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Free Full Text ArticleDental trauma: restorative procedures using composite resin and mouthguards f...
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Dental trauma: restorative procedures using composite resin and mouthguards for prevention.

J Contemp Dent Pract. 2007;8(6):89-95

Authors: Santos Filho PC, Quagliatto PS, Simamoto PC, Soares CJ

AIM: The aim of this article is to describe a step-by-step protocol for emergency care of a patient with a dentoalveolar injury in the anterior region of the mouth as well as the fabrication of a mouthguard to prevent future trauma. BACKGROUND: Dental trauma is one of the most serious oral health problems in active children and adolescents. Care of traumatized patients requires immediate initial emergency treatment followed by integrated procedures to restore damaged oral structures along with a subsequent trauma prevention strategy. Dentoalveolar injuries in the anterior region of the mouth are often characterized by tooth avulsion and coronal fracture. They are managed using procedures such as dental splinting, endodontic therapy with its unique characteristics, and restorative techniques to re-establish function and esthetics as well as protective mouthguards. REPORT: A 16-year-old male presented with avulsion of his maxillary central incisors as a result of a direct, unintentional impact with an opponent during a basketball game. The teeth had been stored in physiological serum immediately following the injury and the patient received immediate care. On clinical examination, the right central incisor was fractured at the incisal third of the crown but no bone fractures were found. The teeth were reimplanted and splinted. The fractured right central incisor was restored following endodontic treatment and a mouthguard was fabricated for the patient. SUMMARY: The dentist must be knowledgeable about the most efficient and suitable treatment for each traumatic scenario in order to provide appropriate care for dental injuries. Coordinated multi-disciplinary action is fundamental in the successful treatment of these injuries. The dental mouthguard is an effective device for protecting the teeth and supportive structures during physical activities and must be part of the protective equipment used by athletes. It is the responsibility of the dental professional to make parents, trainers, and athletic associations aware of the risks associated with physical activities without orofacial protection; this should encourage the proper use of all protective devices to prevent dentoalveolar injuries that compromise oral functions, esthetics, and increase the cost of healthcare.

PMID: 17846676 [PubMed - indexed for MEDLINE]


Free Full Text ArticleAssociations of periodontal damage and tooth loss with atherogenic factors am...
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Associations of periodontal damage and tooth loss with atherogenic factors among patients with type 2 diabetes mellitus.

Intern Med. 2007;46(17):1359-64

Authors: Furukawa T, Wakai K, Yamanouchi K, Oshida Y, Miyao M, Watanabe T, Sato Y

OBJECTIVE: To clarify the associations of periodontal damage and tooth loss with atherogenic factors among diabetic patients. METHODS: We examined the correlations of age, sex, smoking, oral hygiene score, blood pressure, body mass index, and blood chemical data with the mean depth of periodontal pockets or the number of remaining teeth. PATIENTS: One hundred outpatients with type 2 diabetes aged 29 to 77 years. RESULTS: The mean depth of periodontal pockets was significantly associated with smoking, oral hygiene score, and HbA1c; the Spearman correlation coefficients (r) were 0.220, 0.417, and 0.260, respectively. Age, oral hygiene score, and HbA1c were inversely correlated with the number of remaining teeth (r=-0.306, -0.287, and -0.275, respectively). Serum total cholesterol was significantly correlated with the mean depth of pockets after adjustment for smoking, oral hygiene score, and HbA1c (r=0.211; P=0.044), while serum HDL cholesterol tended to be negatively associated with depth (r=-0.202; P=0.055). Serum HDL cholesterol was also associated with an increased number of teeth, which remained significant after adjustment for age, oral hygiene score, and HbA1c (r=0.202; P=0.048). The estimated glomerular filtration rate was significantly and positively correlated with the number of teeth in the univariate analysis, although consideration of the potential confounding factors somewhat weakened the association (r=0.186; P=0.069). CONCLUSIONS: We may expect better management of oral health in diabetic patients with control of dyslipidemia in addition to blood glucose.

PMID: 17827833 [PubMed - indexed for MEDLINE]


Free Full Text ArticleImpact of public preventive programmes on oral quality of life of 11 to 12-yr...
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Impact of public preventive programmes on oral quality of life of 11 to 12-yr-old school students.

Med Oral Patol Oral Cir Bucal. 2007 Sep;12(5):E408-11

Authors: Hita Iglesias C, Prados Atienza MB, Bravo M, Prados Sánchez E, Muñoz Soto E, González Rodríguez MP

OBJECTIVES: The objective was to analyze the impact of preventive programmes on oral quality of life in school students aged 11-12 yrs. STUDY DESIGN: In the school year 1996/97, a quasi-experimental study was initiated in Granada province with four groups of students aged 6-7 yrs: Sealant + Fluoride (sealants on first permanent molars applied in the health centre for a 3-yr active programme, and fluoride varnish applied every four months for 3 yrs, n=65), Sealant (only sealants, n=80), Fluoride (only fluoride varnish, n=107) and Control group (n=59). All students were examined every 6 months at school during the 3-yr active programme and received an oral health report after each examination. At 5.5 yrs (school year 2002/03), after 2.5 yrs with no programme, students were again examined and completed a questionnaire on oral quality of life scored from -6 (minimum) to +6 (maximum). RESULTS: Oral quality of life values (+/- standard deviation) were: 3.31+/-0.30 (Sealant + Fluoride), 3.11+/-0.27 (Sealant), 3.18+/-0.23 (Fluoride) and 2.95+/-0.32 (Control), with no statistically significant differences among them. CONCLUSIONS: Fissure sealant and fluoride varnish programmes had no significant influence on oral quality of life after a 5.5- yr follow-up (3 yrs of active programme plus 2.5 yrs of discontinuation).

PMID: 17767110 [PubMed - indexed for MEDLINE]


Free Full Text Article[Fifty years of fluoridation of public water supplies in Brazil: benefits for...
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[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]


Free Full Text ArticleEarly Childhood Caries among a Bedouin community residing in the eastern outs...
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Early Childhood Caries among a Bedouin community residing in the eastern outskirts of Jerusalem.

BMC Public Health. 2007;7:167

Authors: Livny A, Assali R, Sgan-Cohen HD

BACKGROUND: ECC is commonly prevalent among underprivileged populations. The Jahalin Bedouin are a severely deprived, previously nomadic tribe, dwelling on the eastern outskirts of Jerusalem. The aim of this study was to assess ECC prevalence and potentially associated variables. METHODS: 102 children aged 12-36 months were visually examined for caries, mothers' anterior dentition was visually subjectively appraised, demographic and health behavior data were collected by interview. RESULTS: Among children, 17.6% demonstrated ECC, among mothers, 37.3% revealed "fairly bad" anterior teeth. Among children drinking bottles there was about twice the level of ECC (20.3%) than those breast-fed (13.2%). ECC was found only among children aged more than one year (p < 0.001); more prevalent ECC (55.6%) was found among large (10-13 children) families than among smaller families (1-5 children: 13.5%, 6-9 children: 15.6%) (p = 0.009); ECC was more prevalent among children of less educated mothers (p = 0.037); ECC was more prevalent among mothers with "fairly poor" anterior dentition (p = 0.04). Oral hygiene practices were poor. CONCLUSION: ECC levels in this community were not very high but neither low. This changing population might be on the verge of a wider dental disease "epidemic". Public health efforts clearly need to be invested towards the oral health and general welfare of this community.

PMID: 17650296 [PubMed - indexed for MEDLINE]


Free Full Text ArticleRelationship between smoking status and tooth loss: findings from national da...
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Relationship between smoking status and tooth loss: findings from national databases in Japan.

J Epidemiol. 2007 Jul;17(4):125-32

Authors: Hanioka T, Ojima M, Tanaka K, Aoyama H

BACKGROUND: A causal association between cigarette smoking and periodontal disease has been established. The present study examined the association between smoking and tooth loss using national databases in Japan. METHODS: Records of the Survey of Dental Diseases and the National Nutrition Survey in 1999 were linked electronically using common identification. Records of 3,999 subjects aged older than 40 years were analyzed using logistic regression models, controlling for confounding factors, such as age, frequency of tooth brushing, body mass index, alcohol consumption, and intakes of vitamin C and E. RESULTS: Prevalence of tooth loss in terms of having less than 19 existing teeth was 37.3% overall. Smoking rates differed in males (45.6%) and females (7.8%). The prevalence of tooth loss in nonsmokers, former, and current smokers was 28.5%, 38.6%, and 36.9% in males, and 38.6%, 34.3% and 38.9% in females, respectively. Adjusted means of existing teeth controlling for confounders by smoking status were 21.5, 19.7 and 18.2 in males and 19.0, 19.2 and 16.4 in females, respectively. The association of tooth loss was non-significant in former smokers but significant in current smokers: adjusted odds ratios (95% confidence intervals) relative to nonsmokers in males and females were 1.29 (0.92-1.80) and 0.86 (0.46, 1.60) for former smokers and 2.22 (1.61-3.06) and 2.14 (1.45-3.15) for current smokers, respectively. A dose-response relationship between lifetime exposure and tooth loss was seen (P for trend <0.0001). CONCLUSION: The findings of this cross-sectional study of a nationwide population of Japanese indicated an association between smoking and tooth loss.

