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Showing papers on "Oral hygiene published in 1986"


Journal ArticleDOI
TL;DR: In this paper, the initiation, rate of progress of periodontal disease and consequent tooth loss in a population never exposed to any programs or incidents relative to prevention and treatment of dental diseases was described.
Abstract: This paper describes the initiation, rate of progress of periodontal disease and consequent tooth loss in a population never exposed to any programs or incidents relative to prevention and treatment of dental diseases. The group consisted of 480 male laborers at two tea plantations in Sri Lanka. The study design and baseline data have been published. At the initial examination in 1970, the age of the participants ranged between 14 and 31 years. Subsequent examinations occurred in 1971, 1973, 1977, 1982 and 1985. Thus, the study covers the age range 14-46 years. Throughout the study, the clinical indices were scored by the same two examiners, both well-trained and experienced periodontitis. Intra-examiner reproducibility for each index was tested at baseline and repeated periodically during the study. The data for each examination were computerized and updated on an ongoing basis. At the last examination in 1985, there were 161 individuals who had participated in the first survey. This population did not perform any conventional oral hygiene measures and consequently displayed quite uniformly large aggregates of plaque, calculus and stain on their teeth. Virtually all gingival units exhibited inflammation. Based on interproximal loss of attachment and tooth mortality rates, three subpopulations were identified: (1) individuals (approximately 8%) with rapid progression of periodontal disease (RP), those (approximately 81%) with moderate progression (MP), and a group (approximately 11%) who exhibited no progression (NP) of periodontal disease beyond gingivitis. At 35 years of age, the mean loss of attachment in the RP group was approximately 9 mm, the MP group had approximately 4 mm and the NP group had less than 1 mm loss of attachment. At the age of 45 years, the mean loss of attachment in the RP group was approximately 13 mm and the MP group approximately 7 mm. The annual rate of destruction in the RP group varied between 0.1 and 1.0 mm, in the MP group between 0.05 and 0.5 mm, and in the NP group between 0.05 and 0.09 mm. Since this population was virtually caries free, essentially all missing teeth were lost due to periodontal disease. In the RP group, tooth loss already occurred at 20 years of age and increased throughout the next 25 years. At 35 years of age, 12 teeth had been lost, at 40 years of age 20 teeth were missing and at 45 all teeth were lost. In the MP groups, tooth mortality started after 30 years of age and increased throughout the decade.(ABSTRACT TRUNCATED AT 400 WORDS)

817 citations


Journal ArticleDOI
Martin Addy1
TL;DR: Based on the association of bacterial plaque with the initiation of chronic gingivitis and progression of chronic periodontitis, chemical antiplaque agents have been employed both in prevention of periodontal disease and its treatment.
Abstract: Based on the association of bacterial plaque with the initiation of chronic gingivitis and progression of chronic periodontitis, chemical antiplaque agents have been employed both in prevention of periodontal disease and its treatment. In supragingival plaque control regimens, chlorhexidine has not been superceded as a chemical anti-plaque agent, although other compounds have been shown to be useful. The local side-effects of chlorhexidine and other cationic antiseptics, however, limit their long-term use for prevention. Extrinsic tooth staining in particular remains the greatest problem. Short-term anti-plaque uses for chlorhexidine include as an adjunct to mechanical cleaning in the initial oral hygiene phase of treatment, in situations where mechanical oral hygiene is difficult, including postsurgery, intermaxillary fixation, fixed orthodontic therapy, physically and mentally handicapped individuals, systemic diseases with oral manifestations such as leukaemia. More recent interest in chlorhexidine has resulted from the delivery of compounds subgingivally in the treatment of chronic periodontitis. Such methods have extended the use of chlorhexidine into areas inaccessible to the action of antimicrobial drugs delivered locally by conventional means, such as tooth brushing or mouth rinsing. Available evidence suggests that chlorhexidine may not be as effective as some antimicrobial drugs whose activity is more specific for those organisms considered particularly pathogenic to the periodontal tissues.

