Showing papers on "Oral hygiene published in 1999"
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TL;DR: An oral care system includes a universal handle which is configured to hold any of a plurality of oral hygiene instruments, and a lavage source to apply lavage solution through the oral hygiene instrument to facilitate complete cleaning of a patient's mouth as discussed by the authors.
Abstract: An oral care system includes a universal handle which is configured to hold any of a plurality of oral hygiene instruments, and a lavage source to apply lavage solution through the oral hygiene instruments to facilitate complete cleaning of a patient's mouth Preferably, the universal handle and lavage source are configured to be held in the user's hand with both suction and lavage being controlled manually The orally hygiene instruments attachable to the universal handle typically include a lavage toothbrush, at least one catheter and at least one swab, to thereby enable cleaning of the teeth, gums, soft tissue and crevices therebetween
187 citations
TL;DR: It was concluded that perception of dental self-efficacy plays a decisive rôle in relation to oral health behaviour in diabetic patients, and that compliance with dental recommendations is also related to HbA1c level.
Abstract: Because of a mutual association between severity of periodontitis and poor control of IDDM, regular dental visits and daily oral care are important among diabetics. The aim was to develop a method for analysing dental self-efficacy and to study the relationship between dental self-efficacy and reported oral health behaviour and oral hygiene. The relationship between oral health behaviour and HbA1c level was also studied. Data were collected in relation to 149 IDDM patients by means of a quantitative questionnaire, evaluation of dental plaque and patient records. Results showed that tooth brushing self-efficacy, approximal cleaning self-efficacy and dental visiting self-efficacy related to corresponding reported oral health behaviour (p<0.0005). Visible plaque index (VPI) correlated inversely with tooth brushing self-efficacy (r(s) = -0.208, p = 0.012) and dental visiting self-efficacy (r(s) = -0.240, p = 0.004). Approximal cleaning self-efficacy correlated with age (r(s) = 0.225, p = 0.006) and dental visiting self-efficacy was related to higher professional level of education (p = 0.009). Those having better tooth brushing self-efficacy (p = 0.020), higher frequency of tooth brushing (p = 0.032) and lower VPI (p<0.0005) had better HbA1c level. It was concluded that perception of dental self-efficacy plays a decisive role in relation to oral health behaviour in diabetic patients, and that compliance with dental recommendations is also related to HbA1c level.
164 citations
TL;DR: The aim of this critical review--covering the effects of the physical properties of chewing gum and those of different ingredients both of conventional and of functional chewing gum--is to provide a set of guidelines for the interpretation of such claims and to assist oral health care professionals in counseling patients.
Abstract: The world market for chewing gum is estimated to be 560,000 tons per year, representing approximately US $5 billion Some 374 billion pieces of chewing gum are sold worldwide every year, representing 187 billion hours of gum-chewing if each piece of gum is chewed for 30 minutes Chewing gum can thus be expected to have an influence on oral health The labeling of sugar-substituted chewing gum as "safe for teeth" or "tooth-friendly" has been proven beneficial to the informed consumer Such claims are allowed for products having been shown in vivo not to depress plaque pH below 57, neither during nor for 30 minutes after the consumption However, various chewing gum manufacturers have recently begun to make distinct health promotion claims, suggesting, eg, reparative action or substitution for mechanical hygiene The aim of this critical review--covering the effects of the physical properties of chewing gum and those of different ingredients both of conventional and of functional chewing gum--is to provide a set of guidelines for the interpretation of such claims and to assist oral health care professionals in counseling patients
161 citations
TL;DR: The authors found that men who smoke cigars or pipes were at increased risk of experiencing tooth loss and alveolar bone loss.