PMID: 17641448 [PubMed - indexed for MEDLINE]


Free Full Text ArticleAdjunctive effects of systemic amoxicillin and metronidazole with scaling and...
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Adjunctive effects of systemic amoxicillin and metronidazole with scaling and root planing: a randomized, placebo controlled clinical trial.

J Contemp Dent Pract. 2007;8(5):51-9

Authors: Moeintaghavi A, Talebi-ardakani MR, Haerian-ardakani A, Zandi H, Taghipour S, Fallahzadeh H, Pakzad A, Fahami N

AIMS: The objective of this study was to investigate the effect of the systemic administration of metronidazole and amoxicillin as an adjunct to initial periodontal therapy in patients with moderate to severe chronic periodontitis. METHODS AND MATERIALS: This randomized, double blind, placebo controlled parallel study involved 50 adult patients with untreated periodontitis who were randomly assigned to receive either a full-mouth scaling and root planing along with systemic metronidazole and amoxicillin (T group) or scaling and root planing with a placebo (P group). Clinical measurements including probing depth (PD), clinical attachment levels (CAL), Plaque Index (PI), and Bleeding Index (BI) were recorded at baseline and six to eight weeks after therapy. The deepest pocket was selected and samples for microbiological testing were taken. Patients received coded study medications of either 500 mg amoxicillin in combination with 250 mg metronidazole or an identical placebo every eight hours for seven days following scaling and root planing. RESULTS: There was a significant change in PD (P=0.0001), CAL (P=0.00001), PI (P<0.05), and BI (P<0.05) in the T group compared to the placebo group after therapy. Parallel to the clinical changes, treatment significantly reduced the number of Actinobacillus actinomycetemcomitans (Aa), Porphyromonas gingivalis (Pg), and P. intermedia (Pi) compared with baseline in the T group (P=0.003, 0.021 and 0.0001, respectively). However, in the P group only the Pi colony count was reduced significantly (P=0.0001). After therapy, there was a significant difference between the T and P groups in the number of patients negative for Aa, Pg, and Pi (Pv = 0.033). CONCLUSIONS: The significant differences between treatment and placebo groups are in line with other studies and support the considerable adjunctive benefits of the combination of amoxicillin and metronidazole in the treatment of chronic periodontitis.

PMID: 17618330 [PubMed - indexed for MEDLINE]


Free Full Text ArticleAn anticalculus dentifrice with sodium hexametaphosphate and stannous fluorid...
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An anticalculus dentifrice with sodium hexametaphosphate and stannous fluoride: a six-month study of efficacy.

J Contemp Dent Pract. 2007;8(5):1-8

Authors: Winston JL, Fiedler SK, Schiff T, Baker R

AIM: To compare the anticalculus efficacy of an experimental dentifrice (0.454% stabilized stannous fluoride/sodium hexametaphosphate) with a negative control. METHODS AND MATERIALS: This was a randomized, examiner-blind, parallel group study. After a three-month run-in, qualifying subjects were randomized to the experimental or control dentifrice to use twice a day for six months. Volpe-Manhold Index (V-MI) and oral soft tissue examinations were conducted at baseline, three, and six months. Additional analyses were performed separately at three and six months on three subgroups categorized into high, medium, and low calculus-forming subjects. RESULTS: Compared to the control group, the experimental dentifrice group had a mean calculus score statistically significantly lower at both three months (50%) and six months (55%) post-treatment (p<0.001). Compared to control scores, mean experimental dentifrice calculus scores at three and six months were statistically significantly lower at both points in time for high, medium, and low calculus forming sub-groups (p<0.001). Both products were generally well tolerated. CONCLUSION: The experimental dentifrice revealed significant anticalculus efficacy compared to the control regardless of levels of baseline calculus formation. CLINICAL SIGNIFICANCE: The stannous fluoride/sodium hexametaphosphate dentifrice technology is an effective calculus inhibitor for home care.

PMID: 17618324 [PubMed - indexed for MEDLINE]


Free Full Text ArticleA preliminary report of structural changes to mouthguards during 1 season of ...
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A preliminary report of structural changes to mouthguards during 1 season of high school football.

J Athl Train. 2007 Jan-Mar;42(1):47-50

Authors: Rossi GD, Lisman P, Leyte-Vidal MA

CONTEXT: Extensive changes to mouthguards may occur as a result of wear and tear and equipment abuse. OBJECTIVE: To examine how the shape and thickness of custom-fabricated mouthguards change over the course of a complete season of high school football. DESIGN: Repeated-measures, case-series study. SETTING: High school. PATIENTS OR OTHER PARTICIPANTS: Fifteen high school varsity football players aged 15 to 17 years began the investigation; 4 participants lost their mouthguards before the end of the season. MAIN OUTCOMES MEASURE(S): Custom-made mouthguards were examined before the start of the season, midway through the season, and at the end of the season to document changes to material thickness and shape. Along with evaluating the thickness of mouthguards at the incisor/canine and molar regions, we assessed shape retention by evaluating the width of the mouthguard channel at the first molar. RESULTS: Material thickness at the incisor/canine region decreased by approximately 16% (F(2,20) = 34.20, P < .001) after 6 weeks of participation. Over the same time period, the mouthguard thickness at the molars decreased by 23% (F(2,20) = 31.92, P < .001), and the shape of the mouthguards changed as well (F(1,11) = 6.01, P = .029). CONCLUSIONS: Although test mouthguards displayed significant deterioration in shape and material thickness, more research is needed to establish wearing length. Frequent inspections of mouthguards are advised to ensure that fit and protective abilities have not been compromised.

PMID: 17597943 [PubMed - indexed for MEDLINE]


Free Full Text ArticleThe influence of various factors on high school football helmet face mask rem...
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The influence of various factors on high school football helmet face mask removal: a retrospective, cross-sectional analysis.

J Athl Train. 2007 Jan-Mar;42(1):11-9

Authors: Swartz EE, Decoster LC, Norkus SA, Cappaert TA

CONTEXT: Most research on face mask removal has been performed on unused equipment. OBJECTIVE: To identify and compare factors that influence the condition of helmet components and their relationship to face mask removal. DESIGN: A cross-sectional, retrospective study. SETTING: Five athletic equipment reconditioning/recertification facilities. PARTICIPANTS: 2584 helmets from 46 high school football teams representing 5 geographic regions. INTERVENTION(S): Helmet characteristics (brand, model, hardware components) were recorded. Helmets were mounted and face mask removal was attempted using a cordless screwdriver. The 2004 season profiles and weather histories were obtained for each high school. MAIN OUTCOME MEASURE(S): Success and failure (including reason) for removal of 4 screws from the face mask were noted. Failure rates among regions, teams, reconditioning year, and screw color (type) were compared. Weather histories were compared. We conducted a discriminant analysis to determine if weather variables, region, helmet brand and model, reconditioning year, and screw color could predict successful face mask removal. Metallurgic analysis of screw samples was performed. RESULTS: All screws were successfully removed from 2165 (84%) helmets. At least 1 screw could not be removed from 419 (16%) helmets. Significant differences were found for mean screw failure per helmet among the 5 regions, with the Midwest having the lowest failure rate (0.08 +/- 0.38) and the Southern (0.33 +/- 0.72), the highest. Differences were found in screw failure rates among the 46 teams (F(1,45) = 9.4, P < .01). Helmets with the longest interval since last reconditioning (3 years) had the highest failure rate, 0.47 +/- 0.93. Differences in success rates were found among 4 screw types (chi(2) (1,4) = 647, P < .01), with silver screws having the lowest percentage of failures (3.4%). A discriminant analysis (Lambda = .932, chi(2) (14,n=2584) = 175.34, P < .001) revealed screw type to be the strongest predictor of successful removal. CONCLUSIONS: Helmets with stainless steel or nickel-plated carbon steel screws reconditioned in the previous year had the most favorable combination of factors for successful screw removal. T-nut spinning at the side screw locations was the most common reason and location for failure.

PMID: 17597938 [PubMed - indexed for MEDLINE]


Free Full Text ArticleMeasurement of impact acceleration: mouthpiece accelerometer versus helmet ac...
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Measurement of impact acceleration: mouthpiece accelerometer versus helmet accelerometer.