299 citations


Journal ArticleDOI
TL;DR: It was found that relatively few individuals accounted for most of the loss of attachment and periodontal pockets found in the study and more emphasis should be put on the identification of these particularly susceptible subpopulations.
Abstract: This study describes the cross-sectional findings on dental plaque, calculus, gingivitis, loss of attachment, periodontal pockets and tooth loss in a population of adult Tanzanians aged 30–30 years. In all age groups more than 90% of all tooth surfaces exhibited plaque and 50–50% exhibited calculus deposits. Both plaque and calculus deposits were more extensive in the older age groups whereas gingival bleeding affected 30–30% of the surfaces in all age groups. Less than 35% of all surfaces exhibited a loss of attachment ≥4 mm and less than 10% had a loss of attachment exceeding 6 mm. Loss of attachment was accompanied by recession of the marginal gingiva and pockets deeper than 3 mm were present on less than 10% of all surfaces. The mean number of teeth present ranged from 23.9 in the oldest to 29.5 in the youngest age group. An interesting finding was that relatively few individuals accounted for most of the loss of attachment and periodontal pockets found in the study. Therefore, in future epidemiologic studies more emphasis should be put on the identification of these particularly susceptible subpopulations.

230 citations


Journal ArticleDOI
TL;DR: It was concluded that a 0.12% chlorhexidine gluconate mouthrinse can provide an important adjunct to the prevention and control of gingivitis when used with regular personal oral hygiene procedures and professional care.
Abstract: The effects of a chlorhexidine gluconate mouthrinse on plaque and gingivitis were studied among 430 adults in a six-month clinical trial. Subjects were divided in two comparable treatment groups matched for age, sex, and initial gingivitis severity. Following a thorough oral prophylaxis, they were instructed to rinse twice a day for 30 seconds with 15 ml of a 0.12% chlorhexidine gluconate mouthrinse or a placebo mouthrinse. After three and six months of mouthrinse use, the chlorhexidine group had significantly less gingivitis, gingival bleeding, and plaque accumulation compared to the placebo group. As expected, accumulation of dental calculus and extrinsic dental stain increased in the chlorbexidine group. No significant differences in adverse oral soft tissue effects were observed between the two groups. Since use of oral antimicrobial agents has been reported to produce tooth and tongue stain, gingivitis examinations were done with and without tooth covers to eliminate the potential for examiner bias. Comparable reductions in the Gingival Index scores and gingival bleeding were obtained when the evaluations were conducted with or without the tooth covers. It was concluded that a 0.12% chlorhexidine gluconate mouthrinse can provide an important adjunct to the prevention and control of gingivitis when used with regular personal oral hygiene procedures and professional care.

149 citations


Journal ArticleDOI
TL;DR: By focusing on the most apparent and robust epidemiological relationships, an instructive overview of the epidemiology of gingivitis can be gained and when adjusted for cohort effects, gingival disease appears to be on the decline.
Abstract: In recent years, tremendous strides have been made in understanding the etiology of gingivitis. This increase in knowledge has come, for the most part, from basic research in oral microbiology, immunology, histology and pathology. Over the past decade, less progress has been made in further refining the epidemiological relationships between gingivitis and various host and environmental factors. The major restraint has been the great difficulty in reliably measuring gingival inflammation. This problem has resulted in great inter- and intra-study variation in diagnosing the prevalence and severity of gingivitis in human populations. Consequently, it is almost impossible to estimate longitudinal trends in gingivitis and it is nearly as difficult to make comparisons among different population groups studied by different examiners. Nevertheless, by focusing on the most apparent and robust epidemiological relationships, an instructive overview of the epidemiology of gingivitis can be gained. A number of host and environmental factors have been studied in relation to gingivitis and some of these will be reviewed. With respect to age, there is general concensus that marginal gingivitis begins in early childhood, increases in prevalence and severity to the early teenage years, thereafter subsiding slightly and leveling off for the remainder of the second decade of life. Gingivitis during the adult period is much more difficult to characterize due to paucity of data. Estimates of the general prevalence of adult gingivitis vary from approximately 50 to 100% for dentate subjects. In terms of gingivitis prevalence, the dentate elderly do not deviate appreciably from the general adult pattern. When adjusted for cohort effects, gingival disease appears to be on the decline.(ABSTRACT TRUNCATED AT 400 WORDS)

135 citations


Patent
03 Dec 1986
TL;DR: An integral oral hygiene system which includes an electric toothbrush wherein the brush can be replaced by an interproximal gum stimulator or a floss holder, all of which are driven by the toothbrush motor is described in this article.
Abstract: An integral oral hygiene system which includes an electric toothbrush wherein the brush can be replaced by an interproximal gum stimulator, an interproximal brush or a floss holder, all of which are driven by the toothbrush motor.