Abstract: Background While cigarette smoking is recognized as being detrimental to oral health, the effects of cigar and pipe smoking on tooth-loss risk, alveolar bone loss and periodontal disease are not known. The authors conducted this study to determine whether cigar and pipe smokers were at greater risk of experiencing tooth loss and alveolar bone loss than were nonsmokers. Methods The authors studied 690 dentate men who participate in the Veterans Affairs Dental Longitudinal Study. Subjects are not VA patients, and they receive medical and dental care in the private sector. A board-certified periodontist conducted clinical examinations triennially for 23 years. These examinations included the number of teeth remaining, number of decayed and filled surfaces per tooth, and indicator scores for plaque, calculus, pocket probing depth, gingival bleeding and tooth mobility. Alveolar bone loss was assessed at each examination on intraoral periapical radiographs using the Schei ruler method, which measures loss of bone height in 20 percent increments. Multivariate analyses of tooth-loss rates and alveolar bone loss controlled for demographic and oral hygiene measures. Results The relative risk, or RR, of tooth loss compared with that of nonsmokers was significantly elevated in cigar smokers (RR = 1.3, 95 percent confidence interval, or CI, = 1.2, 1.5), pipe smokers (RR = 1.6, 95 percent CI = 1.4, 1.9) and cigarette smokers (RR = 1.6, 95 percent CI = 1.5, 1.7). The percentages of mesial and distal sites with moderate-to-severe progression of alveolar bone loss (a change of 40 percent or more from baseline) were 8 ± 1 percent (mean ± standard error) in nonsmokers, 16 ± 3 percent in cigar smokers ( P P = .17), and 16 ± 3 percent in cigarette smokers ( P P Conclusion The authors found that men who smoke cigars or pipes were at increased risk of experiencing tooth loss. Cigar smokers also were at increased risk of experiencing alveolar bone loss. These elevations in risk are similar in magnitude to those observed in cigarette smokers. Clinical Implications The increases in risk related to cigar and pipe smoking provide a strong rationale for targeting smoking prevention and smoking cessation programs to smokers of all tobacco products.
122 citations
TL;DR: Implementation of a well-developed oral care protocol by bedside nurses can improve oral health of patients in the intensive care unit.
Abstract: Background Nurses have not been formally trained in assessing the oral status of patients in intensive care units, and no oral care protocols for these patients are available. Objectives To assess the oral status of patients in an intensive care unit, evaluate the effects of a defined oral care protocol on the oral health status of patients in an intensive care unit, and compare oral assessments of a dental hygienist with those of intensive care nurses. Methods A nonequivalent comparison group, longitudinal design with repeated measures was used. In phase 1, oral assessment data on the comparison group were collected by a dental hygienist. In phase 2, nurses were instructed in oral assessment and an oral care protocol. In phase 3, the oral care protocol was implemented in the treatment group, and oral assessment data were collected separately by the dental hygienist and by nurses. Results The mean inflammation score was significantly lower (t test P = .03) in the treatment group (mean, 3.9; SEM, 3.0) than in the comparison group (mean, 12.4; SEM, 2.2). Although not significant, the mean scores of the treatment group were also lower than those of the comparison group on scales of candidiasis, purulence, bleeding, and plaque. Correlations between scores for individual items on the oral assessment tool obtained by the dental hygienist and those obtained by nurses were all greater than 0.6386. Conclusion Implementation of a well-developed oral care protocol by bedside nurses can improve oral health of patients in the intensive care unit.
119 citations
TL;DR: Subjects with diagnosed eating disorders are more susceptible to both dental caries and erosion, and should be encouraged to adopt appropriately tailored preventive programmes and to have regular dental check-ups.
Abstract: The aim was to explore possible correlations between the oral status of patients undergoing treatment at a special outpatient psychiatric clinic for eating disorders and such variables as psychiatric diagnosis and duration of illness, oral hygiene habits, salivary function, and dietary habits. Healthy volunteers of a similar age were recruited for comparison. The material comprised 100 consecutive referrals, of whom 79 were women and 2 were men (age range 17 to 47, median 25 yr) participated. The eating disorders were diagnosed according to the American Psychiatric Association's DSM III-R criteria. The clinical and radiographic examinations were supplemented by standardized intraoral photographs, study models and salivary analysis. The decayed, missing, filled surfaces (DMFS) index was 15.3+/-10.9, a significantly higher caries frequency than for the reference group. More than half the subjects had erosive tooth wear involving the dentine, and about one-third had very low unstimulated salivary flow rates and very high counts of mutans streptococci and lactobacilli. Erosive tooth wear was significantly correlated to the number of years of binge-eating. Compared to age-matched individuals, subjects with diagnosed eating disorders are more susceptible to both dental caries and erosion. They should be encouraged to adopt appropriately tailored preventive programmes and to have regular dental check-ups.
108 citations
TL;DR: A portrait of the conflicting priorities associated with LTC is offered, and practical insights to successful strategies of care in this population of elderly residents are provided.