J Athl Train. 2007 Jan-Mar;42(1):5-10

Authors: Higgins M, Halstead PD, Snyder-Mackler L, Barlow D

CONTEXT: Instrumented helmets have been used to estimate impact acceleration imparted to the head during helmet impacts. These instrumented helmets may not accurately measure the actual amount of acceleration experienced by the head due to factors such as helmet-to-head fit. OBJECTIVE: To determine if an accelerometer attached to a mouthpiece (MP) provides a more accurate representation of headform center of gravity (HFCOG) acceleration during impact than does an accelerometer attached to a helmet fitted on the headform. DESIGN: Single-factor research design in which the independent variable was accelerometer position (HFCOG, helmet, MP) and the dependent variables were g and Severity Index (SI). SETTING: Independent impact research laboratory. INTERVENTION(S): The helmeted headform was dropped (n = 168) using a National Operating Committee on Standards for Athletic Equipment (NOCSAE) drop system from the standard heights and impact sites according to NOCSAE test standards. Peak g and SI were measured for each accelerometer position during impact. MAIN OUTCOME MEASURES: Upon impact, the peak g and SI were recorded for each accelerometer location. RESULTS: Strong relationships were noted for HFCOG and MP measures, and significant differences were seen between HFCOG and helmet g measures and HFCOG and helmet SI measures. No statistically significant differences were noted between HFCOG and MP g and SI measures. Regression analyses showed a significant relationship between HFCOG and MP measures but not between HFCOG and helmet measures. CONCLUSIONS: Upon impact, MP acceleration (g) and SI measurements were closely related to and more accurate in measuring HFCOG g and SI than helmet measurements. The MP accelerometer is a valid method for measuring head acceleration.

PMID: 17597937 [PubMed - indexed for MEDLINE]


Free Full Text Article[Enamel defects, caries in primary dentition and fluoride sources: relationsh...
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[Enamel defects, caries in primary dentition and fluoride sources: relationship with caries in permanent teeth]

Gac Sanit. 2007 May-Jun;21(3):227-34

Authors: Vallejos-S&#xE1;nchez AA, Medina-Solís CE, Casanova-Rosado JF, Maupomé G, Casanova-Rosado AJ, Minaya-Sánchez M

OBJECTIVE: To examine the relationship between the presence of enamel defects, dental caries in primary teeth, and exposure to various fluoride technologies and the presence of dental caries in permanent teeth in children with mixed dentition. MATERIALS AND METHODS: A cross-sectional study was conducted in 713 children aged 6-9 years old in 4 elementary schools in Campeche, Mexico through the use of a questionnaire for the mothers and an oral examination in the children. The dependent variable was the prevalence of caries in permanent dentition. RESULTS: The mean number of decay, missing or filling teeth in primary dentition (dmft) and in permanent dentition (DMFT) was 2.48 (2.82) (deft > 0 = 58.9%) and 0.40 (0.98) (DMFT > 0 = 18.2%), respectively. The significant caries index (SiC), which is calculated in deciduous dentition, was 5.85 for 6 year-olds. Multivariate logistic regression adjusted for variables related to fluoride exposure revealed that older age (OR = 2.99), a deft of > 0 (OR = 5.46), and lower maternal educational level (OR = 1.57) were significantly associated with a higher number of dental caries in permanent teeth. An interaction between sex and enamel defects was also found. CONCLUSIONS: The number of dental caries in both primary and permanent dentitions was relatively smaller than that found in prior studies performed in Mexican populations. The results confirm that the presence of caries in primary dentition is strongly associated with caries in permanent dentition. No significant relationship was found between fluoride exposure and dental caries in permanent dentition.

PMID: 17565898 [PubMed - indexed for MEDLINE]


Free Full Text ArticleFeasibility and costs of water fluoridation in remote Australian Aboriginal c...
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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]


Free Full Text ArticleCharacteristics of breast-fed children with nursing caries.
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Characteristics of breast-fed children with nursing caries.

Bull Tokyo Dent Coll. 2006 Nov;47(4):161-5

Authors: Yonezu T, Yotsuya K, Yakushiji M

The aim of this study was to investigate the characteristics and risk factors of prolonged breast-feeding in children. A total of 105 children aged 18 months were screened for ongoing breast-feeding at a public health center. Of these, 105 children were selected for a more comprehensive examination, involving investigation of dietary, tooth-brushing habits and oral hygiene. The children were examined again, and initial and manifest caries were recorded at 24 months of age. As a result, 20 (19.0%) of the 105 children had caries at 24 months of age. Logistic regression analysis revealed an association between caries and bedtime breast-feeding (p=0.003). Oral hygiene at 18 months of age was also correlated with caries (p=0.015). It was concluded that reducing the frequency of feeding, early establishment of good oral hygiene habits and also regular visits to the dentist are essential in preventing nursing caries in prolonged breast-fed children.

PMID: 17510546 [PubMed - indexed for MEDLINE]


Free Full Text ArticleCase-control study of human papillomavirus and oropharyngeal cancer.
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Case-control study of human papillomavirus and oropharyngeal cancer.

N Engl J Med. 2007 May 10;356(19):1944-56

Authors: D'Souza G, Kreimer AR, Viscidi R, Pawlita M, Fakhry C, Koch WM, Westra WH, Gillison ML

BACKGROUND: Substantial molecular evidence suggests a role for human papillomavirus (HPV) in the pathogenesis of oropharyngeal squamous-cell carcinoma, but epidemiologic data have been inconsistent. METHODS: We performed a hospital-based, case-control study of 100 patients with newly diagnosed oropharyngeal cancer and 200 control patients without cancer to evaluate associations between HPV infection and oropharyngeal cancer. Multivariate logistic-regression models were used for case-control comparisons. RESULTS: A high lifetime number of vaginal-sex partners (26 or more) was associated with oropharyngeal cancer (odds ratio, 3.1; 95% confidence interval [CI], 1.5 to 6.5), as was a high lifetime number of oral-sex partners (6 or more) (odds ratio, 3.4; 95% CI, 1.3 to 8.8). The degree of association increased with the number of vaginal-sex and oral-sex partners (P values for trend, 0.002 and 0.009, respectively). Oropharyngeal cancer was significantly associated with oral HPV type 16 (HPV-16) infection (odds ratio, 14.6; 95% CI, 6.3 to 36.6), oral infection with any of 37 types of HPV (odds ratio, 12.3; 95% CI, 5.4 to 26.4), and seropositivity for the HPV-16 L1 capsid protein (odds ratio, 32.2; 95% CI, 14.6 to 71.3). HPV-16 DNA was detected in 72% (95% CI, 62 to 81) of 100 paraffin-embedded tumor specimens, and 64% of patients with cancer were seropositive for the HPV-16 oncoprotein E6, E7, or both. HPV-16 L1 seropositivity was highly associated with oropharyngeal cancer among subjects with a history of heavy tobacco and alcohol use (odds ratio, 19.4; 95% CI, 3.3 to 113.9) and among those without such a history (odds ratio, 33.6; 95% CI, 13.3 to 84.8). The association was similarly increased among subjects with oral HPV-16 infection, regardless of their tobacco and alcohol use. By contrast, tobacco and alcohol use increased the association with oropharyngeal cancer primarily among subjects without exposure to HPV-16. CONCLUSIONS: Oral HPV infection is strongly associated with oropharyngeal cancer among subjects with or without the established risk factors of tobacco and alcohol use.

PMID: 17494927 [PubMed - indexed for MEDLINE]


Free Full Text ArticleClinical management of an unusual case of gingival enlargement.
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Clinical management of an unusual case of gingival enlargement.

J Contemp Dent Pract. 2007;8(4):88-94

Authors: Sumanth S, Bhat KM, Bhat GS

AIM: The purpose of this article is to report a case of conditioned gingival enlargement managed by non-surgical periodontal therapy. BACKGROUND: Hormones are specific regulatory molecules that modulate a host of body functions. Hormonal effects reflect physiologic and pathologic changes in almost all tissues of the body with the periodontium being no exception. Physiologic changes like puberty, the menstrual cycle, and pregnancy cause hormonal variations that may cause inflammation of the gingiva. Oral contraceptives that contain estrogen and/or progesterone are associated with gingival enlargement. REPORT: A 28-year-old female presented with a complaint of swelling of the gingiva with spontaneous bleeding in the maxillary anterior region for a period of one year. The health history documented the use of contraceptives for one year, and a clinical examination revealed the existence of poor oral hygiene and enlarged painful gingival tissues that bled when touched. SUMMARY: This case reaffirms the fact plaque control is the most important procedure in any periodontal therapy. Another factor contributing to the excellent response to therapy is patient compliance. The patient followed home care instructions well and was effective in personal oral hygiene measures.

PMID: 17486192 [PubMed - indexed for MEDLINE]


Free Full Text ArticleA novel oscillating-rotating power toothbrush with SmartGuide: designed for e...
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A novel oscillating-rotating power toothbrush with SmartGuide: designed for enhanced performance and compliance.