130 citations


Journal ArticleDOI
TL;DR: It is concluded that for a large majority in most of the populations observed, the progress of periodontal disease has been slow and seems to be compatible with retention of a natural dentition until at least the age of 50.
Abstract: Results of 61 CPITN surveys in 39 countries for the age group 15-19 yr, stored in the WHO Global Oral Data Bank as of 1 July 1987, are assembled in an overview showing percentages of persons according to the highest score for each person and the mean numbers of sextants affected per person. The most frequently observed condition was score 2 (calculus with or without bleeding), although some shallow pocketing of 4 or 5 mm was present in most populations surveyed. It should thus be emphasized that the major thrust of activities in periodontal care should be in health promotion and education, leading to improved oral hygiene.

107 citations


Journal ArticleDOI
TL;DR: Microbial plaque has been described by the Council on Dental Therapeutics of the American Dental Association in their recently drafted Guidelines for acceptance of products for the management of dental plaque and gingivitis.
Abstract: Microbial plaque has been described by the Council on Dental Therapeutics of the American Dental Association in their recently drafted Guidelines for acceptance of products for the management of dental plaque and gingivitis. The choice of an index system to be used in plaque trials should be made in terms of the objective of the trial, the size of the population, the period of the study, and the type and extent of change anticipated. The indices currently in use estimate the quantity of plaque in terms of tooth area covered or the thickness of material in the area measured. The Silness and Loe and the modified Turesky methods have been suggested as acceptable indices for the estimation of cleansing ability.

106 citations


Journal ArticleDOI
TL;DR: It was showed that there were few differences in caries prevalence when comparing handicapped children with children attending normal schools, however, the provision of dental care showed significant differences, with the handicappedChildren receiving less restorative treatment.
Abstract: The prevalence of dental caries, the levels of oral hygiene and the periodontal treatment requirements were assessed in 3562 handicapped children and 1344 randomly selected normal children attending schools in Birmingham, UK. The effect of different types of handicapping condition on these parameters was also evaluated. This investigation showed that there were few differences in caries prevalence when comparing handicapped children with children attending normal schools. However, the provision of dental care showed significant differences, with the handicapped children receiving less restorative treatment. There were also significantly poorer levels of oral hygiene and a greater prevalence of periodontal disease in the handicapped children attending special schools. The type of handicapping condition had a significant effect on the periodontal problems observed; those children with mental retardation having the poorest levels of oral hygiene and the greatest periodontal treatment requirements.

93 citations


Journal ArticleDOI
TL;DR: The results point to the need to provide interceptive dental therapeutics for high risk geriatric populations such as those using multiple medications and with a poor history of oral care.
Abstract: In an attempt to determine the association between overall health status, medication history, and oral hygiene status and root caries, 24 older persons residing independently in the community and 23 residents of a nursing home were interviewed and received oral examinations, using the Oral Hygiene Index and the Root Caries Index. The mean age of this population was 80 yr, with the nursing home subjects somewhat older than community-dwelling subjects. Only six persons had no root surface caries; three subjects had caries on all tooth surfaces with gingival recession. Mandibular teeth, particularly molars and premolars, showed the greatest attack rate. The best predictors of root caries were number of teeth remaining, calculus, plaque, and the use of medications with xerostomic effects. Medications were most predictive of maxillary root caries. The results point to the need to provide interceptive dental therapeutics for high risk geriatric populations such as those using multiple medications and with a poor history of oral care.

89 citations


Journal ArticleDOI
TL;DR: Two case reports demonstrating harmful oral effects from hydrogen peroxide rinses are presented, suggesting that oral hygiene techniques emphasizing the use of 3% hydrogenperoxide in periodontal therapy may require reevaluation.
Abstract: Hydrogen peroxide has been advocated for many years as an oral rinse useful in control of various oral conditions. Several authorities, however, have suggested that this material may be harmful to oral tissues, especially if the tissues have been previously injured. This article presents two case reports demonstrating harmful oral effects from hydrogen peroxide rinses. The findings suggest that oral hygiene techniques emphasizing the use of 3% hydrogen peroxide in periodontal therapy may require reevaluation.

