chairside resource. CLINICAL IMPLICATIONS: The dentist, knowing the patient's health history and vulnerability to oral disease, is in the best position to make treatment decisions in the interest of each patient. These clinical recommendations must be balanced with the practitioner's professional expertise and the individual patient's preferences.

PMID: 16873333 [PubMed - indexed for MEDLINE]

[Experimental study of the inhibitory effects of Chelidonium majus L. extractive on Streptococcus mutans in vitro]

Shanghai Kou Qiang Yi Xue. 2006 Jun;15(3):318-20

Authors: Cheng RB, Chen X, Liu SJ, Zhang XF, Zhang GH

PURPOSE: To study the inhibitory effects of Chelidonium majus L. extractive on the growth of Streptococcus mutans in vitro, and to explore its mechanism in caries prevention. METHODS: Streptococcus mutans 25175 was chosen as the experimental bacterium. The Chelidonium majus L. extractives chelidonine and chelerythrine were double diluted to different concentrations by two-fold dilution. The inhibitory effect of Streptococcus mutans was measured by slip diffusion method. The minimal inhibitory concentration(MIC) was also determined. 0.16% liquor hibitane was used as positive control. Spearman correlation was used for statistical analysis. RESULTS: Inhibition zone of Streptococcus mutans appeared in some concentration of chelerythrine, but no inhibition zone in each concentration of chelidonine. The MIC of chelerythrine was 0.78 mg/ml which determined by liquid culture medium. The concentration of chelerythrine was highly related to the inhibitory zone of Streptococcus mutans (r=0.99, P<0.01). CONCLUSION: The antibacterial activity of Chelidonium majus L. extractive chelerythrine on Streptococcus mutans was significant,and the antibacterial activity of the concentration 100 mg/ml was higher than that of 0.16% liquor hibitane (19.4 mm), indicating that chelerythrine can be used as an agent for prevention of dental caries.

PMID: 16862371 [PubMed - in process]

Knowledge, attitude and practices of pediatricians regarding the prevention of oral diseases in Italy.

BMC Public Health. 2006;6:176

Authors: Di Giuseppe G, Nobile CG, Marinelli A, Angelillo IF

BACKGROUND: Pediatricians are in an ideal position to advise families about the prevention and management of oral diseases in children. The objective of the study was to determine knowledge, attitude, and practices regarding the prevention of oral diseases among pediatricians in Italy. METHODS: A systematic random sample of 1000 pediatricians received a questionnaire on socio-demographic and practice characteristics; knowledge on risk factors; attitude and practices towards the prevention of oral diseases. RESULTS: A total of 507 pediatricians participated. More than half knew the main risk factors for oral diseases and this knowledge was higher in primary care pediatricians (p = 0.007), in those with a higher number of hours worked per week (p = 0.012), and who believed that oral diseases may be prevented (p = 0.017). Pediatricians with higher knowledge about the main risk factors (p = 0.006) believe that they have an important role in preventing oral diseases and that they can perform an oral examination. Almost all (89%) prescribed fluoride supplements and those younger (p = 0.016), with a higher number of patients seen in workday (p = 0.001), with longer practice activity (p = 0.004), those who believe that fluoride is effective in preventing caries (p < 0.0001), and who learned about prevention from scientific sources (p = 0.002) were more likely to prescribe fluoride. One-fourth and 40.6% provides and recommends a dental visit once a year and primary care pediatricians (p = 0.014) and those who believed that routine visit is important in preventing oral diseases (p < 0.0001) were more likely to recommend a dental visit once a year. CONCLUSION: The results showed a lack of knowledge among pediatricians although almost all believed that they had an important responsibility in preventing oral diseases and provided an oral examination.

PMID: 16822318 [PubMed - indexed for MEDLINE]

Oral health survey of the child population in the Valencia Region of Spain (2004).

Med Oral Patol Oral Cir Bucal. 2006 Jul;11(4):E369-81

Authors: Almerich Silla JM, Montiel Company JM

INTRODUCTION (BASIS AND OBJECTIVES): The objectives of this study were to study the evolution of child oral health in the Valencia Region and establish a six-year interval for these surveys, at a time of major demographic changes associated with immigration into the region. MATERIALS AND METHODS: A cross sectional study was conducted in a random sample of 509 children aged 6 years, 478 aged 12 years and 401 aged 15-16 years. The clinical examinations were performed by calibrated dentists (Kappa > 0.85). RESULTS: Caries prevalence was 32% at 6 years of age (dft=1.08) in primary dentition and 42.5% at 12 years (DMFT=1.07) and 55.9% at 15-16 years (DMFT=1.84) in permanent dentition. Caries levels in immigrant children were significantly high. The mean numbers of sextants with bleeding were 0.16, 1.58 and 1.10 while the scores for sextants with calculus were 0.15, 0.76 and 0.88, respectively. CONCLUSIONS: Caries levels in both primary and permanent dentition have remained stable at 6 and 12 years of age and have continued to fall in the 15-16-year-old age group. Immigrant children have high caries levels and are a population group in serious need of treatment and prevention plans.

