Showing papers on "Oral hygiene published in 2004"

The long-term effect of a plaque control program on tooth mortality, caries and periodontal disease in adults. Results after 30 years of maintenance

Abstract: Background: The biofilm that forms and remains on tooth surfaces is the main etiological factor in caries and periodontal disease. Prevention of caries and periodontal disease must be based on means that counteract this bacterial plaque. Objective: To monitor the incidence of tooth loss, caries and attachment loss during a 30-year period in a group of adults who maintained a carefully managed plaque control program. In addition, a comparison was made regarding the oral health status of individuals who, in 1972 and 2002, were 51–65 years old. Material and Methods: In 1971 and 1972, more than 550 subjects were recruited. Three hundred and seventy-five subjects formed a test group and 180 a control group. After 6 years of monitoring, the control group was discontinued but the participants in the test group was maintained in the preventive program and was finally re-examined after 30 years. The following variables were studied at Baseline and after 3, 6, 15 and 30 years: plaque, caries, probing pocket depth, probing attachment level and CPITN. Each patient was given a detailed case presentation and education in self-diagnosis. Once every 2 months during the first 2 years, once every 3–12 months during years 3–30, the participants received, on an individual need basis, additional education in self-diagnosis and self-care focused on proper plaque control measures, including the use of toothbrushes and interdental cleaning devices (brush, dental tape, toothpick). The prophylactic sessions that were handled by a dental hygienist also included (i) plaque disclosure and (ii) professional mechanical tooth cleaning including the use of a fluoride-containing dentifrice/paste. Results: Few teeth were lost during the 30 years of maintenance; 0.4–1.8 in different age cohorts. The main reason for tooth loss was root fracture; only 21 teeth were lost because of progressive periodontitis or caries. The mean number of new caries lesions was 1.2, 1.7 and 2.1 in the three groups. About 80% of the lesions were classified as recurrent caries. Most sites, buccal sites being the exception, exhibited no sign of attachment loss. Further, on approximal surfaces there was some gain of attachment between 1972 and 2002 in all age groups. Conclusion: The present study reported on the 30-year outcome of preventive dental treatment in a group of carefully monitored subjects who on a regular basis were encouraged, but also enjoyed and recognized the benefit of, maintaining a high standard of oral hygiene. The incidence of caries and periodontal disease as well as tooth mortality in this subject sample was very small. Since all preventive and treatment efforts during the 30 years were delivered in one private dental office, caution must be exercised when comparisons are made with longitudinal studies that present oral disease data from randomly selected subject samples.

Risk factors for dental caries in young children: a systematic review of the literature.

Abstract: Objective To conduct a systematic review of the literature on risk factors for dental caries in deciduous teeth of children aged six years and under, to give a scientific framework for the international collaborative studies on inequalities in childhood caries. Method Accepted guidelines were followed. Studies were identified by electronic searching and reviewed on the basis of key words, title and abstract by two reviewers to assess whether inclusion criteria were met. Copies of all articles were obtained and assessed for quality according to the study design. Results 1029 papers were identified from the electronic search, 260 met the prima facie inclusion criteria. 183 were excluded once full copies of these papers were obtained. Of the 77 studies included, 43 were cross sectional, 19 cohort studies, 8 case control studies and 7 interventional studies. Few obtained the highest quality scores. 106 risk factors were significantly related to the prevalence or incidence of caries. Conclusion There is a shortage of high quality studies using the optimum study design, i.e. a longitudinal study. The evidence suggests that children are most likely to develop caries if Streptococcus Mutans is acquired at an early age, although this may be partly compensated by other factors such as good oral hygiene and a non- cariogenic diet. Diet and oral hygiene may interact so that if there is a balance of ‘good’ habits by way of maintaining good plaque control and ‘bad’ habits by way of having a cariogenic diet, the development of caries may be controlled.