Abstract: Open-ended interviews were conducted with 109 individuals. These included: administrators, staff, dental personnel, residents, and family members, associated with 12 long-term-care (LTC) facilities to contrast different human resource and organizational strategies for managing the delivery of oral health care to the elderly residents. A multiple case-study analysis revealed that no particular organizational strategy was ideal, although three important components--oral hygiene, diagnostic assessments, and dental treatment--were common to all. The dental personnel everywhere believed that oral health in the midst of other conflicting priorities received inadequate attention, while the administrators and staff acknowledged that they were weak at recognizing oral disorders and assisting with oral hygiene. In all, the interviews offered a portrait of the conflicting priorities associated with LTC, and they provide practical insights to successful strategies of care in this population.
107 citations
TL;DR: The results indicate that stress might affect periodontal health by increasing local I1-1beta levels especially when oral hygiene is neglected.
Abstract: This study analyses the effects of academic stress on crevicular interleukin-1beta(I1-1beta) both at experimental gingivitis sites and at sites of perfect oral hygiene. I1-1beta is thought to play a predominant role in periodontal tissue destruction. 13 medical students participating in a major medical exam (exam group) and 13 medical students not participating in any exam throughout the study period (control group) volunteered for the study. In a split-mouth-design, they refrained from any oral hygiene procedures in two opposite quadrants for 21 days (experimental gingivitis) while they maintained perfect hygiene levels at the remaining sites. Crevicular fluid was sampled for further I1-1beta analysis at teeth 5 and 6 of the upper jaw at days 1, 5, 8, 11, 14, 18 and 21 of the experimental gingivitis period. Exam students showed significantly higher I1-1beta levels than controls both at experimental gingivitis sites (area under the curve, exam group: 1240.64+/-140.07; control group: 697.61+/-111.30; p=0.004) and at sites of perfect oral hygiene (exam group: 290.42+/-63.19; control group: 143.98+/-42.71; p = 0.04). These results indicate that stress might affect periodontal health by increasing local I1-1beta levels especially when oral hygiene is neglected.
103 citations
TL;DR: Implant were colonized by the indigenous periodontal microbiota and were well maintained in patients with a history of periodontitis, suggesting that the presence of putative periodontopathogens at peri-implant andperiodontal sites may not be associated with future attachment loss or implant failure.
Abstract: Background: The purpose of this longitudinal study was to determine the clinical status and the composition of the subgingival microbiota of dental implants and natural teeth in patients with a history of periodontitis. Methods: Twenty-five partially edentulous patients treated for moderate to advanced adult periodontitis and having a total of 42 implants participated in this 3-year study. The assessment of clinical status was done 1, 2, and 3 years after prosthetic loading (T1, T2, and T3, respectively). Clinical parameters evaluated included probing depth (PD), clinical attachment level (CAL), gingival index (GI), and plaque index (PI). The subgingival microbiota at peri-implant and periodontal sites were analyzed at T1 and T2. Results: No significant difference in clinical parameters between implants and teeth and within the 2 groups between different time points was observed through the study. PD and CAL measurements of sampled periodontal and peri-implant sites did not show any statistically signific...
97 citations
01 Jan 1999
TL;DR: The Pharmacological and therapeutic aspects of Miswak and its role in plaque control, gingival recession, tooth wear, bleeding gums and periodontal health is discussed with reference to current literature.
Abstract: Miswak (chewing stick) was used by the Babylonians some 7000 years ago; it was later used throughout the Greek and Roman empires, and has also been used by ancient Egyptians and Muslims. It is used in different parts of Africa, Asia-especially the Middle Eastand South America. Chewing sticks are used for oral hygiene, religious and social purposes. This article presents some of the different types of chewing sticks used around the world with special emphasis on the most commonly used plant in the Middle East, the Arak (Salvadorapersica). The Pharmacological and therapeutic aspects of Miswak and its role in plaque control, gingival recession, tooth wear, bleeding gums and periodontal health is discussed with reference to current literature. Finally, this review concludes with how to select and use the Miswak.
91 citations
TL;DR: The plaque reductions seen in the essential oil and chlorhexidine rinse groups were statistically significant, while the plaque reduction in the amine/stannous fluoride rinse group was not statistically significant (p > 0.05).
