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Showing papers on "Oral hygiene published in 1978"


Journal ArticleDOI
TL;DR: Patients in a private periodontal practice were reexamined an average of 22 years after their active treatment and the patterns of tooth loss were observed and tooth retention seemed more closely related to the case type than the surgery performed.
Abstract: 1. Six hundred patients in a private periodontal practice were reexamined an average of 22 years after their active treatment and the patterns of tooth loss were observed. 2. During the post-treatment period, 300 patients had lost no teeth from periodontal disease, 199 had lost one to three teeth, 76 had lost 4 to 9 teeth and 25 had lost 10 to 23 teeth. 3. Of 2,139 teeth that originally had been considered of questionable prognosis, 666 were lost. Of these, 394 were lost by one sixth of the patients and only 272 by the other five-sixths. 4. Of 1,464 teeth which originally had furcation involvements, 460 were lost, 240 of them by one-sixth of the patients who deteriorated most. 5. The mortality of teeth which were treated with periodontal surgery was compared with that of teeth which did not have surgery. Tooth retention seemed more closely related to the case type than the surgery performed. 6. In general, periodontal disease is bilaterally symmetrical and there is a predictable order of likelihood of tooth loss according to position in the arch.

894 citations


Journal ArticleDOI
TL;DR: It is demonstrated that a preventive program which stimulates individuals to adopt proper oral hygiene habits may resolve gingivitis and prevent progression of periodontal disease and caries in adults.
Abstract: The present report describes the result of a clinical trial in which a group of adults have been maintained on a proper oral hygiene standard over a 6-year period. In 1971–72, 375 individuals were recruited to a test group and 180 to a control group. During the 6 years of trial, 65 persons from the test group and 34 controls were lost. The patients were divided into three age groups; I 50 years. The members of the test and control groups were first subjected to a Baseline examination which included assessments of oral hygiene, gingivitis, periodontal disease and caries. Following this examination all caries lesions were treated and ill-fitting dental restorations adjusted. Each patient was also given a detailed case presentation and a dental prophylaxis. The control group patients were not involved in any further dental health programs during the subsequent 6-year period. Once a year, however, they were recalled to a public dental health clinic for examination and received symptomatic dental treatment. The test group participants, on the other hand, were given a preventive treatment, repeated once every 2–3 months which included (1) instruction and practice in oral hygiene techniques and (2) meticulous prophylaxis. The patients were re-examined 3 and 6 years after the baseline examination. At the Follow-up examinations the parameters studied at the Baseline examination were recorded again. The findings demonstrated that a preventive program which stimulates individuals to adopt proper oral hygiene habits may resolve gingivitis and prevent progression of periodontal disease and caries. Traditional dental care, on the other hand, did not prevent the progression of caries and periodontitis in adults.

590 citations




Journal ArticleDOI
TL;DR: The baseline analysis indicated that due to the choice of study groups and design, the longitudenal data will lend themselves to describing the initiation, pattern of development and the rate of progress of periodontal disease during major portions of the abult life of these people.
Abstract: This is the first in a series of reports on a longitudinal investigation of the initiation and progress of periodontal disease in man. One group was established in Norway in 1969 and consisted of 565 male students and teachers between 17 and 30+years. A second group of comparable age was established in Sri Lanka in 1970 and consisted of 480 tea laborers. Both groups were scored for various disease parameters at start and at intervals during the subsequent seven years. This paper describes the design of the investigation and periodontal state of the two groups at baseline. The results show that th Norwegian group had good to excellent oral hygiene and mild gingivitis. Supra-and subgingival calculus were inconspicous and untreated slowly with age. The mean loss of attachment in the 30+year old was less than one millimeter. Tht Sri Lankan tea laborers showed poor oral hygiene, abundance of calculus and generalized moderate to severe gingivitis. Caries and dental restorations were non-existent. Slight loss of attachment was seen in the 15year old and increased through the twenties. The 30+years old Sri Lankan tea laborer showed a mean loss of more than 3 mm and a subsantial number of teeth exhibited attachment loss in excess of 10 mm. The baseline analysis indicated that due to the choice of study groups and design, the longitudenal data will lend themselves to describing the initiation, pattern of development and the rate of progress of periodontal disease during major portions of the abult life of these people.