Familial and cultural perceptions and beliefs of oral hygiene and dietary practices among ethnically and socio-economicall diverse groups

Abstract: Objective: The aim of this international study was to develop a valid and reliable psychometric measure to examine the extent to which parents' attitudes about engaging in twice-daily tooth brushing and controlling sugar snacking predict these respective behaviours in their children. A supplementary objective was to assess whether ethnic group, culture, level of deprivation or children's caries experience impact upon the relationships between oral health related behaviours, attitudes to these respective behaviours and to dental caries. Clinical setting: Nurseries, health centres and dental clinics in 17 countries. Participants: 2822 children aged 3 to 4 years and their parents. Main outcome measures: Dental examination of children and questionnaire to parents. Results: Factor analysis identified 8 coherent attitudes towards toothbrushing, sugar snacking and childhood caries. Attitudes were significantly different in families from deprived and non-deprived backgrounds and in families of children with and without caries. Parents perception of their ability to control their children's toothbrushing and sugar snacking habits were the most significant predictor of whether or not favourable habits were reported. Some differences were found by site and ethnic group. Conclusions: This study supports the hypothesis that parental attitudes significantly impact on the establishment of habits favourable to oral health. An appreciation of the impact of cultural and ethnic diversity is important in understanding how parental attitudes to oral health vary. Further research should examine in a prospective intervention whether enhancing parenting skills is an effective route to preventing childhood caries.

The prevalence and severity of oral impacts on daily performances in Thai primary school children

Abstract: Background Traditional methods of measuring oral health mainly use clinical dental indices and have been complemented by oral health related quality of life (OHRQoL) measures. Most OHRQoL studies have been on adults and elderly populations. There are no systematic OHRQoL studies of a population-based sample of children. The objective of this study was to assess the prevalence, characteristics and severity of oral impacts in primary school children.

Biological factors in dental caries: role of saliva and dental plaque in the dynamic process of demineralization and remineralization (part 1).

Abstract: Dental caries is a complex disease process that afflicts a large proportion of the world's population, regardless of gender, age and ethnicity, although it does tend to affect more indivduals with a low socioeconomic status to a greater extent. The process of dental caries is dependent upon biological factors that are present within the saliva and dental plaque. There are many different agents within saliva and plaque that serve to protect the tooth surface against caries development. Salivary flow rate, buffering capacity, antimicrobial activity, microorganism aggregation and clearance from the oral cavity, immune surveillance, and calcium phosphate binding proteins all interact to inhibit or reverse demineralization of exposed tooth surfaces. Cariogenic bacteria levels within the saliva and plaque determine whether caries will occur or not, and the concentration in saliva and plaque are intimately related to the type of carbohydrate ingestion and the frequency of ingestion, as well as the oral hygiene practiced by the individual.

Gender Differences in the Relationship Between Periodontal Disease, Tooth Loss, and Atherosclerosis

Abstract: Background and Purpose— Males carry a disproportionate burden of cardiovascular disease. Because males also bear a higher burden of periodontal disease, we investigated the existence of gender differences in the postulated relationship between periodontal infections, tooth loss, and subclinical atherosclerosis. Methods— A total of 1710 randomly enrolled participants between the ages of 45 and 75 with no history of myocardial infarction or stroke received a clinical periodontal examination, carotid scan using high-resolution B-mode ultrasound, and extensive measurements for conventional cardiovascular risk factors (age, education, smoking, alcohol, body mass index, diabetes, systolic blood pressure, low-density lipoprotein-cholesterol, high-density lipoprotein-cholesterol, and triglycerides) as well as markers of healthy lifestyle and social network. Results— In both genders, measures of current and long-term periodontitis worsened as tooth loss increased. In males but not females, an ≈10% difference in ca...

Oral health and treatment needs of the long-term hospitalised elderly.

Abstract: Objectives: To determine the oral health and treatment needs of the long-term hospitalised elderly. Setting: The Laakso long-term hospital, Helsinki, Finland. Design: A cross-sectional study with clinical oral examinations. Subjects: All long-term patients (n = 260) aged 60 and older. Main outcome measures: Edentulousness, presence and hygiene of dentures, mucosal findings, number of teeth, functioning teeth and tooth remnants, level of dental hygiene, and need for operative treatment. Results: Subjects’ mean age was 83.3 years (SD = 8.1); 42% were edentulous, 45% of women and 33% of men (p = 0.12). With no gender difference, 41% had removable dentures, but one in four were considered to be in need of repair or replacement. Denture hygiene was good in 19%, moderate in 44%, and poor in 37%, and for men worse than for women (p = 0.02). Stomatitis was found in 25%, and angular cheilitis in 28% of the denture wearers. The dentate subjects had on average 12.4 (SD = 8.6) teeth with a clear difference by age (p = 0.03), but no difference by gender. Dental hygiene was considered poor. Of the dentate subjects, 37% were in need of restorations, 51% of periodontal therapy and 42% of extractions. Conclusions: Oral cleanliness should be improved with regards to dentures and teeth. More attention should be focused on dental care of the long-term hospitalised elderly.