Abstract: The adjunctive use of antimicrobial mouthrinses to help control supragingival plaque and gingivitis has been shown to contribute significantly to patients' daily oral hygiene regimens. This controlled clinical study used an observer-blind, randomized, cross-over design in a 4-day plaque regrowth model to determine the relative efficacies of an essential oil-containing mouthrinse (Listerine Antiseptic) and an amine fluoride/stannous fluoride-containing mouthrinse (Meridol) in inhibiting the development of supragingival plaque. A 0.1% chlorhexidine mouthrinse (Chlorhexamed-Fluid) was used as a positive control, and a 5% hydroalcohol solution was used as a negative control. Dosing for each of the test mouthrinses was based on the manufacturers' label directions. Because the volume and rinse time for each of the test mouthrinses were different, each test mouthrinse had its own negative control group. On day 1 of each test period, subjects received an oral soft and hard tissue examination and a dental prophylaxis to remove all plaque, calculus, and extrinsic stain. Starting the same day, subjects refrained from all mechanical oral hygiene procedures for the next 4 days and rinsed 2x daily under supervision with their randomly-assigned mouthrinse. On day 5, each subject received a plaque assessment as well as an oral examination to assess side effects. Each test period was separated by a 2-week washout period. 23 volunteers with a median age of 26 years completed the study. Compared to the respective placebos, the median percent plaque reductions at 5 days were 23.0%, 12.2%, and 38.2% for the essential oil, amine/stannous fluoride, and chlorhexidine rinses, respectively. The plaque reductions seen in the essential oil and chlorhexidine rinse groups were statistically significant (p 0.05). Additionally, the essential oil rinse was significantly more effective (p < 0.001) than the amine/stannous fluoride rinse in inhibiting plaque accumulation in this clinical model.
TL;DR: Results support the thesis that gender specificities in oral health depend on individual attitudes to oral health and dental utilization and understanding the cognitive factors of males and females would accelerate dental approaches to modifying oral health behavior of both groups, thus contributing to lifelong health maintenance.
Abstract: This study aimed to evaluate gender differences in oral health behavior and general health habits in adults. The subjects were 207 males and 196 females aged 20-64 yrs who were public officials in the city or town administrations in Chiba Prefecture, Japan. The questionnaire survey included three items: (1) self assessment of oral health status, (2) oral health behavior and (3) general health habits. Statistical analysis was performed using the chi-square test for differences of responses between males and females. The proportion of subjects with cognition of symptoms of oral disease ranged from 14.3 to 23.0%. The percentage of those who had not visited a dentist in the last year were 52.7% for males and 36.7% for females (p < 0.01). Subjects who brushed their teeth almost every day at bed time were 60.9% of males and 88.8% of females (p < 0.01). A comparison of the numbers of positive responses regarding general health habits found no differences in the distribution of general health habits score between males and females. Examining the relationship between oral health behavior and general health habits revealed that males with general habit high scores tended to have positive oral hygiene behavior. These results support the thesis that gender specificities in oral health depend on individual attitudes to oral health and dental utilization. In addition, understanding the cognitive factors of males and females would accelerate dental approaches to modifying oral health behavior of both groups, thus contributing to lifelong health maintenance.
TL;DR: This review provides a clear understanding of what is known about Orthodontic treatment possibilities, limitations and inherent risks in patients who may have certain types of periodontal disorders and underscores the importance of teamwork among the restorative dentist, periodontist and orthodontist when planning treatment for these patients.
Abstract: Background In this article, the author reviews the evidence-based literature in the fields of periodontics and orthodontics to clarify the relationship between orthodontic tooth movement and various types of common periodontal disorders. Types of Studies Reviewed The first section is a review of the literature on common periodontal disorders. The second is a review of evidence-based studies in the combined fields of orthodontics and periodontics, with a focus on orthodontic treatment possibilities, limitations and risks inherent in patients with periodontal disorders, particularly active periodontal disease. Results The literature on orthodontic tooth movement as it relates to periodontal disease shows that proper orthodontic treatment in patients with excellent oral hygiene and the absence of significant periodontal disorders should not pose any significant periodontal risk. In the presence of poor oral hygiene, however, and under circumstances of certain types of periodontal disorders, fixed orthodontic appliances and tooth movement can contribute to significant deleterious periodontal consequences. Clinical Implications This review provides a clear understanding of what is known about orthodontic treatment possibilities, limitations and inherent risks in patients who may have certain types of periodontal disorders. It also underscores the importance of teamwork among the restorative dentist, periodontist and orthodontist when planning treatment for these patients. The author also offers a specific patient management protocol for this interdisciplinary dental team to follow.
TL;DR: This cluster randomized control trial demonstrated that the intervention program resulted in an improvement in knowledge of dental disease and an increase in the reported duration of brushing.