Journal ArticleDOI
TL;DR: It can be concluded that dental care for the handicapped is insufficient and a suitable system for the delivery of preventive measures must be devised for this group of the population.
Abstract: Caries, periodontal disease, oral hygiene and treatment needs were assessed in a group of handicapped adults. The study group comprised 199 individuals aged 17-64 yr, most of whom were mentally subnormal. The mean DMFT values ranged from 17.4 in the 17-24-yr-old age group to 26.9 in the 55-64-yr-old age group. Tooth loss increased rapidly with advancing age. In all age groups the F component was less than 20% and high numbers of untreated carious lesions were found. Of the group studied, 90% needed some conservative treatment. Oral hygiene was poor and a high prevalence of periodontal disease was found. Of the dentulous persons, 49% needed scaling and 34% complex periodontal treatment. The percentage of study group patients requiring dental treatment was very high, so that it can be concluded that dental care for the handicapped is insufficient. This situation must be improved and a suitable system for the delivery of preventive measures must be devised for this group of the population.

Journal ArticleDOI
TL;DR: It is apparent that smoking is detrimental to periodontal health as it worsens the oral hygiene status and depresses the host's defense posture.
Abstract: The literature related to smoking and periodontal disease is reviewed. The effects of smoking on oral hygiene, gingivitis, necrotizing gingivitis, periodontitis, bacteria and the host's response are presented. From this review it is apparent that while the relationship between smoking and periodontal disease needs further study, smoking is detrimental to periodontal health as it worsens the oral hygiene status and depresses the host's defense posture.

Journal ArticleDOI
TL;DR: In this paper, a case presentation and instruction in proper oral hygiene measures, the 16 young individuals were subjected to periodontal treatment, utilizing a split mouth design, by random selection, the diseased sites in one side of the jaws were treated by scaling and root planing in conjunction with a modified Widman flap procedure.
Abstract: The patient sample used in the present study comprised 16 young individuals who were referred for treatment of advanced periodontal disease. Based upon the age of the patients and the location of the diseased sites, the patients were divided into 2 groups; a juvenile periodontitis group (JP) and a post-juvenile periodontitis group (post-JP). The patients in the JP group had periodontal lesions only at first molars and incisors. All 16 subjects were in excellent general health and none had been treated with antibiotics during a period of at least 12 months prior to the 1st examination. At a baseline examination and 6, 24 and 60 months after active therapy, the diseased sites were examined regarding plaque, gingivitis, probing pocket depths, probing attachment level, recession of the gingival margin and marginal alveolar bone level. Following a case presentation and instruction in proper oral hygiene measures, the 16 subjects were subjected to periodontal treatment, utilizing a split mouth design. By random selection, the diseased sites in one side of the jaws were treated by scaling and root planing in conjunction with a "modified Widman flap" procedure, while in the contralateral jaw quadrants treatment was restricted to scaling and root planing. During the 1st 6 months following active therapy, the patients were subjected to professional tooth cleaning once every 4 weeks. Subsequently, the interval between the recall appointment was 3 months. 2 years after treatment, this maintenance care program was terminated. A final examination was performed 5 years after therapy. None of the patients involved in the trial received antibiotic treatment during the 5 years of observation. The findings of the present study revealed that the response of the periodontal tissues to therapy, both in the JP and the post-JP group of patients, was almost identical to that found for similar types of treatment in patients with adult periodontitis. The re-examinations performed after 6, 24 and 60 months following active therapy of JP and post-JP lesions revealed that excision of the granulation tissue in conjunction with flap elevation did not enhance the degree of probing pocket depth reduction, probing attachment gain and bone fill that occurred following meticulous root surface instrumentation.

Patent
06 Nov 1986
TL;DR: Disclosed is an oral hygiene preparation in the form of a dentrifrice spray comprising a portable pump containing a dental cleansing/coating composition suitable for frequently dispensing premeasured dosages to clean the mouth, interrupt plaque formation and provide a prolonged clean, just-brushed feeling as mentioned in this paper.
Abstract: Disclosed is an oral hygiene preparation in the form of a dentrifrice spray comprising a portable pump containing a dental cleansing/coating composition suitable for frequently dispensing premeasured dosages to clean the mouth, interrupt plaque formation and provide a prolonged clean, just-brushed feeling.

Journal Article
TL;DR: Economic theory on the demand for health services and the Andersen model of health services utilization were applied to examine predisposing, enabling, and need characteristics which may influence use of preventive dental health services, and preventive dental behavior.
Abstract: Preventive dental behavior was examined using data from the National Health and Nutrition Examination Survey of 1971-75 conducted by the National Center for Health Statistics. Most research to date has dealt with the use of all types of dental services, with relatively few studies focusing on utilization of dental services for preventive purposes or on preventive dental behavior. Economic theory on the demand for health services and the Andersen model of health services utilization were applied to examine predisposing, enabling, and need characteristics which may influence use of preventive dental health services and preventive dental behavior. The associations between each of three measures of preventive dental behavior and the three sets of characteristics from Andersen's model were analyzed using multiple regression analysis. The enabling factors (income and a regular source of care) were the most important determinants of use of preventive dental services. Need characteristics, measured by self-evaluated condition of teeth, were also significant determinants of use, while the predisposing variables were the least important of the three types. In contrast, for the home care measure, frequency of brushing, the predisposing variables were the most important, with gender and education ranking highest. Consideration of these results may be useful to health educators and to those who formulate policies affecting the distribution of preventive dental services and dental insurance coverage.