Adjunctive benefit of an essential oil–containing mouthrinse in reducing plaque and gingivitis in patients who brush and floss regularly: A six-month study

Abstract: Background Mechanical methods of oral hygiene can be complemented by the use of chemotherapeutic mouthrinses. The authors sought to quantify the additional benefit provided by an essential oil–, or EO–, containing mouthrinse in reducing plaque and gingivitis in patients who brush and floss regularly. Methods The authors randomly assigned patients with gingivitis to one of three treatment groups: brushing and rinsing with a control mouthrinse, or BC; brushing, flossing and rinsing with a control mouthrinse, or BFC; or brushing, flossing and rinsing with an EO–containing mouthrinse, or BFEO. Patients received a dental prophylaxis at baseline, and the authors followed them for six months. Results Of 246 enrolled subjects enrolled in the study, 237 subjects were evaluable at the study's conclusion. After six months, the subjects using the BFEO regimen had statistically and clinically significant lower mean Modified Gingival Index, or MGI, scores and Plaque Index, or PI, scores than did subjects in the BC group (29.9 percent and 56.3 percent, respectively; P P P Conclusions This study confirms that for patients with gingivitis who brush and floss routinely, the adjunctive use of an EO–containing mouthrinse provides a clinically significant and meaningful additional benefit in reducing plaque and gingivitis. Clinical Implications An EO–containing mouthrinse is an effective adjunct to regular brushing and flossing. Therefore, the BFEO regimen can be beneficial for patients with gingival inflammation.

The shortened dental arch: a review of the literature.

Abstract: The functional demands of patients are highly variable and individual, requiring dental treatment to be tailored to the individual's needs and adaptive capability. The World Health Organization indicates that a functional, esthetic, natural dentition has at least 20 teeth, while the literature indicates that dental arches comprising the anterior and premolar regions meet the requirements of a functional dentition. The English-language peer-reviewed literature pertaining to the short dental arch (SDA) was identified through the Medline search engine covering the period between 1966 and the present and critically reviewed. This treatment option for the partially dentate patient may provide oral functionality, improved oral hygiene, comfort, and, possibly, reduced costs.

Dental caries experience and its relationship to social and behavioural factors among 3-5-year-old children in Uganda.

Abstract: Summary. Objective. The aim of this study was to assess the socio-demographic and behavioural correlates of caries experience and sugar intake patterns among pre-school children in Uganda. Methods. Five hundred and eighty-nine, 3‐5-year-old children (51% boys, response rate = 85%), attending nursery schools in urban and peri-urban settings in central Kampala and Nakawa, respectively, were clinically examined for dental caries using the dmft index. Visible plaque on the labial surfaces of their maxillary incisors was recorded as a proxy for oral hygiene habits. A questionnaire designed to assess socio-demographic factors and sugar habits was completed by their caregivers in face-to-face interviews. Results. The mean dmft scores were 1·7, 2·4 and 3·1, and 42%, 44% and 42% had visible plaque among 3-, 4- and 5-year-olds, respectively. In Nakawa, a total of 64%, 62% and 22% of the subjects had dmft > 0, decayed teeth (dt) > 0 and missing teeth > 0, respectively. The corresponding rates in central Kampala were 56%, 55% and 17%. Multivariate analyses revealed that attending school in Nakawa, having a mother with a lower level of education, reporting the intake of cough syrup, visiting a dentist and scoring positively for plaque were associated with higher odds (1·6, 1·5, 3·7 and 2·7) for having dmft > 0. The adjusted mean frequency sugar scores varied systematically between mothers with low and high levels of education (mean scores = 11·0 vs. 10·4), and for children with negative and positive plaque scores (mean scores = 10·6 vs. 10·9). Conclusion. The caries experience was highest among children attending nursery schools in Nakawa and those who had had longer periods of cough syrup consumption, whereas children from the two locations were equally exposed to sugar consumption generally. Both caries experience and frequency of sugar consumption was highest among children of less-well-educated mothers.