PMID: 16816825 [PubMed - indexed for MEDLINE]

Motivating mothers to prevent caries: confirming the beneficial effect of counseling.

J Am Dent Assoc. 2006 Jun;137(6):789-93

Authors: Weinstein P, Harrison R, Benton T

BACKGROUND: The purpose of this study was to compare the effect of a motivational interviewing (MI) counseling visit with traditional health education for mothers of young children at high risk of developing dental caries. METHODS: The authors enrolled 240 infants aged 6 to 18 months and their mothers in the study and randomly assigned them to MI or traditional health education (control) groups. Mothers in the control group received a pamphlet and watched a videotape. Those in the MI group received the pamphlet and watched the videotape, as well as received an MI counseling session and six follow-up telephone calls during the first year. There were no interventions in year 2. RESULTS: After two years, children in the MI group exhibited significantly less new caries (decayed or filled surfaces) than those in the control group (that is, a protective effect of MI) (odds ratio = 0.35, 95 percent confidence interval = 0.15 to 0.83). CONCLUSIONS: MI is a promising approach that warrants further attention in a variety of dental contexts. CLINICAL IMPLICATIONS: The results of this study show that MI has a protective effect with regard to the development of early childhood caries. One reason for this clinical effect is greater compliance with recommended fluoride varnish treatment regimens in families who received MI counseling compared with families who received traditional education.

PMID: 16803808 [PubMed - indexed for MEDLINE]

Watching and waiting.

J Am Dent Assoc. 2006 Jun;137(6):728, 730; author reply 730

Authors: Urban DW

PMID: 16803802 [PubMed - indexed for MEDLINE]

[Dental status among schoolchildren in Kaunas and analysis of oral health care]

Medicina (Kaunas). 2006;42(5):413-23

Authors: Milciuviene S, Matulaitiene Z, Narbutaite J, Vaitkeviciene V, Bendoraitiene E, Timofejeva I

The prevalence of dental caries is very high (98%) among schoolchildren in Lithuania. Effective prevention, early diagnostics, and appropriate treatment of the disease will guarantee good oral health, proper functioning of the dentition. The aim of the present study was to assess the oral status in 7-, 12- and 15-year-old schoolchildren in Kaunas as well as to define the methods of oral health care, quality of the restorations, opinion of the heads of the clinics concerning the oral health care in their institutions. A total of 586 children were examined. The questionnaires were filled out by the heads of the private clinics and primary health care centers. Oral health status was evaluated according to the criteria of World Health Organization. Results of the study showed that the prevalence of dental caries increased with the age of the children ranging from 20.6% among 7-year-olds up to 95.9% among 15-year-olds. The need for dental treatment was found in 38.9% of 7-year-olds and 51.8% of 15-year-olds; 3.8% were in need of prosthodontic treatment. More than a half of fillings (52.5%) were of good quality, and 47.5% had to be replaced. Private clinics had better dental equipment (81.8%) in comparison with the primary health care centers (55.0%). Better instruments and materials were in private clinics (86.4%) than in primary health care centers (40.0%). According to the answers, the heads of the clinics and centers think that better dental service for the patients might be given by better financing of the institutions and effective prevention of dental caries.

PMID: 16778470 [PubMed - indexed for MEDLINE]

[Cost of fluoridating the public water supply: a study case in the city of São Paulo, Brazil, 1985-2003]

Cad Saude Publica. 2006 Jun;22(6):1237-46

Authors: Frias AC, Narvai PC, Araújo ME, Zilbovicius C, Antunes JL

The aim of this study was to estimate the cost of fluoridating the public water supply in the city of S&#xE3;o Paulo, Brazil, from 1985 to 2003. Cost calculation for fluoridation of the public water supply used the following: capital cost of initial installation, chemical product (hydrofluosilicic acid), system's operational cost (maintenance, electricity, and human resources), and monitoring fluoride levels. Fluoridation was effective, since there was a decrease of 73% in dental caries in 12-year-olds--mean DMF was 6.47 (6.12-6.82) in 1986, having decreased to 1.75 (1.48-2.92) in 2002. In this age group, 40% of children presented DMF = 0 in 2002. Average cost per inhabitant/year for 2003 was R$ 0.08 (USD 0.03). The accumulated cost for 18 years of implementation and maintenance of the fluoridation system was R$ 1.44 (USD 0.97) per capita.