Journal ArticleDOI
TL;DR: The concept of nurse administered oral hygiene is developed in a summary of selected nursing, medical and dental literature and methodological issues, implications for practice and suggestions for future research are presented.
Abstract: The concept of nurse administered oral hygiene is developed in a summary of selected nursing, medical and dental literature. The purpose of the review is to identify implications for nursing practice and research. The significance of oral hygiene to nursing is presented from physiologic, pathophysiologic, psychosocial, epidemiologic and economic perspectives. Tools, chemicals and frequency for nurse administered oral hygiene are discussed in relation to dental theory and relevant nursing research is critically reviewed. The therapeutic value of common commercial products, such as the foamstick and the lemon and glycerol swab, is not established in the literature. Methodological issues, implications for practice and suggestions for future research are presented.

Book
01 Jan 1986
TL;DR: The present study focused on the role of supragingival plaque in oral disease initiation and progression and future directions for dental plaque control measures and oral hygiene practices.
Abstract: Preface Acknowledgements Authors Reactors Planning committee Welcoming remarks Role of supragingival plaque in oral disease initiation and progression Role of oral hygiene practices in oral health and general health Current utilization of oral hygiene practices Mechanical oral hygiene practices Antimicrobial agents Methods for plaque biochemistry alteration Tooth-surface alteration agents Ecology alteration Systemic agents Behavioural research related to oral hygiene practices Working group reports and recommendations Future directions for dental plaque control measures and oral hygiene practices General discussion Concluding remarks List of participants

Journal ArticleDOI
TL;DR: A controlled study to determine the extent and the quality of the differences in the early periodontal tissue response towards dental plaque in the deciduous dentition of DS children and matched control children confirmed earlier results from epidemiological studies.
Abstract: Epidemiological studies have shown that there is a high prevalence and rapid progression of periodontal disease in children with Down's Syndrome (DS). In this respect, DS children exhibit a markedly different response compared with healthy children. In order to understand the reasons for this difference, a controlled study was set up to determine the extent and the quality of the differences in the early periodontal tissue response towards dental plaque in the deciduous dentition of DS children and matched control children. In a preliminary investigation, the gingival health was estimated by determining the bleeding tendency. 9 healthy children were selected from a group of 14 and matched with 9 DS children with respect to plaque development, sulcus depth and age. The DS children had a higher bleeding tendency than the matched controls. In the DS children, moreover, a correlation was found between bleeding tendency and age. No such correlation was found in the controls. After a period of intensive oral hygiene, all cleaning of teeth was discontinued for 21 days. The amount of plaque according to the plaque index, the gingival health according to the gingival index, and the amount of crevicular leucocytes and gingival exudate were assessed at days 0, 7, 14 and 21. During the experimental phase of the study, the amount of plaque increased at a similar rate in both groups. In the DS children, the development of gingival inflammation started earlier and was more extensive. It increased after day 14, whereas in the control children, the gingival inflammation seemed to stabilize at this time. The results of the present experimental study thus confirm earlier results from epidemiological studies.(ABSTRACT TRUNCATED AT 250 WORDS)

Journal ArticleDOI
TL;DR: Owing to the increased tendency to caries and the parodontal disease, the majority of patients lost most of their teeth untimely and special measures should be taken to achieve restoration.
Abstract: In 44 patients (22 females, 22 males, aged 18–61 years, mean 36 years) regular dental screening and treatment were started in January 1982. Two years follow-up revealed that the oral hygiene of these haemodialysis patients was worse than that of the average population. In 42 cases calculus formation and gingivitis, in each case atrophy of the alveolar bone and pocket formation were found. We consider these symptoms as cardinal in uraemic haemodialysis patients. As a consequence, the teeth had a pathologic mobility which was proportional to the bone resorption. Although not very typical, 10 cases were found with clicking of the temporomandibular joint associated with painfulness of the joint and the surroundings. Owing to the increased tendency to caries and the parodontal disease, the majority of patients lost most of their teeth untimely. Therefore special measures should be taken to achieve restoration. We emphasize the need for special dental care of haemodialysis patients.