Abstract: OBJECTIVES: This trial investigated the value of a school-based dental health education program in terms of changes in knowledge, reported behavior, and plaque scores. METHODS: A total of 2,678 pupils with a mean age of 12.1 years attending 28 schools participated in a school-based dental health education program. The study used a cluster randomized controlled study design. The health service administrators stipulated that all participants receive the intervention; to meet this requirement, a rolling program of two six-month periods was utilized. During the first six months, half the adolescents received the intervention program, the other half acting as controls. Throughout a further six-month period, all participants received the intervention program. This research design allowed comparisons between participants receiving the program for six and 12 months. At baseline, six, and 12 months, a random subsample of 40 children in each participating school had their plaque scores recorded and a questionnaire was used to record their knowledge of dental health and reported dental behavior. RESULTS: The analysis used the subjects clustered within the schools, which were the units of randomization. The intervention program produced statistically significant improvements (P < .001) in knowledge about periodontal disease and the frequency of sugar intake and dental caries in both assessment time periods. The reported frequency of brushing did not change, but the group who had received 12 months of the intervention were more likely (P < .05) to brush for over a minute. At six months the early intervention group had a statistically significant, 13 percent reduction in the mean proportion of sites with plaque compared with the late intervention group (P = .043). This difference was sustained at 12 months (P = .037). CONCLUSION: This cluster randomized control trial demonstrated that the intervention program resulted in an improvement in knowledge of dental disease and an increase in the reported duration of brushing. These improvements were accompanied by a significant improvement in oral hygiene and a reported reduction in gingival bleeding.
TL;DR: It clearly appears that there is the necessity to investigate other factors connected with toothbrushing (pressure, time, toothpaste quantity) in order to provide an oral hygiene education without undesired effects.
Abstract: The aim of this pilot study was to evaluate the prevalence of gingival recession at buccal tooth surfaces in a student population of Bologna University Dental School. A total of 55 subjects, attending the 1st and 5th year of the course were examined. The clinical examination involved assessment of plaque, calculus, width of keratinized gingiva, buccal probing depth and buccal gingival recession. Information about toothbrushing behavior was collected in an interview. The multiple regression analysis showed that level of education (p=0.002), toothbrushing technique (p=0.013) and toothbrushing frequency (p=0.016) are significant contributors to gingival recession. Notwithstanding the limits of a preliminary study, a higher prevalence of buccal recession is observed in the final year students, which have also a significantly lower % of buccal surfaces with calculus (p=0.014). In addition, it clearly appears that there is the necessity to investigate other factors connected with toothbrushing (pressure, time, toothpaste quantity) in order to provide an oral hygiene education without undesired effects.
Journal Article•
TL;DR: Better education of both the public and dental professionals as to the most frequent cause of halitosis, insufficient oral hygiene, might elevate the level of compliance by patients.
Abstract: OBJECTIVE: This study was undertaken to assess patients' response to their treatment at a multidisciplinary oral malodor clinic. METHOD AND MATERIALS: In 4 years, a multidisciplinary breath odor clinic in Belgium examined 406 patients. The team consisted of an ear, nose, and throat specialist, a periodontologist, occasionally a specialist in internal medicine, and, more recently, a psychiatrist. After the initial visit, each patient was scheduled for a follow-up appointment 2 to 6 months later; however, only 143 patients (35%) showed up for this control visit. The remaining 65% of the patients answered a mailed questionnaire. RESULTS: About half of the patients who returned no longer had complaints, while 17% reported no improvement. This group was characterized by imaginary bad breath and manifest psychologic problems. There was also disbelief of their cure, although clinical examination (organoleptic evaluation and volatile sulfide measurement by means of a portable monitor) did not reveal any oral malodor. Some also insufficiently performed the recommended oral hygiene measures (tongue brushing and interdental cleaning). Most of the patients who returned the questionnaire were disappointed by the suggestion that their halitosis was the result of insufficient oral hygiene. CONCLUSION: Better education of both the public and dental professionals as to the most frequent cause of halitosis, insufficient oral hygiene, might elevate the level of compliance by patients.
TL;DR: The OAG seems to be a reliable and clinical useful tool for assessing the oral cavity status and determining changes and should be trained to ensure high levels of reliability in the oral assessments.
Abstract: Oral complications are common in patients with haematological malignancies who undergo chemotherapy treatment. A pilot study including 16 haematological patients was carried out to evaluate the oral status using an Oral Assessment Guide (OAG) and to test the reliability of the OAG. The oral assessments were made daily by registered nurses at a Department of Internal Medicine in Sweden. Once a week a dental hygienist made the oral assessments independent of the registered nurses in order to provide data for calculations of inter-rater reliability. All patients had varying degrees of alterations in the oral cavity, especially in the mucous membranes, teeth/dentures and gums. The inter-rater agreement between the nurses and the dental hygienist was good for saliva and swallow, and moderate for voice and gums. Assessments to detect alterations in the oral cavity afford the opportunity for early and individualized interventions and may decrease the risk of oral infections. It is necessary to train the nurses to ensure high levels of reliability in the oral assessments. The OAG seems to be a reliable and clinical useful tool for assessing the oral cavity status and determining changes.