J Contemp Dent Pract. 2007;8(4):1-9

Authors: Walters PA, Cugini M, Biesbrock AR, Warren PR

AIM: The aim of this article is to provide a review of common power toothbrush technologies with a focus on the oscillating-rotating motion used in a novel toothbrush; describe features to drive compliance such as the "SmartGuide" innovation; and finally recommend steps to motivate patients to adopt a power toothbrush as part of their home care regimen. BACKGROUND: Contemporary power toothbrushes are available with various modes of actions, bristle designs, and features. Clinical research shows these factors can impact the effectiveness of a toothbrush by altering its ability to remove plaque, particularly in areas that are difficult to access. An independent systematic review of power toothbrush technologies showed toothbrushes with a rotation-oscillation motion provided significant advantages over manual toothbrushes for plaque removal and gingivitis reduction. No other powered toothbrush technology showed results as consistently superior to manual toothbrushes. CONCLUSIONS: Recently, an advanced oscillating-rotating toothbrush was introduced, the Oral-B Triumph with SmartGuide (Procter & Gamble, Cincinnati, OH, USA), using clinically proven oscillating-rotating technology and incorporating a unique wireless remote display to drive good brushing technique and increase brushing time. This type of innovation in power toothbrush technology provides dental professionals and consumers with additional home care tools to help improve oral health. In recommending any power toothbrush, dental professionals should reinforce the benefits to patients in a way that addresses their values, use experiential learning tools to ensure they understand how to use the brush, explain the desired outcomes, and gain their commitment to comply with the recommendation.

PMID: 17486181 [PubMed - indexed for MEDLINE]


Free Full Text ArticleBottled, filtered, and tap water use in Latino and non-Latino children.
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Bottled, filtered, and tap water use in Latino and non-Latino children.

Arch Pediatr Adolesc Med. 2007 May;161(5):457-61

Authors: Hobson WL, Knochel ML, Byington CL, Young PC, Hoff CJ, Buchi KF

OBJECTIVES: To describe bottled, filtered, and tap water consumption and fluoride use among pediatric patients; to analyze differences between ethnic and socioeconomic groups; and to describe the frequency of physician-parent discussions regarding water consumption. DESIGN: Convenience sample survey. SETTING: An urban public health clinic. PARTICIPANTS: Parents attending a public health clinic. OUTCOME MEASURES: The primary outcome measure was the prevalence of tap, filtered, and bottled water use. The secondary outcome measures were supplemental fluoride use and the percentage of patients reporting discussions of water consumption with their physician. RESULTS: A total of 216 parents (80.5% Latino and 19.5% non-Latino) completed the survey. Of the parents, 30.1% never drank tap water and 41.2% never gave it to their children. Latino parents were less likely than non-Latino parents to drink tap water (odds ratio, 0.26; 95% confidence interval, 0.10-0.67) and less likely to give tap water to their children (odds ratio, 0.32; 95% confidence interval, 0.15-0.70). More Latinos believed that tap water would make them sick (odds ratio, 5.63; 95% confidence interval, 2.17-14.54). Approximately 40% of children who never drank tap water were not receiving fluoride supplements. Of the lowest-income families (<or=$14 999 per year), 64.9% always gave bottled (32.9%) or filtered (32.0%) water to their children. Of the parents surveyed, 82.5% reported that their child's physician had never discussed the type of water they should use. CONCLUSIONS: Many Latino families avoid drinking tap water because they fear it causes illness. Unnecessary use of bottled and filtered water is costly and may result in adverse dental health outcomes. Physicians should provide guidance to families regarding the safety, low cost, and dental health benefits of drinking tap water.

PMID: 17485621 [PubMed - indexed for MEDLINE]


Free Full Text ArticleStatus of oral health awareness in Indian children as compared to Western chi...
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Status of oral health awareness in Indian children as compared to Western children: a thought provoking situation (a pilot study).

J Indian Soc Pedod Prev Dent. 2007 Mar;25(1):15-9

Authors: Grewal N, Kaur M

A study was conducted to evaluate the level of oral health awareness in a selected sample of Indian children and a selected sample of western children residing in Amritsar city of Punjab. Children were evaluated on the basis of a standardized questionnaire developed by WHO, for health awareness in children. Final results revealed the level of awareness in both the groups and the practical application of their knowledge about dental health in day to day life.

PMID: 17456961 [PubMed - indexed for MEDLINE]


Free Full Text ArticlePrevalence and severity of hypertension in a dental hygiene clinic.
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Prevalence and severity of hypertension in a dental hygiene clinic.

J Contemp Dent Pract. 2007;8(3):13-20

Authors: Thompson AL, Collins MA, Downey MC, Herman WW, Konzelman JL, Ward ST, Hughes CT

AIM: The purpose of this study was to assess the prevalence and severity of hypertension in a dental hygiene clinic and evaluate factors related to the disease. METHODS AND MATERIALS: Records of 615 patients, treated by dental hygiene students during 2003, were reviewed. Data collected included systolic and diastolic blood pressure, presence of diabetes and renal disease, non-modifiers (race, gender, and age), and modifiers (marital status, smoking habits, and occupation). RESULTS: According to the Seventh Report of the Joint National Committee on the Prevention, Detection, Evaluation, and Treatment of High Blood Pressure (JNC7) classification, 154 (25%) of the subjects had normal blood pressure readings, 374 (60.8%) had prehypertension, and 87 (14.1%) had stage 1 hypertension. Statistical analysis showed a significant difference in the JNC7 classification between groups when considering the non-modifiers' race (p=.02) and the modifiers' smoking habits (p=.03) and occupation (p=.01). A statistically significant difference in the JNC7 classification existed between groups with diabetes (p=.00). The majority of patients had blood pressure readings in the prehypertension stage. CONCLUSION: Based on these results, the researchers recommend clinical policy modifications which include: additional documentation for blood pressure readings in the prehypertension stage, lowering the systolic reading from 160 mmHg to 140 mmHg when adding hypertension alert labels, and noting prehypertension/hypertension on the dental hygiene care plan with the appropriate interventions.

PMID: 17351677 [PubMed - indexed for MEDLINE]


Free Full Text ArticleTreatment of periodontitis and endothelial function.
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Treatment of periodontitis and endothelial function.

N Engl J Med. 2007 Mar 1;356(9):911-20

Authors: Tonetti MS, D'Aiuto F, Nibali L, Donald A, Storry C, Parkar M, Suvan J, Hingorani AD, Vallance P, Deanfield J

BACKGROUND: Systemic inflammation may impair vascular function, and epidemiologic data suggest a possible link between periodontitis and cardiovascular disease. METHODS: We randomly assigned 120 patients with severe periodontitis to community-based periodontal care (59 patients) or intensive periodontal treatment (61). Endothelial function, as assessed by measurement of the diameter of the brachial artery during flow (flow-mediated dilatation), and inflammatory biomarkers and markers of coagulation and endothelial activation were evaluated before treatment and 1, 7, 30, 60, and 180 days after treatment. RESULTS: Twenty-four hours after treatment, flow-mediated dilatation was significantly lower in the intensive-treatment group than in the control-treatment group (absolute difference, 1.4%; 95% confidence interval [CI], 0.5 to 2.3; P=0.002), and levels of C-reactive protein, interleukin-6, and the endothelial-activation markers soluble E-selectin and von Willebrand factor were significantly higher (P<0.05 for all comparisons). However, flow-mediated dilatation was greater and the plasma levels of soluble E-selectin were lower in the intensive-treatment group than in the control-treatment group 60 days after therapy (absolute difference in flow-mediated dilatation, 0.9%; 95% CI, 0.1 to 1.7; P=0.02) and 180 days after therapy (difference, 2.0%; 95% CI, 1.2 to 2.8; P<0.001). The degree of improvement was associated with improvement in measures of periodontal disease (r=0.29 by Spearman rank correlation, P=0.003). There were no serious adverse effects in either of the two groups, and no cardiovascular events occurred. CONCLUSIONS: Intensive periodontal treatment resulted in acute, short-term systemic inflammation and endothelial dysfunction. However, 6 months after therapy, the benefits in oral health were associated with improvement in endothelial function.

PMID: 17329698 [PubMed - indexed for MEDLINE]


Free Full Text ArticleEffects of oral care on development of oral mucositis and microorganisms in p...
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Effects of oral care on development of oral mucositis and microorganisms in patients with esophageal cancer.