Journal ArticleDOI
TL;DR: It was concluded that this simplified oral hygiene system was effective in reducing periodontal inflammation and pocket depth, although no significant added benefit with 0.02% CH was apparent.
Abstract: The aim of this study was to investigate the effects of a simplified system of oral hygiene, comprising Bass brushing, scaling, root planing and subgingival irrigation using a pulsated monojet oral irrigator, in patients with chronic periodontitis. After initial assessment, patients received scaling, root planing and instruction in Bass brushing and in use of a pulsated jet oral irrigator (Water Pik + Imax attachment) to irrigate subgingivally. 11 patients with 262 approximal periodontal pockets used 0.02% chlorhexidine (CH), or a placebo as the irrigating solution once daily for 28 days. Plaque index (P1I), sulcus bleeding index (SBI), and probing pocket depth (PPD) were assessed on days 0, 28, 56 and 84. Within procedure comparisons for all groups showed that the regime was highly effective in reducing P1I, SBI and PPD, improvements being maintained at least until day 84. Between procedure comparisons showed that benefits were improved only marginally by the use of 0.02% CH as the irrigation fluid. The patients found the procedure pleasant and neither injuries nor staining were noted during the study. It was concluded that this simplified oral hygiene system was effective in reducing periodontal inflammation and pocket depth, although no significant added benefit with 0.02% CH was apparent. The technique may be useful in patients who cannot achieve high levels of routine mechanical oral hygiene, particularly interdentally. The effects of using higher concentrations of chlorhexidine should be investigated.

Journal ArticleDOI
TL;DR: More study and research are necessary about the gingivitis/stomatitis syndrome and subgingival resorptive lesions so that improved prevention and treatment recommendations can be made.
Abstract: Periodontal disease and chronic gingivitis/stomatitis are the most common feline dental diseases. With routine dental care and increased emphasis on home oral hygiene, these diseases can be controlled. Cats can be seen with a number of other dental disorders, and improved treatment methods such as restorations of early subgingival resorptive lesions, endodontic therapy, and orthodontic therapy can be performed successfully. More study and research are necessary about the gingivitis/stomatitis syndrome and subgingival resorptive lesions so that improved prevention and treatment recommendations can be made.

Journal ArticleDOI
TL;DR: The results confirm the high prevalence of periodontal problems but show a very low prevalence of caries in Dar es Salaam, but oral hygiene education should be promoted.
Abstract: In the developing countries, the main dental problem has traditionally been periodontal disease, but recently dental caries has been reported to be increasing. There are some findings showing the same pattern in Tanzania. The aim of the present study was to explore the prevalence of caries and the periodontal status among schoolchildren in Dar es Salaam. The series consisted of pupils of classes 6 and 7 in five primary schools (n = 640, ages 12-18 yr). Two-thirds of the children examined were caries-free. Boys had significantly lower DMF scores than girls, 0.7 and 1.2, respectively. Almost all the children showed early signs of gingivitis and assessment by the Community Periodontal Index of Treatment Needs (CPITN) showed that in over 50% all sextants of the mouth were affected. In the older age group (15-18 yr) girls had a significantly higher number of periodontally healthy sextants than boys. The results confirm the high prevalence of periodontal problems but show a very low prevalence of caries. Thus, there are no signs of an alarming caries problem in Dar es Salaam, but oral hygiene education should be promoted.

Journal ArticleDOI
TL;DR: Clinical differences between groups were relatively small, except for CH effect on PII, and within procedure comparisons, CH was better in reducing PII at all times except at day 84, and on several occasions in reducing GI and SBI.
Abstract: This study compared a simplified oral hygiene regime (scaling, root planing and Bass brushing) with this same regime plus 0.02% chlorhexidine (CH), 0.05% metronidazole (MD) and inactive control (PL) solutions delivered supragingivally by a pulsating water jet irrigator. 22 patients were distributed randomly into 3 groups, 0.02% chlorhexidine (CH), 0.05% metronidazole (MD), and inactive control (PL). Approximal surfaces with associated pockets greater than or equal to 4 mm were monitored at day 0, for plaque index (PII), gingival index (GI), sulcus bleeding index (SBI), baseline measurement for gingival shrinkage and probable pocket depth. All monitored surfaces were then immediately scaled and root planed. All patients received identical oral hygiene instruction (Bass brushing), with a sodium fluoride toothpaste and a multituft toothbrush, and were shown how to use the oral irrigator. Proficiency in use of the oral irrigator was checked again at day 7. No interdental cleaning was taught. The active treatment period was 28 days. Patients were seen at days 7, 28, 56 and 84, and all parameters were recorded at each visit, but no further oral hygiene instruction was given. Within procedure comparisons of the findings at days 28 (end of active treatment) 56 and 84 with those at day 0, showed statistically highly significant improvements in all parameters for all groups. Regarding between procedure comparisons, CH was better in reducing PII at all times except at day 84, and on several occasions in reducing GI and SBI. Irrigated groups were always better than nonirrigated groups. Although the differences were statistically highly significant, clinically the differences between groups were relatively small, except for CH effect on PII.(ABSTRACT TRUNCATED AT 250 WORDS)