Oral hygiene device and method of use therefor

Abstract: An oral hygiene device including, in combination, a system for relatively effortlessly and effectively cleansing dental, inter-dental, gingival and deep-gum surfaces and crevices, and a convenient teeth bleaching system that may be selectively implemented following cleansing of the oral surfaces, wherein the present invention may be utilized in conjunction with, or in lieu of, conventional brushing and/or flossing practices.

Ten-year cross-sectional and incidence study of coronal and root caries and some related factors in elderly Swedish individuals.

Abstract: Objective: The 10-year incidence of dental caries was related to some associated factors in a random sample of 65, 75 and 85-year-old inhabitants of Gothenburg. Subjects: Of the 208 persons examined at baseline, 102 (49%) participated in the follow-up examination; 56, 37 and nine, respectively, in the different age groups. For the purpose of time-trend comparisons, a new random sample of 98 individuals aged 55 years was examined. Results: Ninety-five per cent of the participants had developed one or more carious lesions during the 10-year period and the incidence of coronal and root caries increased with age. In the 65-year-olds, 9% of the root surfaces had decayed during the period, compared with 25% in the 85-year-olds. Secondary caries predominated over primary caries and prosthetic crowns accounted for 70% of the restored tooth surfaces. Twenty per cent of the individuals were daily smokers and 61% were taking drugs with hyposalivatory side-effects. The mean saliva secretion rates were lower in the older groups compared with the ‘younger’ ones. The overall salivary counts of mutans streptococci and lactobacilli had increased during the period and the values were highest in the oldest age groups. Salivary levels of lactobacilli and mutans streptococci, number of teeth, daily numbers of cigarettes and drugs and oral hygiene were the best predictors of the incidence of caries. Conclusion: The findings indicate that there is an increased risk of dental caries with age owing to unfavourable caries-related factors.

Dental fear and oral health and family characteristics of Finnish children.

Abstract: Objectives: Our aim was to describe the occurrence of dental fear among Finnish children of different ages and to ascertain how oral health and family characteristics are associated with dental fear. Methods: The subject groups were aged 3, 6, 9, 12, and 15 years in two middle‐sized cities, and the 1474 participants were distributed over fairly equal samples of each age. A questionnaire given to each child to be filled out at home enquired about social background, oral hygiene habits, diet, and dental fear. Oral health status was examined clinically and radiographically by two calibrated dentists. Multiple logistic regression analyses were performed for each age group in order to study the associations between dental fear and selected factors. Results: Dental fear was higher among 12‐ and 15‐year‐old children than among the younger ones. Pain, drilling, and local anesthesia were reported to be the most frightening aspects. Excluding the 12‐year‐olds, children whose family members reported dental fear were...

A practical guide to infant oral health.

Abstract: Early childhood caries is the most common chronic disease in young children and may develop as soon as teeth erupt. Bacteria, predominately mutans streptococci, metabolize simple sugars to produce acid that demineralizes teeth, resulting in cavities. Physicians should examine children's teeth for defects and cavities at every well-child visit. Any child with significant risk factors for caries (e.g., inadequate home dental care and poor oral hygiene, a mother with a high number of cavities, a high sugar intake, enamel defects, premature birth, special health care needs, low socioeconomic status) should be referred to a dentist by 12 months of age. Promoting appropriate use of topical and systemic fluoride and providing early oral hygiene instruction can help reduce caries in young patients, as can regularly counseling parents to limit their child's consumption of sugar.

Self-reported denture hygiene of a sample of edentulous attendees at a University dental clinic and the relationship to the condition of the oral tissues.