PMID: 16751963 [PubMed - indexed for MEDLINE]

Facing the challenges of ceramic veneers.

J Am Dent Assoc. 2006 May;137(5):661-4

Authors: Christensen GJ

Ceramic veneers are extremely popular and have been used for many years. In spite of their phenomenal success, they offer numerous challenges during service. In this column, I have identified and discussed several degenerative situations commonly observed, and I have described methods of preventing or reducing the problems. When properly placed, ceramic veneers are among the most beautiful and long-lasting of all dental restorations.

PMID: 16739547 [PubMed - indexed for MEDLINE]

In vitro caries formation in primary tooth enamel: role of argon laser irradiation and remineralizing solution treatment.

J Am Dent Assoc. 2006 May;137(5):638-44

Authors: Westerman GH, Hicks MJ, Flaitz CM, Powell GL

BACKGROUND: The authors evaluated the effects of argon laser (AL) diation and remineralizing solution (RS) treatment alone and in combination on carieslike lesion formation in primary tooth enamel in an in vitro study. MATERIALS AND METHODS: The authors divided 10 caries free primary tooth enamel surfaces into four segments and assigned them to one of four treatment groups: no treatment control, AL irradiation alone at 13.5 joules per square centimeters (0.270 watts, 5-millimeter beam, 10 seconds), RS treatment alone for two minutes and AL irradiation before RS treatment. The authors created in vitro caries using a modified ten Cate solution. They evaluated longitudinal sections (three per tooth segment, 30 per treatment group) for mean lesion depth. RESULTS: After lesion formation, mean lesion depths (+/- standard deviation) were 179 +/- 16 micrometers for the no treatment controls, 137 +/- 19 microm for AL irradiation alone, 87 +/- 9 microm for RS treatment alone and 68 +/- 12 microm for AL irradiation before RS treatment. All treatment groups had mean lesion depths that were significantly less than those for the matched no-treatment control group (analysis of variance [ANOVA], Duncan multiple range [DMR] test, P < .05). AL irradiation before RS treatment significantly reduced lesion depth compared with AL irradiation alone or RS treatment alone (ANOVA, DMR test, P < .05). CONCLUSIONS: The maximum reduction in lesion depth in primary tooth enamel was achieved when the RS--which contained calcium, phosphate and fluoride in a carbopol base--was combined with AL irradiation. CLINICAL IMPLICATIONS: It would appear that to improve clinical caries resistance to enamel dissolution, AL irradiation before RS treatment could be used.

PMID: 16739544 [PubMed - indexed for MEDLINE]

A two-year randomized clinical trial of chlorhexidine varnish on dental caries in Chinese preschool children.

J Dent Res. 2006 Jun;85(6):557-9

Authors: Du MQ, Tai BJ, Jiang H, Lo EC, Fan MW, Bian Z

The objective of this study was to assess the effect of six-monthly professional applications of chlorhexidine varnish on the prevention of dental caries in primary molars in Chinese preschool children. In a double-blinded, randomized, placebo-controlled clinical trial, 334 children aged 4-5 years were randomly divided into two groups. Children in the test group received six-monthly applications of a 40% chlorhexidine varnish, and the control children received a placebo varnish. Caries status of the children was assessed by two calibrated examiners at baseline and after 24 months, according to criteria recommended by the World Health Organization. The two-year mean caries increments in the test and the control group children were 1.0 and 1.6 decayed, missing, or filled molar surfaces (dmfs-molar), respectively, a 37.3% reduction (t test, p = 0.036). No side-effects were found. It was concluded that six-monthly applications of chlorhexidine varnish were effective in reducing the incidence of dental caries in primary molars.

PMID: 16723655 [PubMed - indexed for MEDLINE]

Introducing a clinical-behavioural scoring system for children's oral hygiene.

Rev Salud Publica (Bogota). 2006 Jan-Apr;8(1):14-24

Authors: Medina-Sol&#xED;s CE, Maupomé G, Segovia-Villanueva A, Casanova-Rosado AJ, Vallejos-Sánchez AA, Casanova-Rosado JF

OBJECTIVES: Developing and testing a clinical-behavioural scoring system for assessing children's oral hygiene. MATERIALS AND METHODS: One clinical variable (the presence of dental plaque, measured using Silness and Loe's index) and one behavioural variable (self-reported tooth brushing frequency) were combined into secondary data analysis of research databases for 3-6-year-olds and 6-13-year-olds in a Mexican community. The combined scoring is an ordinal scale that depicts suitable, moderate and inadequate hygiene. Blinded dental examiners also collected dmft/DMFT data in standardised conditions. Data was analysed with Spearman's rho, Kruskall-Wallis, non-parametric tests for trends and Pearson's chi2 tests. RESULTS: 1303 children aged 3-6 years old and 1644 children aged 6-13 years old participated in the study. Clear relationships existed between the combined scoring system and dmft (p < 0.01) and between the scoring system and DMFT (p < 0.01), suggesting that the combined clinical-behavioural scoring system is a reasonably accurate measurement of the relationship between caries experience and oral hygiene in children in the given setting. CONCLUSIONS: The combined clinical-behavioural scoring system is a simple, easy-to-use tool that incorporates clinical and behavioural data commonly found in dental systems. Whether the clinical-behavioural scoring system can be generalised remains to be established.