272 citations



Journal ArticleDOI
Lars Matsson1
TL;DR: In this article, a comparative study of pre-school children and young adults was made with objective registration methods to confirm the existence of a difference in the propensity to develop gingivitis when oral hygiene is abandoned.
Abstract: Earlier studies suggest that children and adults differ in the propensity to develop gingivitis when oral hygiene is abandoned. To confirm the existence of such a difference, a comparative study of pre-school children and young adults was made with objective registration methods. The author performed all registrations. After a period of intensive oral hygiene, all cleaning of teeth was discontinued for 21 days. The amount of bacterial plaque, the amount of gingival exudate and crevicular leukocytes and the bleeding tendency were registered on days 0, 7, 14 and 21. During the experiment the amount of bacterial plaque increased continously in both groups. The amount of gingival exudate and the tendency to gingival bleeding increased to high values in the adults, while only a small rise was seen in the children. The amount of crevicular leukocytes increased in both groups, but the increment was greater in the adults. A comparison concerning differences in gingival exudate and bleeding tendency between pre-school children and adults was undertaken for gingival units that showed a similar plaque development. Under these statistically acceptable prerequisites, it was shown that there is a real difference in the tendency to develop gingivitis between pre-school children and adults.

104 citations


Journal ArticleDOI
TL;DR: No relationship appeared to exist due to the differences of progesterone or estrogen content in the various brands of oral contraceptives, and increased accumulative exposure to oral contraceptives apparently had no effect upon Oral Debris Indices or Gingival Inflammatory Indices.
Abstract: The relationship between gingival inflammation and type of oral contraceptive used or duration of use was investigated in 168 women between the age of 18-35. To qualify for the study patients had to have professional prophylaxis within the past year but not within the past month. An Oral Debris Index and Gingival Inflammatory Index was obtained during a clinical examination of four line angles for each patient following which the patients provided a history of their oral contraceptive use other drug use and current systemic diseases or conditions they may have. The clinical data were analyzed according to 1) current use of oral contraceptives; 2) brand of oral contraceptives used; and 3) duration of use. It was found that oral contraceptive users as a group (93 patients) had a significantly higher Gingival Inflammatory Index and a significantly lower Oral Debris Index. When this group was divided according to brand use users of Norinyl 1/50 and Ovral had a significantly lower Oral Debris Index than nonusers and users of Ovulen Ovral and Norinyl 1/80 had significantly higher Gingival Inflammatory Index. No differences were found based on different hormonal composition however or on duration of use. The higher gingival inflammatory indices in oral contraceptive users are in agreement with previous findings and may be due to elevated levels of progesterone. The lower Oral Debris Index in users may be caused by variability in oral hygiene among subjects or by an increased production of gingival fluid which may affect the disclosing solution. Further research is needed to determine the effect of long-term oral contraceptive use on various periodontal diseases.

75 citations



Journal ArticleDOI
Berit Olsson1
TL;DR: The mefaka was found to be as effective as the toothbrush in removing oral deposits and should be recommended for use in preventive dental programs in Ethiopia since it is effective, inexpensive, and familiar to the population.
Abstract: The effect of oral hygiene programs was studied in 248 children from five school classes in Asella, Ethiopia. All children received professional toothcleaning after an initial clinical examination, and were again examined after a trial period of 3 months. The classes were assigned to the following procedures: one class received information and instruction in the use of the toothbrush, and a second class in the use of the mefaka, a wooden chewing stick traditionally used for oral cleaning. The children were advised to clean their teeth daily. Two other classes received similar information and instruction with regard to the toothbrush and the mefaka. Oral cleaning was then performed daily under direction and supervision, in one class with the toothbrush and in the other class with the mefaka. The fifth class was used as control. Instruction only was found to have no effect on the amount of oral deposits. Supervised oral cleaning, on the other hand, improved the oral hygiene of the schoolchildren significantly. The mefaka was found to be as effective as the toothbrush in removing oral deposits. It was concluded that the mefaka should be recommended for use in preventive dental programs in Ethiopia since it is effective, inexpensive, and familiar to the population.