Abstract: Objectives: This article aims to evaluate the habits of hygiene and usage of a sample group of Brazilian wearers of complete dentures. Design: This study has a cross-sectional design. Setting: It was performed in the dental clinic of the University of Mogi das Cruzes. Subjects: A sample group of 236 complete denture wearers was selected. Intervention: The individuals were interviewed and clinically examined. Main outcome measures: Most commonly used hygiene habits were assessed and recorded. Possible relationships between habits and oral conditions were also assessed. Results: Dental treatment was sought by 43.6% 10 years after their last dental appointment, 77.5% declared they had been given no instructions regarding the hygiene of their dentures, only 22.9% said they had been instructed about oral hygiene, and 91.9% stated they had not been told to return for periodical review visits. Denture stomatitis was found in 42.4%, although 89% of these patients presented with no symptoms; 98.7% of the group brushed their dentures; 27.1% regularly immersed their dentures in chemical products; 26.3% removed their dentures overnight. A positive relationship was observed between the lack of recommendations regarding oral and denture cleansing and the presence of denture-related stomatitis and hyperplasia. Family income and periodicity of visits to the dentist were also found to be related. Conclusion: Mechanical cleaning is the most prevalent method of hygiene. Self-reported lack of guidance to oral care was statistically related to inflammatory oral conditions. Future research is necessary to clarify possible causal role between these factors.

Dental Caries, Oral Hygiene, and Oral Clearance in Children with Craniofacial Disorders

Abstract: The reason that children with cleft palates tend to have a greater prevalence of tooth decay than normal children is unclear. We hypothesized that children with cleft palates would have increased oral clearance times for foods and, consequently, higher levels of caries and caries-associated micro-organisms than control children. Children aged 6-16 yrs, with (n = 81) or without (n = 61) cleft palates, were studied. Children with cleft palates had DMFT and dmft scores greater (p < 0.01) than those of the control group. The number of caries-associated organisms was greater in the saliva of the cleft palate children (all p < 0.001). The oral hygiene, plaque and gingival index scores were greater (p < 0.0001), oral clearance was longer (p < 0.01), and levels of sucrose and starch-derived saccharides higher (p < 0.01) in the cleft palate group. However, salivary concentrations of organic acids were lower in the children with craniofacial disorders, probably reflecting the altered physiology of the more mature dental biofilm. The longer oral clearance times of foods and the consequent generation of fermentable sugars from starches may contribute to the higher caries prevalence observed in children with cleft palates.

Oral hygiene care for adults with dementia in residential aged care facilities

Abstract: Objective The objective of this systematic review was to report on the best available evidence relating to oral hygiene for adults with dementia in residential aged care facilities, including: • documenting the prevalence and incidence, as well as the experiences and increments, of oral diseases and conditions • the use of assessment tools by carers to evaluate oral health • oral hygiene care strategies to prevent oral diseases and conditions • the provision of dental treatment and the ongoing management of oral diseases and conditions. Inclusion criteria This review considered any randomised or non-randomised controlled studies, cohort studies, case-control studies, multiple time series studies, uncontrolled studies, descriptive studies and opinions of respected authorities (including theses and other publications) related to residents with dementia living in residential aged care facilities in Australia and overseas; community-dwelling adults with dementia; and special needs adult populations (for preventive oral hygiene care strategies and interventions). The review considered studies and publications designed to: 1 quantify the oral health status of older adults living in residential aged care facilities; 2 quantify the oral health status of adults with dementia living in the community and in residential aged care facilities; 3 evaluate tools used to assess the oral health of residents by staff and carers working in residential aged care facilities; 4 evaluate preventive oral hygiene care strategies and interventions used in special needs adult populations (including adults with dementia); and 5 evaluate oral health care training and oral hygiene care provision, staff and carers working in residential aged care facilities. Dental outcome measures of interest were those relating to the prevalence, incidence, experiences and increments of oral diseases and conditions including: denture problems, coronal and root caries, periodontal diseases (plaque accumulation, gingivitis, loss-of-attachment), oral mucosal conditions, xerostomia and salivary gland hypofunction, tooth loss, difficulty chewing, behavioural problems and pain/discomfort. Related characteristics and outcomes of interest included: medical conditions, medications, cognitive status, functional status, nutritional status and sociodemographics. Search strategy The aim of the search was to locate relevant English-language studies and publications appearing between 1980 and 2002. The search utilised a two-step approach, involving an initial search of electronic databases using combinations of key words followed by a second extensive search carried out using the identified key words. This was supplemented with a secondary search of the references cited in the identified studies. Electronic database searched were: Cinahl, Embase, Psycinfo, Medline and Current Contents. Methodological quality All selected studies were critically appraised by two reviewers prior to inclusion in the review. Results In regards to relevance, incidence, experiences, and increments of oral diseases and conditions, possible risk factors identified included: saliva dysfunction, polypharmacy, comorbid medical conditions, swallowing and dietary problems, increased functional dependence, need for assistance with oral hygiene care, and poor access and utilisation of dental care. Evidence on the use of assessment tools by carers to evaluate residents' oral health showed that successful assessment of residents with and without dementia by nursing staff requires appropriate staff training by a dental professional. Coupled with appropriate training, an oral assessment screening tool designed for residents with dementia has been successfully used by nursing and care staff to identify residents requiring further review by dental professionals. Expert opinion in the field indicates that oral assessment screenings by a staff member and then by a dentist would ideally be undertaken upon admission to a facility, and regularly thereafter by staff and/or dentists as required. Clinicians and researchers suggested that oral hygiene care strategies to prevent oral diseases and conditions were found to be effective in preventing oral diseases, TRUNCATED AT 600 WORDS