Jpn J Infect Dis. 2007 Feb;60(1):23-8

Authors: Yoneda S, Imai S, Hanada N, Yamazaki T, Senpuku H, Ota Y, Uematsu H

We evaluated the effects of special oral care using a toothbrush with combined irrigation and suctioning functions, along with povidone-iodine to treat oral bacteria and mucositis, in esophageal cancer patients undergoing chemoradiotherapy. In the special care group, oral hygiene was performed 3 days a week after dinner. Bacteria in saliva and plague samples were measured at various sampling points after chemoradiotherapy. The incidence of mucositis was significantly reduced in the special care group in comparison with the control group. Total streptococci were significantly decreased in the opportunistic pathogens-positive and lower-level mutans streptococci control group during chemoradiotherapy, but they were not reduced in the opportunistic pathogens-negative and higher-level mutans streptococci control groups or in the special care group. Our results showed that a special oral care regimen enabled the total population of streptococci microflora to remain stable, was negatively correlated with opportunistic pathogens and positively correlated with mutans streptococci infection, and prevented the development of mucositis.

PMID: 17314421 [PubMed - indexed for MEDLINE]


Free Full Text Article[External control over the fluoridation of the public water supply in Bauru, ...
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[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]


Free Full Text ArticleAugmentation of keratinized gingiva through bilaminar connective tissue graft...
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Augmentation of keratinized gingiva through bilaminar connective tissue grafts: a comparison between two techniques.

Minerva Stomatol. 2007 Jan-Feb;56(1-2):3-20

Authors: Bertoldi C, Bencivenni D, Lucchi A, Consolo U

AIM: A mucogingival deficiency is considered a potential risk factor for periodontal disease. In particular, mucogingival deficiency can lead to gingival recession, which is a pathological entity per se, due to the increased risk for dental hypersensitivity and root caries. The aim of this study was to evaluate and compare 2 bilaminar grafting techniques normally employed to achieve root coverage. METHODS: Thirty-five patients were divided into 2 groups. Group 1 included 19 patients with 49 gingival recessions treated by Nelson technique (as modified by Harris), while group 2 included 15 patients with 40 recessions treated by Langer technique. Clinical evaluation was performed at preoperative level (T0), after 1 month (T1) and after 1 year (T2). Statistical analysis was performed by means of Friedmann and Wilcoxon test and U-Mann-Whitney test. RESULTS: The statistical analysis did not reveal any significant difference between groups, both in terms of percentage of root coverage and of width of keratinizaed gingiva gain. A significant difference was only observed within each group, for the amount of keratinized gingiva at T1 vs T0 and at T2 vs T1. CONCLUSIONS: This study did not show any statistical difference between the Nelson and the Langer technique as to root coverage and gain in keratinized gingiva.

PMID: 17287702 [PubMed - indexed for MEDLINE]


Free Full Text ArticleDental management of low socioeconomic level patients before radiotherapy of ...
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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]


Free Full Text ArticleEfficacy of Carisolv as an adjunctive therapy to scaling and root planing on ...
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Efficacy of Carisolv as an adjunctive therapy to scaling and root planing on subgingival calculus removal.

Braz Dent J. 2006;17(3):213-8

Authors: Grisi DC, Salvador SL, Marcantonio RA

The purpose of this study was to evaluate the effectiveness of subgingival application of Carisolv gel as an adjunctive therapy to scaling and root planing (SRP) on calculus removal compared to conventional instrumentation. Forty-five teeth requiring extraction due to severe periodontal disease were randomized to the following treatments: 1) SRP alone; 2) placebo gel + SRP; 3) Carisolv gel + SRP. Either test or placebo gel was applied subgingivally for 1 min and then the root were instrumented until a smooth and calculus-free surface was achieved. Instrumentation time and the number of strokes required were recorded. After extraction, the efficacy of root surface instrumentation was measured by percentage of remaining calculus. There was no statistically significant difference (p>0.05) between the treatment groups regarding either time required for instrumentation or the percentage of residual calculus. The subgingival application of Carisolv gel prior to SRP did not provide any additional benefit to root instrumentation compared to scaling and root planing alone.

PMID: 17262127 [PubMed - indexed for MEDLINE]


Free Full Text ArticlePrevalence of dental caries in children born prematurely or at full term.
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Prevalence of dental caries in children born prematurely or at full term.

Braz Oral Res. 2006 Oct-Dec;20(4):353-7

Authors: Gravina DB, Cruvinel VR, Azevedo TD, de Toledo OA, Bezerra AC

The objective of this study was to evaluate the prevalence of dental caries in 192 children, 96 born prematurely and 96 at full term, in a regional hospital in Brazil. Mean age at clinical examination was 40.72 months in the full-term group (G1) and 30.44 months in the premature group (G2). The children were divided in two age subgroups: 0 to 3 and 4 to 6 years. Statistical results (Student's t and Kruskal-Wallis tests) showed that dmft was 0.43 for G1 and 0.01 for G2 in the 0-3 age subgroup, and 1.7 for G1 and 1.1 for G2 in the 4-6 age subgroup. Differences were significant between G1 and G2 only in the 0-3 age subgroup (p = 0.047). Caries evaluation showed that, of the 96 children in G1, 75 were caries free, while in G2, 84 did not have the disease. These differences were not significant (p = 0.088). The lower mean dmft found in the 0-3 age subgroup in G2 may be attributed to routines established by the hospital's neonatology staff, such as frequent dental visits and preventive instructions about oral habits, oral hygiene and diet. After this age, with the completion of the primary dentition, values increased and became similar between the G1 and G2 groups. Results also suggested a highly skewed distribution since most caries were found in only a small number of children.

PMID: 17242798 [PubMed - indexed for MEDLINE]


Free Full Text ArticleHistological analysis of effects of 24% EDTA gel for nonsurgical treatment of...
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Histological analysis of effects of 24% EDTA gel for nonsurgical treatment of periodontal tissues.

J Oral Sci. 2006 Dec;48(4):207-14

Authors: de Vasconcellos LM, Ricardo LH, Balducci I, de Vasconcellos LG, Carvalho YR

The aim of this study was to investigate, by means of histological and histomorphometric analysis, the effects of 24% ethylenediaminetetraacetic acid (EDTA) gel in periodontal tissue when used in combination with conventional periodontal treatment. Periodontitis was induced in the 2nd upper left permanent molars of 45 male Wistar rats by means of ligature. After 5 weeks, this was removed and debridement was performed. The animals were then randomly divided into 3 groups; group 1: mechanical treatment, group 2: mechanical treatment and EDTA gel application for 2 min, and group 3: mechanical treatment and placebo gel application for 2 min. After the treatment, rinsing was done with 0.9% saline solution for 1 min in all cases, followed by root notching in the deepest part of the pocket. After 4, 10, and 28 days the animals were sacrificed. The averages obtained were evaluated by means of test two-way analysis of variance (ANOVA) and Tukey statistical tests (P < 0.05). The results showed that with respect to the type of treatment employed, there were no statistically significant differences in the vitality of the periodontal tissue. It was concluded that 24% EDTA gel did not interfere with periodontal tissue repair when used in combination with conventional periodontal treatment.

PMID: 17220618 [PubMed - indexed for MEDLINE]


Free Full Text ArticleOral health status and treatment needs in institutionalized psychiatric patie...
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Oral health status and treatment needs in institutionalized psychiatric patients: one year descriptive cross sectional study.

Indian J Dent Res. 2006 Oct-Dec;17(4):171-7

Authors: Kumar M, Chandu GN, Shafiulla MD

BACKGROUND AND OBJECTIVES: Psychiatric patients are one of the special groups requiring attention as they are often neglected. Oral health is an major determinant of general health for psychiatric patients and may have a low priority in the context of mental illness. The present study was conducted to assess the oral health status and treatment needs of institutionalized psychiatric patients of Davangere. METHODS: 220 psychiatric patients admitted in two general hospitals of Davangere during the period of one year were included in the study. The oral health status was evaluated with respect to caries, oral hygiene, and periodontal status. RESULTS: Of the 180 examined with the response rate of 81.8%. 58.3% were males, mean age was 36.7 years, 57.8% had < 1 year of mental illness with a mean of 2.2 years, and 90% were self-sufficient. The multiple logistic regression analysis showed that the mean DMFT (0.92) increased with age, duration of mental illness, and irregularity of oral hygiene habits (P<0.001). Mean OHI-S score was 3.3 and multiple logistic regression analysis showed that the mean OHI-S score increased with age (P<0.001). The multiple logistic regression analysis showed that the CPI score increased with age, duration of mental illness, and degree of helplessness (P<0.001). INTERPRETATION AND CONCLUSION: The findings of this study demonstrates low caries prevalence, poor oral hygiene, and extensive unmet needs for dental treatment.

PMID: 17217213 [PubMed - indexed for MEDLINE]


Free Full Text ArticleToothbrush selection: a dilemma?
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Toothbrush selection: a dilemma?