62 citations



Journal ArticleDOI
TL;DR: The study covered 515 children, aged 4 years and 1 month at the time of examination, selected from a total sample of about 1,600 individuals from two limited areas in southern Sweden.
Abstract: The study covered 515 children, aged 4 years and 1 month at the time of examination, selected from a total sample of about 1,600 individuals from two limited areas in southern Sweden. The investigatio

Journal ArticleDOI
11 Aug 1978-JAMA
TL;DR: Gingivitis and periodontitis account for more than 95% of all inflammatory diseases of the tissues surrounding the teeth, comprising the principal cause of tooth loss in adults.
Abstract: Gingivitis and periodontitis account for more than 95% of all inflammatory diseases of the tissues surrounding the teeth, comprising the principal cause of tooth loss in adults. Gingivitis is a relatively innocuous inflammation of the gums, with associated bleeding and exudation. Gingivitis may convert to periodontitis, a destructive aggressive disease with resorption of alveolar bone, destruction of collagen with fibrosis, and formation of deep pockets around the necks of the teeth. Gingivitis and periodontitis are caused by microorganisms populating the gingival sulcus and periodontal pocket. Treatment is directed toward arresting the progress of the disease through debridement and stabilization of the teeth. Toothbrushing and other measures by which the teeth are mechanically cleaned remain the most effective way to control plaque accumulation and periodontal disease.

Journal ArticleDOI
TL;DR: Evaluations of plaque and gingivitis showed that less plaque had accumulated and less gingvitis developed during the enzyme than during the placebo period, but bacteriologic studies of interproximal plaque did not reveal differences that could explain the clinical findings.
Abstract: The effect of a Trichoderma harzianum enzyme preparation containing mutanase (alpha-1,3 glucan glucanohydrolase) on plaque accumulation and composition and on occurrence of gingivitis was assessed in 20 persons in a double-blind cross-over investigation. The enzyme preparation was administered in chewing gum. Two test periods of 1 week were preceded by scaling and cleansing of the teeth, oral hygiene instruction, and controlled hygiene for at least 3 weeks. Oral hygiene measures were discontinued during the test periods, while the persons chewed six pieces of chewing gum per day, one half using enzyme-containing gum, and the other half using placebo gum. The test periods were identical, only enzyme gum was used instead of placebo, or vice versa. Evaluations of plaque and gingivitis showed that less plaque had accumulated and less gingivitis developed during the enzyme than during the placebo period, but bacteriologic studies of interproximal plaque did not reveal differences that could explain the clinical findings. Treatment with the enzyme preparation caused some local side effects, but no primary skin irritation, delayed hypersensitivity, nor anti-enzyme IgE was detected in any of the persons.

Journal ArticleDOI
TL;DR: The effect of a field program, based on systematic plaque control, on caries and gingivitis was tested during a 3-year period on 1,100 schoolchildren.
Abstract: The effect of a field program, based on systematic plaque control, on caries and gingivitis was tested during a 3-ycar period on 1,100 schoolchildren. Once every 3rd week the children were given oral hygiene instructions, professional toothcleaning and fluorides topically delivered by specially trained dental nurses. The children of a control group of approximately the same number of pupils, participated in a preventive program consisting of mouthrinsings once every 2nd week with a 0.2% sodium fluoride solution. The children of the third and fourth grades were, at the start of the experiment, selected as reference groups and then continuously examined once every year. At the end of the trial the mean reduction of surfaces harboring plaque and units with gingival inflammation was 59% and 73%, respectively. The reduction in caries increment was 51%.