Subgingival plaque microbiota in Saudi Arabians after use of miswak chewing stick and toothbrush

Abstract: BACKGROUND: The chewing stick, the miswak, is used in many developing countries as the traditional means for oral hygiene. It is prepared from the roots, twigs and stem of Salvadora persica or othe ...

Epidemiological studies of tooth wear and dental erosion in 14-year old children in North West England. Part 2: The association of diet and habits.

Abstract: Objective To determine the strength of association (expressed as Odds Ratios) of potential risk factors with erosion and tooth wear in 14-year-old schoolchildren. Design A random sample of 2,385 children were selected by a stratified two-stage technique based on schools and children. Setting Schools in NW England. Methods Tooth wear was assessed by one examiner on three surfaces of all 12 anterior teeth (labial, incisal and palatal) and the occlusal surface of all four first molars using a four-point scale. Enamel wear was scored 0, dentine exposure 1/3 scored 2 and secondary dentine or pulpal exposure, scored 3. A questionnaire enquired about general health, dental health, habits and the frequency of intake of a wide range of foods and drinks. Results The Odds Ratios for tooth wear on any surface for habits, reflux and certain foods were: bruxism, 1.10; stomach upset, 1.45; pickles 1.86; vinegar 1.36; salt and vinegar crisps 1.33; brown/other sauces 1.57. Similarly, the odds ratios for potentially erosive drinks were: fizzy drinks 1.32; sport drinks 1.58; herbal/lemon tea 3.97. The frequency of intake was bi-modal with 397 children drinking a can per day and 207 drinking two cans per day. A significant number drank acidic beverages at bedtime but this was not associated with dental erosion. Conclusion Although odds ratios greater than unity indicate an association, this was not high for carbonated beverages and many other acidic foods or drinks. Examining at fourteen years may not be ideal, as the determinants of erosion/tooth wear have not acted for long, the indices do not discriminate sufficiently and proportionately few subjects have dentine exposed on smooth surfaces.

Caries experience and oral hygiene status of blind, deaf and mentally retarded female children in Riyadh, Saudi Arabia.

Abstract: Objective To determine the caries experience and oral hygiene status in blind, deaf and mentally retarded female children in Riyadh, Saudi Arabia. Method All (N=218) the 6-7-year-old and 11-12-year-old blind, deaf and mentally retarded female children registered with the Presidency of Girls' Education schools in Riyadh were examined for dental caries and oral hygiene in a dental operatory setting. Results All (100%) the blind 6-7-year-old had caries with a mean dmft score of 6.58 (SD 2.02). The caries prevalence in blind 11-12-year-olds was 88.2% with a mean DMFT score of 3.89 (SD 2.67). Among 6-7-year-old blind children 8.3 %, and in 11-12-year-old blind children 29.4% had good oral hygiene. The caries prevalence in deaf 6-7-year-olds was 95.7% with a mean dmft score of 7.35 (SD 3.51). The caries prevalence in 11-12-year-old deaf children was 93% with a mean DMFT of 5.12 (SD 3.45). Less than one-fifth (17.4%) of the 6-7-year-old deaf children and only 7.0% of 11-12-year-old deaf children had good oral hygiene. The caries prevalence in mentally retarded 6-7-year-old was 93.9% with a mean dmft of 8.00 (SD 4.1). All the mentally retarded 11-12-year-old had carious teeth with a mean DMFT score of 5.81 (SD 2.95). Only 3.1% of the mentally retarded 6-7-year-old and none of the mentally retarded 11-12-year-olds had good oral hygiene. Conclusions Caries prevalence and severity in all the three groups of female special children were very high, and the number of children with good oral hygiene was very low.