Indian J Dent Res. 2006 Oct-Dec;17(4):167-70

Authors: Sasan D, Thomas B, Mahalinga BK, Aithal KS, Ramesh PR

The toothbrush is a fundamental tool used for accomplishing plaque control. Various types of toothbrushes available in the market keep the buyer in a state of dilemma as to which one to choose, due to lack of information about the "quality" of it. This study has been designed to understand whether all the products available in the market adhere to the specifications laid down by the ADA, which is universally accepted in standardization of a tooth brush. 95% of the brushes surveyed contain less number of bristles per tuft than specified and a large percentage deviate from the standard prescribed value for their bristle diameter and other dimensions. Few brushes labeled as "Soft" were "Medium" and labeled "Medium" were "Hard". The study will bring to light the quality of toothbrushes available in India for a rationalised selection of appropriate toothbrush by the community at large.

PMID: 17217212 [PubMed - indexed for MEDLINE]


Free Full Text ArticleOral care in the intensive care unit: a review.
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Oral care in the intensive care unit: a review.

J Contemp Dent Pract. 2007 Jan 1;8(1):76-82

Authors: Abidia RF

Oral care for patients in the hospital's Intensive Care Unit (ICU) is important, but this is usually the responsibility of nurses without sufficient knowledge in oral care or comprehensive protocols to follow. The problems of maintaining oral care with oral intubation, performing oral assessment, guidelines for oral hygiene care, frequency of oral care needed, and suggested mouth care protocol followed by recommendations are presented and discussed in this paper.

PMID: 17211508 [PubMed - indexed for MEDLINE]


Free Full Text ArticleA comparative evaluation of self-reported oral hygiene practices among medica...
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A comparative evaluation of self-reported oral hygiene practices among medical and engineering university students with access to health-promotive dental care.

J Contemp Dent Pract. 2007 Jan 1;8(1):68-75

Authors: Doshi D, Baldava P, Anup N, Sequeira PS

AIM: This study was conducted to test the null hypothesis that no difference exists in the oral hygiene knowledge and practices of university students in different courses when they have equal opportunity to access health-promotive dental care. METHODS AND MATERIALS: The study was conducted using 120 students each from the medical and engineering colleges at the University of Manipal Academy of Higher Education who had easy access to the dental college within the campus which provides health-promotive dental care to all its patients. A self-administered structured questionnaire consisting of questions on demographic data, oral hygiene knowledge and practices, and dental service utilization patterns was distributed among the students. The data collected was analyzed using SPSS 10 version. RESULTS: Statistically significant differences were found between the two groups with respect to the knowledge of fluoridated toothpastes, frequency of toothbrush renewal, use of dental floss, and a tongue cleaner (p < 0.001). The groups were similar in all other practices including the utilization of dental services. There were no significant differences between the self-reported oral hygiene knowledge and practices among medical and engineering university students, but the knowledge levels of the students were considerably lower than expected.

PMID: 17211507 [PubMed - indexed for MEDLINE]


Free Full Text ArticleRoot coverage with free gingival autografts--a clinical study.
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Root coverage with free gingival autografts--a clinical study.

Indian J Dent Res. 2006 Jul-Sep;17(3):126-30

Authors: Deepalakshmi D, Arunmozhi U

AIM: To assess the percentage of root coverage with autogenous free gingival grafts. MATERIALS & METHODS: Ten non-smoking patients with Miller's class I or class II recessions were included in the study. The clinical parameters such as recession depth, recession width, probing pocket depth, clinical attachment level and width of the keratinized gingiva were recorded at the baseline, at the end of 1 month, 3 months, and 6 months after the surgical procedure. Autogenous free gingival grafts harvested from the palatal mucosa were used to cover the denuded roots. RESULTS: Four out of ten sites showed 100% root coverage. A mean percentage of 80.3% of root coverage was achieved.

PMID: 17176829 [PubMed - indexed for MEDLINE]


Free Full Text ArticleAssessment of full-time dental hygiene faculty participation in clinical prac...
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Assessment of full-time dental hygiene faculty participation in clinical practice.

J Dent Educ. 2006 Dec;70(12):1298-307

Authors: Kiser JR, Wilder RS, Fleming DE, George MC

The purpose of this research project was to determine how many U.S. dental hygiene (DH) programs had full-time (FT) faculty members who provided direct patient care unrelated to the curriculum. Questions in this project also assessed attitudes and opinions of DH directors regarding clinical practice and opportunities for salary supplementation. A questionnaire of twenty open-ended and closed-ended questions was designed on Survey Monkey, an online survey engine. After IRB approval and pilot testing, 278 U.S. DH program directors received two emails with the survey link requesting their participation. A response rate of 69.1 percent (n=192) was achieved. Results revealed that 14.2 percent of the programs required FT DH faculties to participate in clinical practice settings unrelated to the curriculum, while 67 percent of the programs had faculties who also participated in clinical practice. Eighty-three percent of respondents reported faculties who participated in clinical practice were financially compensated. The majority (95.4 percent) of directors indicated maintaining clinical skills was an advantage to clinical practice, while 48 percent of directors indicated participation takes time away from being an educator. Overall, the majority of DH programs did not require FT faculties to participate in clinical practice; however, respondents were generally in favor of allowing faculties the opportunity to practice and thought that it enhanced their competency as clinical instructors.

PMID: 17170320 [PubMed - indexed for MEDLINE]


Free Full Text ArticleQuality of life and oral hygiene in older people with manual functional limit...
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Quality of life and oral hygiene in older people with manual functional limitations.

J Dent Educ. 2006 Dec;70(12):1261-2

Authors: Montandon AA, Pinelli LA, Fais LM

PMID: 17170314 [PubMed - indexed for MEDLINE]


Free Full Text ArticleThe effect of tool handle shape on hand muscle load and pinch force in a simu...
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The effect of tool handle shape on hand muscle load and pinch force in a simulated dental scaling task.

Appl Ergon. 2007 Sep;38(5):525-31

Authors: Dong H, Loomer P, Barr A, Laroche C, Young E, Rempel D

Work-related upper extremity musculoskeletal disorders, including carpal tunnel syndrome, are prevalent among dentists and dental hygienists. An important risk factor for developing these disorders is forceful pinching which occurs during periodontal work such as dental scaling. Ergonomically designed dental scaling instruments may help reduce the prevalence of carpal tunnel syndrome among dental practitioners. In this study, eight custom-designed dental scaling instruments with different handle shapes were used by 24 dentists and dental hygienists to perform a simulated tooth scaling task. The muscle activity of two extensors and two flexors in the forearm was recorded with electromyography while thumb pinch force was measured by pressure sensors. The results demonstrated that the instrument handle with a tapered, round shape and a 10 mm diameter required the least muscle load and pinch force when performing simulated periodontal work. The results from this study can guide dentists and dental hygienists in selection of dental scaling instruments.

PMID: 17156742 [PubMed - indexed for MEDLINE]


Free Full Text ArticleFor the dental patient ... Protecting teeth with mouthguards.
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For the dental patient ... Protecting teeth with mouthguards.

J Am Dent Assoc. 2006 Dec;137(12):1772

Authors:

PMID: 17138721 [PubMed - indexed for MEDLINE]


Free Full Text ArticleUsing mouthguards to reduce the incidence and severity of sports-related oral...

Using mouthguards to reduce the incidence and severity of sports-related oral injuries.

J Am Dent Assoc. 2006 Dec;137(12):1712-20; quiz 1731

Authors: ,

BACKGROUND: This report reviews the available literature on the types and properties of athletic mouthguards, current fabrication methods and the role of mouth protectors in reducing the incidence and severity of sports-related oral injuries. OVERVIEW: For more than 50 years, the American Dental Association has promoted the protective value of wearing properly fitted mouthguards while participating in athletic or recreational activities that carry a risk of dental injury. Safety is essential to maintaining oral health, and a properly fitted mouthguard can minimize the risks of sustaining oral injuries during participation in sports. CONCLUSIONS: The dental literature supports the use and protective value of mouthguards in reducing sports-related injuries to the teeth and soft tissues. Dentists are encouraged to educate patients regarding the risks of oral injury in sports, fabricate properly fitted mouthguards, and provide appropriate guidance on mouthguard types and their protective properties, costs and benefits. Further studies addressing the effectiveness of currently available mouthguard types and population-based interventions for reducing oral injuries are recommended. CLINICAL IMPLICATIONS: Participants in sporting and recreational activities are often susceptible to oral injury. To reduce the incidence and severity of sports-related oral trauma, the use of a properly fitted mouthguard is recommended in any athletic or recreational activity that carries a risk of injury.

PMID: 17138717 [PubMed - indexed for MEDLINE]


Free Full Text ArticleA meta-analysis of six-month studies of antiplaque and antigingivitis agents.
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A meta-analysis of six-month studies of antiplaque and antigingivitis agents.

