Measuring Health: A Guide to Rating Scales and Questionnaires

Christensen, R. (2002), Plane Answers to Complex Questions: The Theory of Linear Models (3rd ed.), New York: Springer-Verlag. Crocker, D. C. (1980), Review of Linear Regression Analysis, by G. A. F. Seber, Technometrics, 22, 130. Datta, B. N. (1995), Numerical Linear Algebra and Applications, Paci c Grove, CA: Brooks/Cole. Draper, N. R. (2002), “Applied Regression Analysis Bibliography Update 2000–2001,” Communications in Statistics: Theory and Methods, 2051– 2075. Golub, G. H., and Van Loan, C. F. (1996), Matrix Computations (3rd ed.), Baltimore, MD: Johns Hopkins University Press. Graybill, F. A. (2000), Theory and Application of the Linear Model, Paci c Grove, CA: Brooks/Cole. Hocking, R. R. (2003), Methods and Applications of Linear Models: Regression and the Analysis of Variance (2nd ed.), New York: Wiley. Porat, B. (1993), Digital Processing of Random Signals, Englewood Cliffs, NJ: Prentice-Hall. Ravishanker, N., and Dey, D. K. (2002), A First Course in Linear Model Theory, Boca Raton, FL: Chapman and Hall/CRC. White, H. (1984), Asymptotic Theory for Econometricians, Orlando, FL: Academic Press.

Generalized Estimating Equations

We conducted a systematic review of the Medline database (U.S. National Library of Medicine, National Institutes of Health, Bethesda, MD, U.S.A) to determine if consistent molecular vaginal microbiota (VMB) composition patterns can be discerned after a decade of molecular testing, and to evaluate demographic, behavioral and clinical determinants of VMB compositions. Studies were eligible when published between 1 January 2008 and 15 November 2013, and if at least one molecular technique (sequencing, PCR, DNA fingerprinting, or DNA hybridization) was used to characterize the VMB. Sixty three eligible studies were identified. These studies have now conclusively shown that lactobacilli-dominated VMB are associated with a healthy vaginal micro-environment and that bacterial vaginosis (BV) is best described as a polybacterial dysbiosis. The extent of dysbiosis correlates well with Nugent score and vaginal pH but not with the other Amsel criteria. Lactobacillus crispatus is more beneficial than L. iners. Longitudinal studies have shown that a L. crispatus-dominated VMB is more likely to shift to a L. iners-dominated or mixed lactobacilli VMB than to full dysbiosis. Data on VMB determinants are scarce and inconsistent, but dysbiosis is consistently associated with HIV, human papillomavirus (HPV), and Trichomonas vaginalis infection. In contrast, vaginal colonization with Candida spp. is more common in women with a lactobacilli-dominated VMB than in women with dysbiosis. Cervicovaginal mucosal immune responses to molecular VMB compositions have not yet been properly characterized. Molecular techniques have now become more affordable, and we make a case for incorporating them into larger epidemiological studies to address knowledge gaps in etiology and pathogenesis of dysbiosis, associations of different dysbiotic states with clinical outcomes, and to evaluate interventions aimed at restoring and maintaining a lactobacilli-dominated VMB.

http://icrh.org/sites/default/files/http___www.plosone.org_article_fetchObject.action_uri%3Dinfo_doi_10.1371_journal.pone.pdf

The vaginal microbiota: What have we learned after a decade of molecular characterization?

https://deepblue.lib.umich.edu/bitstream/handle/2027.42/94273/idj12007.pdf;sequence=1

Minimal intervention dentistry for managing dental caries - a review: report of a FDI task group.

Position of the Academy of Nutrition and Dietetics: Use of Nutritive and Nonnutritive Sweeteners

Xylitol is promoted in caries-preventive strategies, yet its effective dose range is unclear This study determined the dose-response of mutans streptococci in plaque and unstimulated saliva to xylitol gum Participants (n = 132) were randomized: controls (G1) (sorbitol/maltitol), or combinations giving xylitol 344 g/day (G2), 688 g/day (G3), or 1032 g/day (G4) Groups chewed 3 pellets/4 times/d Samples were taken at baseline, 5 wks, and 6 mos, and were cultured on modified Mitis Salivarius agar for mutans streptococci and on blood agar for total culturable flora At 5 wks, mutans streptococci levels in plaque were 10x lower than baseline in G3 and G4 (P = 0007/0003) There were no differences in saliva At 6 mos, mutans streptococci in plaque for G3 and G4 remained 10x lower than baseline (P = 0007/004) Saliva for G3 and G4 was lower than baseline by 8 to 9x (P = 0011/0038) Xylitol at 644 g/day and 1032 g/day reduces mutans streptococci in plaque at 5 wks, and in plaque and unstimulated sal