Journal ArticleDOI
TL;DR: In this paper, the effect of brushing frequency, pattern and duration on plaque removal was analyzed in a study with 110 schoolchildren aged 13, who were examined before and after brushing their teeth in the habitual way.
Abstract: Individual toothbrushing habits are usually consistent. Frequency, pattern and duration are different aspects of the toothbrushing habit. The aim of this study was to analyze the effect of habitual toothbrushing in children. The schoolchildren (n = 110) aged 13, were examined clinically before and after brushing their teeth in the habitual way; the brushing procedure was filmed without the children's knowledge. From the film, the pattern of brushing was assessed by three dentists, and the duration measured in seconds. Frequency of toothbrushing was assessed by postal questionnaire 2 months after the clinical examination. The examination included both photographed plaque and disclosed plaque diagnosed clinically. From the photographs, plaque was measured by computer planimeter as a % of plaque area and clinically by the oral debris index recommended by WHO. Subjects who had little plaque before toothbrushing were excluded from the analyses. Frequency seemed to affect plaque removal only in boys and only in the maxillary teeth. The pattern affected plaque removal in girls, but for boys, this aspect of toothbrushing affected only the left side of the jaws. Duration had produced the strongest effect on plaque removal. Therefore, duration of toothbrushing should be emphasized more in dental health education.

Journal ArticleDOI
TL;DR: The findings showed a similar improvement in the status of oral hygiene in both groups, indicating that in the hands of the patients, the electric toothbrush was just as effective as the comprehensive oral hygiene kit.
Abstract: The effectiveness of an electric toothbrush (Rota-dent), which in design and mode of action resembles the rotating instruments used by professionals in tooth cleaning, was assessed. 40 adult periodontal patients were divided into 2 groups matched with regard to oral cleanliness: an electric toothbrush group (EB) comprising 20 patients who received an electric toothbrush as well as instruction in it's use by a dental hygienist; a control group (CO) comprising 20 patients who were provided with an oral hygiene kit containing a conventional toothbrush, an interspace brush, toothpicks, disclosing tablets and a lighted mouth mirror and who received the oral hygiene instruction by means of a self-teaching manual. All patients received professional mechanical tooth cleaning 1 week prior to the instruction. At a 3-week follow-up session, additional instruction was given by a dental hygienist according to needs. The presence or absence of dento-gingival plaque after disclosing with the Plak-lite system and gingival bleeding by gentle probing was recorded on 4 tooth surfaces of all teeth, initially and after 3 months. The findings showed a similar improvement in the status of oral hygiene in both groups, indicating that in the hands of the patients, the electric toothbrush was just as effective as the comprehensive oral hygiene kit.

Journal ArticleDOI
TL;DR: In 8- and 13-yr-olds it was possible to show that children with a low caries increment had lower mean values for frequency of meals, daily sucrose consumption and prevalence of lactobacilli and S. mutans in the saliva thanChildren with a high caries Increment had higher meanvalues for toothbrushing frequency, use of fluoridated toothpaste and NaF-mouthrinse.
Abstract: The aim of this study was to assess the modifying effect of oral hygiene, and the use of fluorides on caries increment in children when frequency of meals, intake of sugars and prevalence of lactobacilli and S. mutans in the saliva were known. In 8- and 13-yr-olds it was possible to show that children with a low caries increment (0-2 surfaces) had lower mean values for frequency of meals, daily sucrose consumption and prevalence of lactobacilli and S. mutans in the saliva than children with a high caries increment (greater than or equal to 3 surfaces). There were higher mean values in the low caries-increment groups for toothbrushing frequency, use of fluoridated toothpaste and NaF-mouthrinse. Gingival bleeding index (GBI %) was used as an objective measure of oral hygiene and revealed statistically significant differences between the two groups in both age groups (P less than 0.05, P less than 0.01) with the highest scores recorded in the high caries-increment groups. Using as discriminating variables number of meals/day, daily consumption of sucrose and other sugars and number of lactobacilli and S. mutans in the saliva, 77% of the 8-yr-olds and 70% of the 13-yr-olds were correctly classified with regard to net caries increment. If GBJ %, tooth-brushing frequency, use of fluoridated toothpaste and NaF-mouthrinse were included in the analysis another 4% of the 8-yr-olds and 11% of the 13-yr-olds could be correctly classified.