J Am Dent Assoc. 2006 Dec;137(12):1649-57

Authors: Gunsolley JC

BACKGROUND AND METHODS: The author conducted a systematic review of the literature to evaluate the efficacy of antigingivitis and antiplaque products in six-month trials. He searched electronic databases for six-month randomized clinical studies that evaluated both antiplaque and antigingivitis properties of dentifrices or mouthrinses. In addition, the author solicited unpublished studies from manufacturers. RESULTS: Seventeen studies support the antiplaque, antigingivitis effects of dentifrices containing 0.30 percent triclosan, 2.0 percent Gantrez copolymer. There was no evidence of efficacy for triclosan products containing either soluble pyrophosphate or zinc citrate. Dentifrices with stannous fluoride had statistically significant, but marginally clinically significant, evidence of an antiplaque effect; however, there was both a statistically and clinically significant antigingivitis effect. The largest body of studies (21 studies) supported the efficacy of mouthrinses with essential oils. A smaller body of studies (seven) supported a strong antiplaque, antigingivitis effect of mouthrinses with 0.12 percent chlorhexidine. Results for mouthrinses with cetylpyridinium chloride varied and depended on the product's formula. CONCLUSIONS: The studies in this systematic review provide strong evidence of the antiplaque, antigingivitis effects of multiple agents. These results support the use of these agents as part of a typical oral hygiene regimen.

PMID: 17138709 [PubMed - indexed for MEDLINE]


Free Full Text ArticlePeriodontal treatment does not reduce the risk of preterm delivery, study finds.
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Periodontal treatment does not reduce the risk of preterm delivery, study finds.

J Am Dent Assoc. 2006 Dec;137(12):1642-3

Authors: Garvin J

PMID: 17138706 [PubMed - indexed for MEDLINE]


Free Full Text ArticleOne in a million: the first community trial of water fluoridation.
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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]


Free Full Text ArticlePlaque removal by young children using old and new toothbrushes.
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Plaque removal by young children using old and new toothbrushes.

J Dent Res. 2006 Dec;85(12):1138-42

Authors: van Palenstein Helderman WH, Kyaing MM, Aung MT, Soe W, Rosema NA, van der Weijden GA, van 't Hof MA

There is inconclusive evidence about the relationship between toothbrush wear and plaque removal. This randomized cross-over clinical trial aimed to validate or invalidate non-inferiority in the plaque-removal efficacy of old vs. new toothbrushes in the hands of 7- and 8-year-old children. The lower limit for non-inferiority was set a priori as a difference in plaque score<15%. Children (n=101) brushed, in the first session, with either their 14-month-old toothbrush or a new one, and in the second session vice versa. The mean Quigley-Hein plaque score, before and after children brushed with old brushes, was 2.9 and 2.4, and with new brushes 2.8 and 2.1. The plaque score after they brushed with the new toothbrush was 10.9% lower (p<0.001) than after they brushed with the old toothbrush. The confidence interval of 7.6%-13.9% was within the acceptance band (<15%), and non-inferiority of old toothbrushes in the hands of these children was validated.

PMID: 17122169 [PubMed - indexed for MEDLINE]


Free Full Text ArticleFactors related to periodontal disease in a rural population.
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Factors related to periodontal disease in a rural population.

Braz Oral Res. 2006 Jul-Sep;20(3):257-62

Authors: de Mac&#xEA;do TC, Costa Mda C, Gomes-Filho IS, Vianna MI, Santos CT

To estimate the prevalence and related aspects of periodontitis in a rural area of the State of Bahia, Brazil, this cross-sectional study was carried out in the village of Matinha dos Pretos, Feira de Santana County, Bahia, among 172 subjects ranging from 20 to 60 years of age. During household visits, a full-mouth periodontal exam was performed on each subject, who also answered a questionnaire about socio-demographic, economic and health-related issues. The factors assessed were plaque index, bleeding on probing index, probing depth, gingival recession or hyperplasia measurements. Clinical attachment loss was also calculated. The multivariate logistic regression method was used to evaluate the relative contribution of these factors to the periodontitis condition. The prevalence of periodontitis was 24.4%. The following factors were all positively associated with the presence of periodontitis: being male (OR = 1.58; 1.00 - 2.53), being 30 years of age or older (OR = 2.80; 1.00 - 7.39), living in a house where there was more than one person per room (OR = 1.53; 0.96 - 2.45), being a cigarette or pipe smoker or ex-smoker (OR = 1.49; 0.92 - 2.39), having a plaque index of over 65% (OR = 2.97; 2.72 - 7.39) and more than four missing teeth (OR = 1.51; 0.82 - 2.78). The authors concluded that socioeconomic and biological factors, especially poor oral hygiene and older age, are positively associated with periodontitis in the rural population of a small village in the county of Feira de Santana, State of Bahia, Brazil.

PMID: 17119710 [PubMed - indexed for MEDLINE]


Free Full Text ArticleHow did we get here? Where are we going? Hopes and gaps in access to oral hea...
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How did we get here? Where are we going? Hopes and gaps in access to oral health care.

J Dent Educ. 2006 Nov;70(11):1125-32

Authors: Patthoff DE

This article reviews the history and future good of acceptance ethics and helps frame the publication of papers presented at the workshop on Professional Promises: Hopes and Gaps in Access to Oral Health Care. Discovery and development of Universal Patient Acceptance (UPA), a practical application of acceptance ethics, is key to systematizing access to oral health; UPA expands partnerships among professional volunteerism, culture, and economic structures. A Veterans' Administration health services preventive dentistry research project and a West Virginia school children's preventive dental program raised awareness of acceptance. A state insurance crisis revealed an underlying systems ethics problem that was not purely legal, political, educational, economic, or scientific in nature. Key players were identified for dialogue, and questions were ranked. UPA was articulated and proposed as a unique, practical, and positive professional promise. The experience involved PEDNET, a dental ethics education group. An intensive applied dental ethics course for practicing dentists was developed; it attracted the American College of Dentists (ACD) and American Dental Association (ADA). Annual ACD LeaderSkills helped expand continuing education of ethics; several dental ethics summits were initiated. Concepts like discourse, adequate care, and viewing organizations as both persons and machines motivated further exploration of acceptance. Separating acceptance from diagnosis, treatment, and payment improves discourse on the various philosophical notions and practical applications that dominate each area.

PMID: 17106022 [PubMed - indexed for MEDLINE]


Free Full Text Article[Influence of acculturation on self-perceived oral health among Japanese-Braz...
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[Influence of acculturation on self-perceived oral health among Japanese-Brazilian elderly]

Cad Saude Publica. 2006 Nov;22(11):2441-8

Authors: Hiramatsu DA, Franco LJ, Tomita NE

Utilizing a qualitative methodology, this study aimed to evaluate the influence of acculturation on the elderly population and self-perception of their oral health. The target population included 40 individuals, divided into two groups: first- and second-generation Japanese immigrants. Through recorded interviews, acculturation level was assessed for each group, as was its influence on attention to oral health and self-evaluation of oral health status and time elapsed since the last dental appointment. Acculturation affected both groups, although to a greater degree in second-generation Japanese-Brazilians. However, it does not interfere in self-perception of oral health by this population. The main individual care with their oral health included brushing, flossing, and soaking dentures in antiseptic solutions. In self-assessed oral health, the main complaints related to wearing dentures, and the time elapsed since the last dental appointment was 1.4 years for the non-edentulous and 6.3 years for the edentulous.

PMID: 17091181 [PubMed - indexed for MEDLINE]


Free Full Text ArticleReasons for third molar teeth extraction in Jordanian adults.
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Reasons for third molar teeth extraction in Jordanian adults.

J Contemp Dent Pract. 2006 Nov 1;7(5):88-95

Authors: Hamasha AA, Al Qudah MA, Bataineh AB, Safadi RA

AIMS: To assess reasons for third molar teeth extractions in a sample of Jordanian dental patients and to evaluate the association of extractions with other independent variables. METHODS AND MATERIALS: The study sample was comprised of dental patients in North Jordan who had third molar extractions. Data were collected from 36 dentists who were instructed to administer questionnaires to their adult patients undergoing third molar extractions and then to record the primary reason for those extractions. The data in this study was analyzed using a descriptive summary and chi square statistics. RESULTS: Dentists performed 810 extractions for 648 patients. The reasons for the extractions were: dental caries and its consequences about 42%, eruption problems 39%, periodontal diseases about 7%, and approximately 9% of extractions were a result of the dentist's choice. The percentage of extractions due to dental caries significantly increased with increasing age. However, significant numbers of teeth were extracted due to eruption problems (51%-69%) in young adults. For 46+ year olds, 23% of extractions were caused by periodontal diseases. Extraction due to dental caries was distributed equally among the sexes. Persons with irregular tooth brushing and fewer dental visits had significantly more third molar teeth extracted due to caries and periodontal diseases compared to persons with regular tooth brushing and dental visits.