TL;DR: A multidisciplinary approach, systematic oral assessment and consistent oral hygiene measures are critical and may be the most important factors in the prevention of significant complications of cancer chemotherapy and bone marrow transplantation.
Abstract: The oral complications associated with cancer chemotherapy and bone marrow transplantation may be prevented or ameliorated by aggressive dental and oral hygiene interventions. Pretherapy dental evaluation and medically necessary oral care can eliminate potential sites of infection and trauma. A multidisciplinary approach, systematic oral assessment and consistent oral hygiene measures are critical and may be the most important factors in the prevention of significant complications.
TL;DR: Results showed that a raw food diet bears an increased risk of dental erosion compared to conventional nutrition and no significant correlation was found between nutrition or oral health data and the prevalence of erosions.
Abstract: The aim of the study was to investigate the frequency and severity of dental erosions and its association with nutritional and oral hygiene factors in subjects living on a raw food diet. As part of a larger dietary study 130 subjects whose ingestion of raw food was more than 95% of the total food intake were examined. The median duration of the diet was 39 (minimum 17, maximum 418) months. Before the clinical examination, the participants answered questionnaires and recorded their food intake during a 7-day period. Dental erosions were registered using study models. As a control 76 sex- and age-matched patients from our clinic were randomly selected. The raw food diet records showed the median daily frequency of ingesting citrus fruit to be 4.8 (minimum 0.5, maximum 16.1). The median intake of fruit was 62% (minimum 25%, maximum 96%) of the total, corresponding to an average consumption of 9.5 kg of fruit (minimum 1.5, maximum 23.7) per week. Compared to the control group subjects living on a raw food diet had significantly (p
TL;DR: The findings suggest that risk factors for the development of CTX-induced mucositis are not as simple and direct as clinicians may believe.
Abstract: Oral mucositis is one of the dose-limiting toxicities of several chemotherapy (CTX) agents. There are suggested risk factors that could influence the development of mucositis. The presence of dental appliances, history of oral lesions, or smoking have the potential to irritate the oral mucosa and produce breaks in the integrity of the mucosa. The purposes of this study were to determine if there were differences in the incidence, severity, and time to onset of CTX-induced mucositis in oncology outpatients who wore dental appliances, had a history of oral lesions, had varying oral hygiene/care practices, and had a history of smoking and those who did not. Patients who were initiated a course of CTX that included stomatotoxic agents were followed for three complete cycles of CTX. They were instructed on how to examine their mouths for mucositis, to contact, and then visit their outpatient settings if it occurred. Clinicians corroborated the presence of mucositis, and the Eiler's Oral Assessment Guide was used by clinicians to determine the severity. Of 332 outpatients, almost half (46%) wore some type of dental appliance, 32% had a history of oral lesions, 10% were currently smoking, and 63% had a history of smoking. Oral hygiene/care practices varied: 81% brushed their teeth two or more times a day, 29% flossed at least daily, 11% had visited their dentist within 2 months of beginning CTX, and 10% had their teeth professionally cleaned within two months of beginning CTX. There was a 31% (n = 104) incidence of CTX-induced mucositis. No significant differences were found in the incidence between patients who wore dental appliances, had a history of oral lesions, had a history of smoking, and practiced different hygiene/care and patients who did not. Of 104 patients who developed mucositis, the average severity rating was 13.05 +/- 2.88 (+/-SD) (a normal mouth is rated at 8) and the average time to onset was 22.3 +/- 21.46 days. There were no significant differences found in severity or time to onset of mucositis between patients who wore dental appliances, had a history of oral lesions, had a history of smoking, and practiced different dental hygiene/care and patients who did not. Although not significant, there were interesting differences in the time to onset across the suggested risk factors (e.g., patients who had visited a dentist or who had their teeth professionally cleaned within 2 months before beginning before CTX developed mucositis 7.4 and 10.6 days sooner, respectively, than patients who did not). These findings suggest that risk factors for the development of CTX-induced mucositis are not as simple and direct as clinicians may believe.