Impact of socio-demographic variables, oral hygiene practices, oral habits and diet on dental caries experience of Indian elderly: a community-based study.

Abstract: A number of factors influence the caries experience and the pattern of restorative care especially in the older age group. Objective: To evaluate the dental caries experience and restorative treatment needs of an elderly Indian population and to study the impact of socio-demographic variables, oral hygiene practices, oral habits and dietary practices on them. Design: A community-based study. Setting: An urban area in the south zone of Delhi and a cluster of four villages in its neighbourhood. Subjects: A total of 1240 elderly subjects, 716 urban and 524 rural, were included in the study. Results: Of the 1052 dentate elderly subjects, 676 (64.2%) had decayed teeth (66.7% root caries and 33.3% coronal caries), 69 (6.6%) had filled teeth and 17 (1.6%) had recurrent decay. Restorations were indicated in 233 (22.2%) subjects, endodontic treatment in 51 (4.8%) and extractions in 424 (40.3%). Urban–rural differences in caries experience were statistically significant. Multivariate regression analysis showed that dental caries was associated with literacy level, oral hygiene practices, oral health perception and diet, while previous restorative treatment was correlated only with location (urban–rural) and presence or absence of systemic diseases. Conclusion: Dental caries prevalence was high amongst the studied elderly population and significant differences were observed in those living in a rural compared with an urban setting. Only a small percentage of elderly had evidence of previous restorative treatment whereas their unmet treatment need was significant.

Methods and compositions for oral hygiene

Abstract: The present invention comprises novel compositions and methods for oral hygiene and for treating and preventing oral disease in humans and in animals. In one embodiment, the novel compositions of the present invention comprise a unique oral hygiene solution that can be added to drinking water. The invention provides compositions and methods for maintaining oral health that are convenient to use and are formulated so that they are safe for regular use by humans and animals.

The miswak (chewing stick) and oral health. Studies on oral hygiene practices of urban Saudi Arabians.

Abstract: The miswak, a traditional chewing stick for cleaning teeth, is made from the plant Salvadora persica. For religious and cultural reasons, miswak use is firmly established and widespread in Saudi Arabia and most other Muslim countries. Only recently has scientific evaluation of the miswak been undertaken. The aims of the thesis were: 1) to explore current oral hygiene habits and oral health awareness among urban Saudi Arabians in relation to age, gender and educational level (papers I and II); 2) to compare mechanical plaque removal and gingival health after miswak use and toothbrushing (paper III); 3) to compare the effect of miswak use and toothbrushing on subgingival plaque microflora (paper IV). In papers I and II, structured interviews were conducted with 1200 regular patients at two centres in the city of Makkah, providing dental care for university and military staff and their families, respectively. Consecutive patients were stratified according to gender and age, into 6 age groups from 10 to 60 years, with 50 male or female subjects in each group at each centre. Oral hygiene habits were correlated with the subjects' age, gender, and educational levels and analysed statistically by a generalized linear model and ANOVA. In papers III and IV, the subjects comprised 15 healthy Saudi Arabian male volunteers aged 21 to 36 years, attending the Dental Center at Al-Noor Specialist Hospital in Makkah City. A single-blind, randomised crossover design was used. The Turesky modified Quigley-Hein plaque and Loe-Silness gingival indices and digital photographs of plaque distribution were recorded in Paper III and in Paper IV plaque was sampled for DNA-testing. Inhibition zones around miswak material were examined on agar plates with Actinobacillus actinomycetemcomitans and the leukotoxicity of this bacterium was analysed in a bioassay with macrophages +/- miswak extracts (paper IV). In papers I and II, 73% of the subjects used a toothbrush and 65% used a miswak daily. There were significant differences between genders and age groups, and between the centres. Regular miswak use was more prevalent among men (p < 0.01), while women used a toothbrush more often than a miswak (p < 0.05). For the majority (88%) of the individuals, oral hygiene began late, after the age of 7 yrs. Oral hygiene habits were strongly correlated to educational level (p < 0.001). The miswak was preferred by less educated people. Tooth brushing started earlier among the better educated (p < 0.001). In paper III, compared to tooth brushing, use of the miswak resulted in significant reductions in plaque (p < 0.001) and gingival (p < 0.01) indices. In paper IV, A. actinomycetemcomitans was significantly reduced by miswak use (p < 0.05) but not by tooth brushing. These results were supported by the in vitro observations that extracts from S. persica interfered with growth and leukotoxicity of A. actinomycetemcomitans. It was concluded that oral hygiene practice is introduced very late, is strongly correlated to educational level, and that more women prefer toothbrushing to miswak use. It was further concluded that miswak use was at least as effective as toothbrushing for reducing plaque and gingivitis, and that the antimicrobial effect of S. persica is beneficial for prevention/treatment of periodontal disease. There is clearly a need for further oral health education in Saudi Arabia. Because of its close association with Islam, maximum benefits may be achieved by encouraging optimum use of the miswak. Oral hygiene may be improved by complementing traditional miswak use with modern technological developments such as toothbrushing and by tailoring oral hygiene recommendations to educational level.