Patent
14 Mar 1978
TL;DR: Disclosed is a dental hygiene preparation in the form of a filled capsule or a filled sweet comprising an outer shell containing a hydrophilic dental and/or oral hygiene substance and an inner core of a lipophilic substance as mentioned in this paper.
Abstract: Disclosed is a dental hygiene preparation in the form of a filled capsule or a filled sweet comprising an outer shell containing a hydrophilic dental and/or oral hygiene substance and an inner core of a lipophilic substance.

Journal ArticleDOI
TL;DR: Tumours of the oral cavity and the oropharynx account for 12% of the malignancies in the patient material and permanent damage to the covering squamous epithelium was demonstrated histologically.

Journal ArticleDOI
TL;DR: Rinsing with the test solution in conjunction with toothbrushing appears useful as an oral hygiene measure for orthodontic patients.

Journal ArticleDOI
TL;DR: The results showed that, while both groups A and B demonstrated extensive plaque deposits and gingivitis, these were present to a significantly lesser degree in Water Pik users.
Abstract: The influence of the water irrigating device, Water Pik, on the accumulation of plaque and development of gingivitis has been studied using the model, "experimental gingivitis in man". The investigation was carried out on 41 patient volunteers whose teeth were thoroughly scaled and polished during a 4-week period of intensive oral hygiene preceding each experimental period. Gingival exudation, Plaque Index and Gingival Index were registered at the beginning of the experimental periods. The participants were then divided into four groups. Groups A and B abandoned all forms of active oral hygiene. Group A, however, were given Water Pik devices as the only oral hygiene aid. Groups C and D continued to clean their teeth using a toothbrush and Group C were given Water Pik devices as a supplementary aid. After 14 days, gingival exudation, Plaque Index, Gingival Index and soft tissue injuries were registered. The results showed that , while both groups A and B demonstrated extensive plaque deposits and gingivitis, these were present to a significantly lesser degree in Water Pik users. The toothbrushing groups (C and D) failed to demonstrate any further reduction of plaque or gingivitis when Water Pik was introduced as an additional measure. No soft tissue injuries were found.

Journal Article
TL;DR: Dental caries can be largely prevented by highly efficient removal of plaque by toothbrushing and flossing, however, the available evidence suggests that regular prophylaxis by dental personnel is essential to maintain the necessary high level of efficiency.

Journal ArticleDOI
TL;DR: The average oral hygiene and periodontal health was poor except for patients in a few institutions where the nurses were trained to clean teeth regularly and the preventive programs used in some institutions seemed to be effective.
Abstract: Oral hygiene, periodontal health and periodontal treatment needs were studied in the dentulous patients (n = 328) of a sample selected to be representative of all institutionalized mentally subnormal persons in Norway aged 5--45. The average oral hygiene and periodontal health was poor except for patients in a few institutions where the nurses were trained to clean teeth regularly. Increased age, epilepsy, Down's syndrome and a high degree of mental deficiency were all elements that apparently contributed to impairment of periodontal health and to increased treatment requirements. The preventive programs used in some institutions seemed to be effective. Still better results, however, could probably be obtained by the use of dental hygienists.