TL;DR: Decisive factors in the sustained long-term improvement of patients who respond satisfactorily to treatment are probably initial scaling and root planing; a brief course of metronidazole; and regular follow-up examinations at 6-month intervals for oral hygiene and scaling androot planing.
Abstract: Background: Periodontitis consists of a mixture of diseases, most of which respond favorably to traditional mechanical therapy. It is now recognized that advanced periodontitis does not always respond to conventional management with scaling, periodontal surgery, and oral hygiene measures. However, various types of antibiotics given systemically or locally improve the success rate of periodontal therapy. In short-term studies, it has been shown that metronidazole, when systemically administered after debridement, resulted in treatment benefits including less need for surgical intervention. Methods: In this double-blind study, we evaluated periodontal treatment involving initial non-surgical treatment, systemic administration of metronidazole for 1 week, and then follow-ups for scaling and root planing every 6 months, for 5 years. The study population consisted of 64 subjects (37 smokers and 27 nonsmokers), mean age 36.3 (±3.0 SD) years, with severe periodontal disease. After initial scaling and root planin...
TL;DR: It is suggested that differences exist in the inflammatory response to de novo plaque formation in young and old individuals.
Abstract: . The aim of the present experiment was to study changes in (i) the composition of the inflammatory cell infiltrates and (ii) levels of σ 2-macroglobulin, lactoferrin and IgG subclasses in gingival crevicular fluid in young and old individuals during 3 weeks of plaque formation. To establish healthy gingival conditions, all subjects received professional tooth cleaning during a 4 week preexperimental period. The experimental sites included the mesio-palatal, palatal, and disto-palatal surfaces of all teeth present in the 15...25 tooth region. At baseline (day 0) assessments of plaque and gingivitis, microbial sampling and gingival fluid assessment were performed and one gingival biopsy harvested from each subject. Following the baseline examination, the participants abolished mechanical tooth cleaning measures in the palatal and approximal surfaces of 15... 25. The clinical examination and the gingival fluid measurement were repeated on days 7, 14 and 21 of no oral hygiene. The microbiological sampling and the biopsy procedure were repeated on days 7 and 21. The gingival crevicular fluid samples harvested from the old individuals had higher levels of a 2-macroglobulin and IgG3 compared to young subjects. The immunohistochemical analyses of the biopsies demonstrated that the gingival lesion representing the old individuals harbored a higher proportion of B-cells and a lower density of PMN cells compared to the infiltrate in the young group of subjects. It is suggested that differences exist in the inflammatory response to de novo plaque formation in young and old individuals.
TL;DR: Insights gained from qualitative data can help to identify the less obvious causes for poor oral care delivery, which can then be addressed in education and training initiatives in nursing home settings.
Abstract: Objective: To identify qualitatively carer staff attitudes, practices and clinical comments related to oral health care of functionally dependent nursing home clients.
Design: Open-ended questions included in a longer quantitative questionnaire.
Setting: 22 randomly selected nursing homes in the Bristol area.
Subjects: 416 carers employed in these homes.
Results: The majority of carers thought that clients had a right to good oral health, accepted the carers' role in helping clients with oral and denture hygiene, but recognised that oral health care provision was deficient. However, some carers believed oral health care to be solely the clients' responsibility despite high disability levels. Main barriers to providing oral health care were low prioritisation of oral health by nursing management, lack of co-operation from cognitively impaired clients, and lack of training. Carers were critical of homes' lack of arrangements for routine professional dental cheeks, lack of commitment to staff training, low standards of oral health care by colleagues, and lack of provision of oral hygiene aids and cleansing materials for clients. Many responses indicated ways in which nursing home oral health care could be improved. Carers reported contrasting experiences of dental treatment, and deplored recent decreased availability of subsidised dental care.
Conclusions: Carers' generally positive attitudes towards clients' oral health care should encourage health educators. Insights gained from qualitative data can help to identify the less obvious causes for poor oral care delivery, which can then be addressed in education and training initiatives in nursing home settings.
TL;DR: The data suggest that, as in adults, oral malodor in children is related primarily to oral factors, suggesting that postnasal drip plays a major role.
TL;DR: Post-irradiated NPC patients constitute a high-risk group for dental root caries and oral candidiasis, and the carriage rate of Streptococcus mutans and Lactobacillus spp.
TL;DR: Three daily mouth rinses with fluoride and xylitol, separately or in combination, did not affect the salivary flow rate or micro–biota, dental plaque accumulation, gingivitis development, or the acidogenic potential of plaque.