PMID: 16703959 [PubMed - indexed for MEDLINE]

Prevalence of dental caries, severity, and pattern in age 6 to 7-year-old children in a selected community in Saudi Arabia.

J Contemp Dent Pract. 2006 May 1;7(2):46-54

Authors: Al-Malik MI, Rehbini YA

AIMS: The aim of this study was to determine the prevalence, severity, and pattern of dental caries in 6 to 7-year-old children in military primary schools in Jeddah city, Saudi Arabia. METHODS AND MATERIALS: A random sample of 300 children (6 to 7-year-olds) was drawn from six schools of military dependents. Clinical examinations were carried out under standardized conditions by two trained and calibrated examiners (MAM) and (YR). Caries were diagnosed using the British Association for the Study of Community Dentistry (BASCD) criteria. RESULTS: Caries were diagnosed in 288 (96%) of the children, and only 4% were clinically caries free. Mean decayed, missing, and filled teeth (dmft) for the 300 children was 8.06 (+ 4.04) per child and mean decayed, missing, and filled surfaces (dmfs) was 23.18 (+ 15.64). The teeth most affected by caries were mandibular primary second molars (83.35%), and the least affected were mandibular primary central incisors (1.15%). CONCLUSIONS: The level of caries was higher than seen in children of equivalent age in other studies. The level of caries is expected to increase in permanent dentition. The above findings stress the need for an effective program of oral prevention in these children, such as a school dental health education program for children and their parents in order to improve their oral health status.

PMID: 16685294 [PubMed - indexed for MEDLINE]

The 'new' operative dentistry.

J Am Dent Assoc. 2006 Apr;137(4):531-3

Authors: Christensen GJ

During the past few decades, life expectancy has increased significantly. As a result, mature patients often have receding gingival tissues, physical and mental debilitation, less energy and motivation, and the resultant Class V carious lesions. In this article, I suggest the use of high-level fluoride in toothpastes, remineralizing pastes and high-level fluoride gels for topical application in trays to reduce the progression of caries. To accompany fluoride therapy, high-fluoride-releasing restorative materials are indicated for Class V carious lesions. Adequate caries-preventive and restorative concepts for mature patients require planning, patient education and close patient supervision.

PMID: 16637483 [PubMed - indexed for MEDLINE]

Caries-inhibiting effect of chlorhexidine varnish in pits and fissures.

J Dent Res. 2006 May;85(5):469-72

Authors: Zhang Q, van 't Hof MA, Truin GJ, Bronkhorst EM, van Palenstein Helderman WH

Evidence regarding the caries-inhibiting effect of chlorhexidine varnish is inconclusive. This study investigated the caries-inhibiting effect of the varnish EC40 on pits and fissures of first permanent molars. A two-year randomized controlled trial was carried out among 461 six- to seven-year-old children. In a split-mouth design, one group of molars received EC40 at baseline, 6, 12, and 18 months, and another group at baseline, 3, 12, and 15 months. Control molars did not receive EC40. Adherence to the treatment protocol was good. The dropout rate was 17%. Blinded examiners performed dental examinations.The caries-inhibiting effects of the two EC40 application schemes were comparable. The prevented fraction of caries was 25% (95%CI, 1%, 49%, p = 0.04) after 2 years and 9% (95%CI, -11%, 29%, p = 0.20) one year after termination of the trial, suggesting a short-term benefit from the use of EC40. The efficiency of EC40 is questionable in low-caries-incidence child populations.

PMID: 16632763 [PubMed - indexed for MEDLINE]

Food labeling: health claims; dietary noncariogenic carbohydrate sweeteners and dental caries. Final rule.

Fed Regist. 2006 Mar 29;71(60):15559-64

Authors:

The Food and Drug Administration (FDA) is announcing its decision to authorize the use of a health claim regarding the association between sucralose and the nonpromotion of dental caries. Based on its review of evidence described in the proposed rule and comments submitted on the proposed rule, the agency has concluded that sucralose does not promote dental caries. Therefore, the agency has decided to amend the regulation that authorizes a health claim regarding noncariogenic carbohydrate sweeteners to include sucralose.

PMID: 16572525 [PubMed - indexed for MEDLINE]