Journal ArticleDOI
04 Mar 1978-BMJ
TL;DR: No relationship between total sugar intake and the extent of dental caries as assessed by the decayed-missing-filled (DMF) index was revealed and a small but significant correlation between sugar intake in solid foods and the DMF index was found.
Abstract: SIR,-Dr A R P Walker and Professor P E Cleaton-Jones (11 February, p 361) have commented on the fact that epidemiological studies often do not support the conventional view that dental caries is strongly promoted by the amounts of sugar and snacks that are consumed. On the other hand experiments with animals and, less conclusively, with human subjects show that dental decay is promoted by the carbohydrate fraction of the diet and that the most cariogenic of the carbohydrates is sucrose I We believe that the reason for this discrepancy lies in the fact that experimental studies attempt to control all factors except sugar intake, whereas epidemiological studies usually do not adequately allow for some of the other environmental causes that determine whether teeth will develop caries. Most people accept that for sucrose to produce tooth decay it must adhere to the tooth surface for a sufficient length of time. Thus sucrose in tea, coffee, or soft drinks or in most sorts of ice-cream may produce little or no caries. On the other hand biscuits, chocolate, cakes, and sweets such as toffee could be strongly cariogenic, but the degree of damage that occurs may be affected by the extent to which the individual uses a toothbrush or has fluoride in the drinking water. In addition, people have a varying degree of resistance to dental decay, determined chiefly by genetic factors, so that it cannot be expected that even identical diets and identical practice of oral hygiene will produce identical degrees of caries. These genetic factors may account at least in part for the differences noted by Dr Walker and Professor Cleaton-Jones between their groups of white, Indian, coloured, and black children. Nevertheless, it should be possible to demonstrate some association between sugar consumption and caries by ignoring the sugar drunk in solution and by allowing for the frequency with which people brushed their teeth. We examined the teeth of 133 Caucasian children -89 boys and 44 girls-aged 15 to 18 and independently assessed their sugar intake by means of a questionnaire devised especially for this purpose.2 Subsequent analysis revealed no relationship between total sugar intake and the extent of dental caries as assessed by the decayed-missing-filled (DMF) index; we did, however, find a small but significant correlation between sugar intake in solid foods and the DMF index (table above). We then assessed the practice of dental hygiene in the girls by asking them whether they used a toothbrush more than twice a day (good hygiene), twice a day (moderate hygiene), or less than twice a day (poor hygiene). Those who claimed good or moderate hygiene showed no significant correlation of DMF index with sugar taken in solid foods, whereas the 12 who admitted to bad dental hygiene showed a high correlation (r= 081; P< 0001). This was in line with what we had predicted: the cariogenic effect of sucrose can be reduced or eliminated if good dental hygiene is practised.

Journal ArticleDOI
TL;DR: Results suggest that A. visocus is capable of inducing a specific cellular immune response during the development of experimental gingivitis and may be important as a causative plaque constituent.
Abstract: The purpose of the present investigation was to evaluate the ability of antigens of human dental plaque microorganisms to stimulate peripheral blood lymphocytes (PBL) from humans during the development and recovery from experimental gingivitis. Eleven healthy dental students (22–36 years) participated in the study. At the start of the experiment, they exhibited clean teeth and clinically healthy gingivae. They then abstained from all oral hygiene measures for four weeks according to the model proposed by Loe et al. (1965). At the start, after 1, 2, 3 and 4 weeks of abolished oral hygience and 2 weeks following reinstitution of oral hygiene, the oral conditions were assessed, using the critieria of the Plaque Index system (Loe & Silness 1964) and the Gingival Index system (Loe & Silness (1963). At each examination triplicate microcultures, each containing 2 × 105 viable PBL in .2 ml TC 199 with glutamine and antibiotics containing 10% fetal calf serum, were stimulated with four concentrations of sonicates from V. alcalescens, F. nucleatum, B. melaninogenicus, A. viscosus, A. naeslundii, S. sanguis and pooled dental plaque all obtained from the previsouly performed experimental gingivitis. The cultures were incubated for 78 hours at 37°C in 5% CO2. 3H-thymidine was added for the final 8 hours. Only A. viscosus was able to stimulate PBL to undergo blastogenesis during the development of experimental gingivitis. A. viscosus stimulated the PBL of 3 subjects after one week but all subjects after 2 weeks of abolished oral hygiene. The stimulation indices (SI) remained >2.5 for the rest of the experimental period. Following 2 weeks of reinstituted oral hygiene, the SI reached preexperimental levels. These results suggest that A. visocus is capable of inducing a specific cellular immune response during the development of experimental gingivitis and may be important as a causative plaque constituent. Further research is indicated to study this association.

Journal ArticleDOI
TL;DR: This study showed that 0.15, 0.10, and 0.05% chlorhexidine gluconate solutions used on the toothbrush subsequent to scaling were for at least 45 days able to maintain plaque and gingivitis scores lower than those obtained 14 days after scaling and oral hygiene instruction.
Abstract: This study showed that 0.15, 0.10, and 0.05% chlorhexidine gluconate solutions used on the toothbrush subsequent to scaling were for at least 45 days able to maintain plaque and gingivitis scores lower than those obtained 14 days after scaling and oral hygiene instruction. Discolorations of teeth and fillings were the only side effects observed.