Abstract: The aim of this study was to test the hypothesis that xylitol, alone and in combination with fluoride, affects the salivary flow rate and micro–biota, dental plaque accumulation, gingivitis developmen
TL;DR: The data indicate that the patients with Behçet's disease generally exhibit clinical findings of established periodontal disease, and results suggest that the bacterial plaque ecology and/or immune responses to these microorganisms may be affected in Behçett's disease which could lead to changes in the expression of periodontAL disease.
Abstract: Background: Behcet's disease is a multisystem disorder of unknown etiology, affecting predominantly the oral mucosa, skin, and eyes. Recurrent and painful episodes of oral ulcerations interfere with regular oral hygiene leading to rapid bacterial plaque accumulation. The aims of this study were to evaluate the periodontal status of patients with Behcet's disease and determine serum antibody responses to selected oral microorganisms, including major periodontopathogens in these patients. Methods: Thirty-three patients with Behcet's disease and 15 healthy subjects were included in the study. Plaque, sulcular bleeding, periodontal index scores, probing depths, and total number of teeth were recorded. Serum IgG antibody levels to a panel of 13 oral microorganisms were determined. Results: Significantly higher values for each of the clinical measures were observed in patients with Behcet's disease compared to healthy subjects (P <0.0001). Antibody levels to selected members of plaque, including Actinomyces vis...
TL;DR: The findings of this study showed that the CNA's are as capable as the Licensed Nurses in assessing oral health status, and increased emphasis on identification of problems in specific areas may improve the overall assessments by nurses and nursing assistants.
Abstract: Dental care and oral hygiene are often neglected in nursing homes This study examines the effect of an education program on the ability of nursing staff to conduct an oral health assessment for a population of persons with Alzheimer's disease and related disorders The findings of this study showed that the CNA's are as capable as the Licensed Nurses in assessing oral health status In future training of nursing staff, increased emphasis on identification of problems in specific areas may improve the overall assessments by nurses and nursing assistants
TL;DR: In this paper, the distribution of caries lesions among tooth types and surfaces in the primary dentition of young children with different levels of disease was described in detail, and the authors found that decay on primary canines and buccal/lingual surfaces of primary molars was strongly indicative of high caries experience.
Abstract: The aim of the present study was to describe in detail the distribution of caries lesions among tooth types and surfaces in the primary dentition of young children with different levels of disease. A total of 125 children (between 2 and 6 years old) attending the pediatric dental clinic of the University Hospital of Leuven was allocated to three groups based on their caries experience: dmft=1–5 formed the low caries experience group (LC, n=27), dmft=6–9 the moderate caries experience group (MC, n=61) and those with dmft>=10 the high caries experience group (HC, n=37). Caries experience (at patient level, tooth and tooth surface level) and oral hygiene were evaluated. Oral health habits were recorded using a questionnaire (completed by parents). Caries lesions were not evenly distributed among different tooth types. Teeth most frequently affected were lower (first and second) primary molars. Primary incisors were rarely found to be carious. The distribution of the lesions followed a comparable pattern, irrespective of the disease level of the child. Decay on primary canines and buccal/lingual surfaces of primary molars was strongly indicative of a high caries experience. There was a clear link with reported oral hygiene habits and the use of a pacifier and baby bottle with sugared content.
Journal Article•
TL;DR: The present findings strongly suggest the need for more prophylactic measures, and dental education, in kindergartens and elementary schools, by such means, a considerable improvement in levels of oral hygiene might be achieved, together with lower levels of fear of dental treatment.
Abstract: Working with 59 ambulant patients (average age 42 +/- 16 years), male and female, at the Dental Clinic of the University of Mainz, questions concerning fear of treatment were raised, and the answers compared with clinical findings on the status of oral health and with habits of oral hygiene. Pulse and blood pressure were also measured before and after treatment. 65% of the patients reported some level of fear of dental treatment. Younger patients had significantly more fear of treatment than older patients (p 10 beats/min) and changes in blood pressure were measured. Oral health correlated with levels of fear only for younger patients. Although the frequency of caries (DMF/T) and the degree of treatment need (CPITN) showed a significant correlation (p >0.005) with subjective fear of treatment among patients under 35 years of age, the correlation weakens with increasing age of the patients studied. The present findings strongly suggest the need for more prophylactic measures, and dental education, in kindergartens and elementary schools. By such means, a considerable improvement in levels of oral hygiene might be achieved, together with lower levels of fear of dental treatment.