Journal ArticleDOI
TL;DR: The dental health status of a dentate elderly population in terms of remaining teeth, periodontal condition and oral hygiene in a municipality near Oslo in 1979/80 is described.
Abstract: The purpose of the present study was to describe the dental health status of a dentate elderly population in terms of remaining teeth, periodontal condition and oral hygiene. In a municipality near Oslo, 371 respondents from a random sample of elderly subjects were clinically examined in 1979/80. Of these, 169 were dentate, 39% had 1–9 teeth and 28% had 20 teeth or more. The mean number of teeth present was 13.8. Income, bone loss and oral hygiene explained most of the variance in the number of remaining teeth whereas age seemed to play a minor role. Gingivitis was recorded adjacent to 54% of the teeth, and plaque was visible on 63%. The variance in gingivitis was mainly explained by plaque, calculus and number of remaining teeth, while the amount of plaque was associated with differences in cleaning habits, the number of teeth and social class. 38% of the alveolar bone height was on average lost at teeth present at the time of examination. The variance was mainly explained by presence of plaque and gingivitis. However, the majority of remaining teeth displayed a fair periodontal condition.

Journal ArticleDOI
TL;DR: Results indicate that measures improving the oral health may be of major importance in preventing recurrent caries and thereby increase the durability of amalgam restorations.
Abstract: The purpose of the present cross-sectional clinical study was to evaluate the relationship between recurrent caries prevalence, quality of class II amalgam restorations and various oral health parameters. One hundred and forty-four randomly selected 35-yr-old citizens of Oslo were included in the investigation. Caries was scored based on a combined clinical and radiographic examination according to the DMFS index system. Oral hygiene (OHI-S) and periodontal index (PI) were registered, and the quality of class II amalgam restorations was ranked according to a set of occlusal index pictures. A total of 1694 class II amalgam restorations were included and 93 (5.5%) of these were affected by recurrent caries. A statistically significant correlation was found between prevalence of recurrent caries and poor oral hygiene, high PI-scores and prevalence of primary caries. However, a severe deterioration of the quality of amalgam restorations had to be present before a concomitant increase in recurrent caries prevalence could be registered. The present results indicate that measures improving the oral health may be of major importance in preventing recurrent caries and thereby increase the durability of amalgam restorations.

Journal ArticleDOI
TL;DR: The first part of this study showed that the younger, in comparison to the older, patients developed inflammation in terms of bleeding on probing more rapidly, which may indicate that the patients are at risk for recurrence of periodontal breakdown.
Abstract: In the present investigation, a number of histological and immunohistochemical characteristics of periodontal tissues as well as the phase-contrast microscopy of dental plaque were studied after experimentally-induced gingival inflammation in relation to susceptibility to periodontal disease. The study included a younger (mean age 34.1 years) and an older age group (mean age 48 years) with a reduced but healthy periodontium. Both age groups had the same amount of loss of attachment which may suggest that they had different degrees of susceptibility to periodontal disease. At the start of the experiment, each patient was instructed to abstain from oral hygiene in one quadrant of the mouth for a period of 18 days. At the end of the 18-day period, supra-gingival plaque and gingival tissue samples were taken. As determined by phase-contrast microscopy, the plaque samples of both age groups contained relatively high proportions of spirochetes. This may indicate that the patients are at risk for recurrence of periodontal breakdown. The general histopathologic picture of the gingival tissue samples of both age groups was similar to the so-called 'early lesion'. However, IgA-producing plasma cells were found in most tissue samples of both age groups. The first part of this study showed that the younger, in comparison to the older, patients developed inflammation in terms of bleeding on probing more rapidly. These clinical results cannot be explained by the host-parasite parameters investigated in the present study.