PMID: 17091144 [PubMed - indexed for MEDLINE]


Free Full Text ArticleCorrelations between two plaque indices in assessment of toothbrush effective...
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Correlations between two plaque indices in assessment of toothbrush effectiveness.

J Contemp Dent Pract. 2006 Nov 1;7(5):1-9

Authors: Cugini M, Thompson M, Warren PR

BACKGROUND: The Rustogi et al. Modified Navy (RMNPI) and Turesky et al Modification of the Quigley Hein (TQHPI) plaque indices are commonly used to measure plaque removal. This study evaluated the possible correlations of both indices using data relative to a single use assessment of plaque removal using commercially available toothbrushes. METHODS: Single use crossover study designs have been previously reported. Disclosed plaque was scored pre- and post-brushing using both the RMNPI and the TQHPI. Sixty subjects, with an initial mean RMNPI score of 0.6 or greater, were enrolled and completed the study. No minimum score was required for TQHPI. After the initial scoring, the order for each index was randomized so that each subject was scored with either RMNPI followed by TQHPI or vice versa. Two manual toothbrushes [Oral-B CrossAction (CA) and Colgate Navigator (NA)] and one battery-powered brush (Crest SpinBrush Pro) (SBP) were evaluated in the trial. One examiner performed all clinical measurements. Pearson correlations were performed on whole mouth, buccal, and lingual plaque scores for the CA toothbrush. RESULTS: Strong positive correlations were found between the two plaque indices for pre- and post-brushing scores for the whole mouth and on lingual and buccal surfaces, where Pearson correlation coefficients ranged between 0.963 and 0.995. There was no correlation between the pre-brushing plaque score and the amount of plaque removed by brushing indicating that higher plaque levels before brushing do not necessarily predict that greater amounts of plaque will be removed during toothbrushing. Each toothbrush was found to be safe and significantly reduced plaque levels after a single brushing (t-test, p=0.0001). Significantly greater plaque reductions were found with the CA than the NA and SBP toothbrushes at whole mouth, lingual, and approximal surfaces for both indices (analysis of variance (ANOVA), p < or = 0.0002 for all comparisons). CONCLUSIONS: Strong positive correlations were found between two plaque indices (the RMNPI and TQHPI) for pre- and post-brushing scores at whole mouth, lingual, and buccal surfaces as assessed using data from a single use assessment of plaque removal. Efficacy data from this study demonstrated the CA toothbrush provided superior cleaning when compared to the NA manual toothbrush and SBP battery toothbrush. CLINICAL IMPLICATIONS: Two commonly used indices for assessing plaque removal in clinical studies are RMNPI and TQHPI. However, each index differs in the way plaque is scored. This study used both indices to assess comparative toothbrush efficacy and showed a strong correlation between indices for both pre- and post- brushing plaque scores. The result suggests that both indices demonstrate sufficient sensitivity to differentiate toothbrush efficacy.

PMID: 17091134 [PubMed - indexed for MEDLINE]


Free Full Text ArticleTreatment of periodontal disease and the risk of preterm birth.
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Treatment of periodontal disease and the risk of preterm birth.

N Engl J Med. 2006 Nov 2;355(18):1885-94

Authors: Michalowicz BS, Hodges JS, DiAngelis AJ, Lupo VR, Novak MJ, Ferguson JE, Buchanan W, Bofill J, Papapanou PN, Mitchell DA, Matseoane S, Tschida PA,

BACKGROUND: Maternal periodontal disease has been associated with an increased risk of preterm birth and low birth weight. We studied the effect of nonsurgical periodontal treatment on preterm birth. METHODS: We randomly assigned women between 13 and 17 weeks of gestation to undergo scaling and root planing either before 21 weeks (413 patients in the treatment group) or after delivery (410 patients in the control group). Patients in the treatment group also underwent monthly tooth polishing and received instruction in oral hygiene. The gestational age at the end of pregnancy was the prespecified primary outcome. Secondary outcomes were birth weight and the proportion of infants who were small for gestational age. RESULTS: In the follow-up analysis, preterm birth (before 37 weeks of gestation) occurred in 49 of 407 women (12.0%) in the treatment group (resulting in 44 live births) and in 52 of 405 women (12.8%) in the control group (resulting in 38 live births). Although periodontal treatment improved periodontitis measures (P<0.001), it did not significantly alter the risk of preterm delivery (P=0.70; hazard ratio for treatment group vs. control group, 0.93; 95% confidence interval [CI], 0.63 to 1.37). There were no significant differences between the treatment and control groups in birth weight (3239 g vs. 3258 g, P=0.64) or in the rate of delivery of infants that were small for gestational age (12.7% vs. 12.3%; odds ratio, 1.04; 95% CI, 0.68 to 1.58). There were 5 spontaneous abortions or stillbirths in the treatment group, as compared with 14 in the control group (P=0.08). CONCLUSIONS: Treatment of periodontitis in pregnant women improves periodontal disease and is safe but does not significantly alter rates of preterm birth, low birth weight, or fetal growth restriction. (ClinicalTrials.gov number, NCT00066131 [ClinicalTrials.gov].).

PMID: 17079762 [PubMed - indexed for MEDLINE]


Free Full Text ArticleBuccodental health and oral mucositis. Clinical study in patients with hemato...
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Buccodental health and oral mucositis. Clinical study in patients with hematological diseases.

Med Oral Patol Oral Cir Bucal. 2006 Nov-Dec;11(6):E497-502

Authors: Sabater Recolons Mdel M, L&#xF3;pez López J, Rodríguez de Rivera Campillo ME, Chimenos Küstner E, Conde Vidal JM

OBJECTIVES: The objective of the present study is to assess whether a good buccodental status (evaluated by means of dentogingival indices), is associated with a lower incidence and severity of oral mucositis in patients with hematological diseases who receive treatment with chemotherapy or bone marrow transplant. STUDY DESIGN: The study was carried out on 97 patients admitted to the Hematology Service of the Hospital Duran y Reynals in Barcelona during 2002-2003. These patients received treatment with chemotherapy or conditioning prior to bone marrow transplant. A descriptive study was made, analyzing oral hygiene, one dental index, and two gingivales indices, and evaluating their relationship with the appearance of mucositis. RESULTS: The patients with high plaque (PI) and gingival (GI) indices during chemotherapy presented a higher percentage of mucositis (77.4% and 65.7% respectively) against those who had little or no visible plaque. In the case of the PI, the differences were statistically significant (p=0.015). Likewise, patients who brushed their teeth 3 times/day presented mucositis in only 26.7% of cases, against those who did not brush, or brushed only once a day (65.9% and 68.4%), these differences also being statistically significant (p=0.013). The CAO showed similar results in patients with or without mucositis (7.59 and 7.03 respectively). CONCLUSIONS: In our study, a good gingival status as well as good oral hygiene during chemoradiotherapy is associated with a lower incidence and severity of mucositis.

PMID: 17072254 [PubMed - indexed for MEDLINE]


Free Full Text ArticleOral cleanliness of 12-13-year-old and 15-year-old school children of Sunsari...
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Oral cleanliness of 12-13-year-old and 15-year-old school children of Sunsari District, Nepal.

J Indian Soc Pedod Prev Dent. 2006 Sep;24(3):146-51

Authors: Yee R, David J, Khadka R

The aim of the study was to evaluate the oral cleanliness of school children in the District of Sunsari, Nepal. A multi-stage random sampling oral epidemiological survey was conducted in private and government, urban, rural town and rural village schools in 15 illakas of Sunsari District, Eastern Nepal. A total of 600, 12-13-year-old and 600 15-year-old school children were examined by trained examiners using the simplified oral hygiene index (OHI-S). The average age-group, debris and calculus index scores were combined to obtain the simplified oral hygiene index (OHI-S). The mean OHI-S scores were compared and evaluated using the parametric t-test for two independent samples. The mean OHI-S for urban 12-13-year-old school children was 0.98 compared to 1.34 for school children of rural towns and 1.44 for school children of rural villages and these differences in mean OHI-S were statistically significant (P < 0.005). In the 15-year-old age group, urban school children had a mean OHI-S score of 1.00 compared to 1.37 for rural towns and 1.43 for rural villages. The variance in the mean OHI-S scores were statistically significant (P < 0.005). The overall level of cleanliness in the school children surveyed was good. Children of urban schools had the lowest scores followed by school children from rural towns and then rural villages. When the mean OHI-S scores were compared with the DMFT scores, there was an inverse relationship between oral cleanliness and dental caries. Frequency of sugar consumption and the availability and affordability of fluoridated toothpaste may be important factors in the development of dental caries than oral cleanliness.

PMID: 17065783 [PubMed - indexed for MEDLINE]



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