Mutans Streptococci Dose Response to Xylitol Chewing Gum

The purpose of this report was to provide an overview of xylitol and other polyol sweeteners and dental caries for clinicians and to discuss current applications for dental practice and potential community-based public health interventions. Xylitol, like other polyol sweeteners, is a naturally occurring sugar alcohol. Studies suggest polyols are noncariogenic. Furthermore, studies indicate that xylitol can decrease mutans streptococci levels in plaque and saliva and can reduce dental caries in young children, mothers, and in children via their mothers. Food products containing xylitol are now available and have the potential to be widely accessible to consumers to help control rampant decay. Determining whether products contain adequate xylitol amounts for practical use towards prevention is challenging, however, because xylitol content is not clearly labeled. Sufficient evidence exists to support the use of xylitol to reduce caries. Clinicians and dental associations should push for clear recommendations of efficacious dose and frequency of xylitol use and for clear labeling of xylitol content in products to help consumers choose appropriately.

Xylitol, sweeteners, and dental caries.

Background The authors provide an overview of chewing gum as a delivery vehicle for dental-protective agents, highlighting xylitol and its potential application in caries-prevention programs for children. Types of Studies Reviewed The authors reviewed selected clinical investigations and previous reviews associated with chewing gum containing substances such as calcium, bicarbonate, carbamide, chlorhexidine, fluoride and xylitol and their effects on reducing caries. They searched the MEDLINE database by using the key words “dental caries,” “oral health,” “calcium,” “bicarbonate,” “carbamide,” “chlorhexidine,” “fluoride” and “xylitol.” Results Chewing gum is being used as a delivery vehicle for substances such as calcium, bicarbonate, carbamide, chlorhexidine, fluoride and xylitol to improve oral health and reduce caries. These substances exhibit properties that are protective of the oral environment and mediate common oral diseases. The debate for advocating xylitol use in caries prevention is advancing; however, chewing gum use by young schoolchildren in the United States is hindered by choking hazard concerns and lack of specific xylitol dosing recommendations. Clinical Implications The use of chewing gum containing dental-protective substances, particularly xylitol, in caries-prevention programs can reduce the tooth decay epidemic. Chewing gum use by children in the school setting should be reconsidered.

The Potential of Dental-Protective Chewing Gum in Oral Health Interventions

Background The prevalence of dentin hypersensitivity is uncertain, yet appropriate diagnosis and treatment of dentin hypersensitivity require accurate knowledge regarding its prevalence. The authors conducted a study to estimate the prevalence of dentin hypersensitivity in general dental practices and to investigate associated risk factors. Methods The authors conducted a cross-sectional survey of 787 adult patients from 37 general dental practices within Northwest Practice-based Research Collaborative in Evidence-based DENTistry (PRECEDENT). Dentin hypersensitivity was diagnosed by means of participants' responses to a question regarding pain in their teeth and gingivae, and practitioner-investigators conducted a clinical examination to rule out alternative causes of pain. Participants recorded their pain level on a visual analog scale and the Seattle Scales in response to a one-second air blast. The authors used generalized estimating equation log-linear models to estimate the prevalence and the prevalence ratios. Results The prevalence of dentin hypersensitivity was 12.3 percent; patients with hypersensitivity had, on average, 3.5 hypersensitive teeth. The prevalence of dentin hypersensitivity was higher among 18- to 44-year olds than among participants 65 years or older; it also was higher in women than in men, in participants with gingival recession than in those without gingival recession and in participants who underwent at-home tooth whitening than in those who did not. Hypersensitivity was not associated with obvious occlusal trauma, noncarious cervical lesions or aggressive toothbrushing habits. Conclusions One in eight participants from general practices had dentin hypersensitivity, which was a chronic condition causing intermittent, low-level pain. Patients with hypersensitivity were more likely to be younger, to be female and to have a high prevalence of gingival recession and at-home tooth whitening. Practical Implications Given dentin hypersensitivity's prevalence, clinicians should diagnose it only after investigating all other possible sources of pain.

https://jada.ada.org/article/S0002-8177(14)60372-X/pdf

The prevalence of dentin hypersensitivity in general dental practices in the northwest United States

Background
Saliva is one of the intraoral host factors that influence caries development. The authors conducted a study to investigate whether salivary characteristics are associated with recent dental caries experience.

Marilynn Rothen

Papers

Mutans Streptococci Dose Response to Xylitol Chewing Gum

Xylitol, sweeteners, and dental caries.

The Potential of Dental-Protective Chewing Gum in Oral Health Interventions

The prevalence of dentin hypersensitivity in general dental practices in the northwest United States

Salivary characteristics and dental caries: evidence from general dental practices.