Journal ArticleDOI
TL;DR: Damage to the oral tissues arises when the patients fail to adopt adequate oral hygiene measures, and this is worse when teeth and gingivae are covered, as in lingual plate dentures.

Journal Article
TL;DR: Lymphocyte transformation to solubilized dental plaque is not a useful diagnostic tool in periodontitis, but should continue to be a valuable research tool for investigating pathological mechanisms in periodentitis.
Abstract: Twenty dentulous subjects undergoing clinical therapy for severe periodontitis were used to determine the longitudinal effects of bacterial plaque reduction in vitro lymphocyte transformation The therapy consisted of either complete extractions or partial extractions and periodontal surgery combined with rigorous oral hygiene Prior to therapy lymphocytes from these subjects responded significantly to Streptolysin O (SLO) but were not transformed significantly by solubilized dental plaque However, after therapy lymphocytes from these same subjects responded significantly to both solubilized dental plaque and SLO This indicates that the severe periodontitis patients were specifically unresponsive to solubilized dental plaque prior to therapy The mechanism of the unresponsiveness is not clear, but probably does not involve serum factors because supplementation of the lymphocyte cultures with pooled homologous plasma from individuals with gingivitis or moderate periodontitis (instead of the patient's autologous plasma) did not significantly change the mean lymphocyte responses to solubilized dental plaque In addition, lymphocytes from eleven long-term (5--18 yr) edentulous subjects, who were free of oral inflammation, were significantly transformed by solubilized dental plaque The latter lymphocyte responses and those of the treated periodontitis patients could be due either to the presence of low levels of oral bacteria in the edentulous mouth or to the lymphocyte transformation assay being a measure of previous antigen sensitization rather than current disease status In either case, lymphocyte transformation to solubilized dental plaque is not a useful diagnostic tool in periodontitis, but should continue to be a valuable research tool for investigating pathological mechanisms in periodontitis

Journal ArticleDOI
TL;DR: The objective of this study was to assess the prevalence of dental caries in the earliest age at which children were organized as a group in the national education system and to find possible associations with variables that may help to identify "groups at risk" in this population.
Abstract: The objective of this study was to assess the prevalence of dental caries in the earliest age at which children were organized as a group in the national education system and to find possible associations with variables that may help to identify "groups at risk" in this population. A total of 965 children, 5 years old, were examined. They were selected by a method to form a representative sample of all West Jerusalem compulsory kindergarten classes in 1971. Caries, gingivitis and oral hygiene were assessed and demogrphic data were collected. It was found that 84% of the children were affected with mean dif value of 4.7 (+/- 3.6). Association was found between caries and social class. The high morbidity suggests that organized services should be planned for this age group. Since the resources are limited, efforts should be directed mainly towards "groups at risk".

Journal Article
TL;DR: The results of this study suggested that subjects using the CPC containing mouthwash formed less plaque than those using the placebo mouthwash.
Abstract: The effect on formed dental plaque of a commercial mouthwash containing cetylpyridinium chloride (CPC) was evaluated in forty-one adults. During this fourteen day study no oral hygiene other than the use of a mouthwash was provided. Plaque and gingival indices were scored on sixteen teeth at days 0, 7 and 14. The results of this study suggested that subjects using the CPC containing mouthwash formed less plaque than those using the placebo mouthwash. No change in the Gingival Index was observed. Of those patients using the CPC containing mouthwash, four showed a slight staining of the anterior teeth and five reported a mild burning sensation of the tongue.

Journal ArticleDOI
TL;DR: Surgical dental procedures are now considered possible for hemophiliacs and may be performed on an outpatient basis, but they must be judiciously coordinated by the dental and medical team.
Abstract: Certain precautions need to be followed in treating patients with hemophilia, but even surgical procedures are possible.