The prevalence of dental caries among 12 to 15-year-old school children in Nigeria: report of a local survey and campaign.

Abstract: PURPOSE To assess the prevalence of dental caries among school children in Egor local government area (district) and establish baseline data. DESIGN Cross-sectional survey of urban and rural, private and public school children in Egor district, Edo State, Nigeria. MATERIALS AND METHODS A total of 358 randomly selected school children aged 12 to 15 years from urban and rural, private and public schools in Egor District were examined for dental caries according to the World Health Organization (WHO) criteria. A questionnaire was administered to elicit information from the participants on tooth cleaning, dietary habits and dental experience. An oral health campaign was conducted in the selected schools as an incentive. Data were analyzed using SPSS 7.5. RESULTS Sixty-seven percent (n = 238) of the school children were caries-free. Mean DMFT score was 0.65 (sd = 1.14). Decayed teeth accounted for the largest component (98.6%). No fillings were recorded. Prevalence (mean DMFT) was higher in females (0.70) than males (0.59); urban (0.72) more than rural (0.53); private schools (0.75) more than public schools (0.55). DMFT scores at age 12, 13, 14 and 15 were 0.51, 0.63, 0.78 and 0.66 respectively; 81.4% of the school children had never visited a dental clinic, 95.8% claimed to use a toothbrush and 87.5% regularly consumed snacks. CONCLUSION The prevalence of caries in Egor District is very low. Untreated caries indicates that preventive and restorative treatment needs are high. Dental and dietary habits are likely to increase this prevalence; hence the need for continuous monitoring, preventive and restorative programmes.

Do Circumstances in Early Life Contribute to Tooth Retention in Middle Age

Abstract: The relative contributions of factors operating in fetal life, childhood, and adulthood to risk of disease in middle age have become an important research issue, though oral health has rarely been considered. This study investigated the relative impacts of risk factors operating at different stages throughout life on the number of teeth retained at ages 49-51 yrs based on data from the Newcastle Thousand Families cohort. Very little variation in tooth retention in middle age was explained by factors operating at earlier stages in life. The previously noted relationship between childhood socio-economic status and oral health in adulthood appears, with respect to tooth retention, to diminish with increasing age as adult socio-economic position and lifestyle factors have an increasing effect. Promotion of a healthier adult lifestyle and continued improvements in oral hygiene would appear to be the public health interventions most likely to increase tooth retention in middle age.

The aetiology and treatment of oral halitosis: an update.

Abstract: Halitosis refers to the condition of offensive mouth odour. More than 90% of cases of halitosis originate from the oral cavity. The implicated bacteria (Fusobacterium nucleatum, Prevotella intermedia, and Tannerella forsythensis) are located in stagnant areas in the oral cavity, such as the dorsal surface of tongue, periodontal pockets, and interproximal areas. These bacteria proteolyse the amino acids releasing volatile sulphur compounds. The management of halitosis involves determining and eliminating the causes, which includes identifying any contributory factors, because certain medical conditions are also associated with characteristic smells. Professional advice should be given on oral hygiene and diet, and treatments should include dental scaling, and root planing of the associated periodontal pockets to reduce the bacterial loading. In addition to the normal oral hygiene practice, tongue cleaning and use of mouthwash are advocated. This paper discusses the common aetiological factors, classification of oral halitosis, and its treatment.

Oral health and habits in children with asthma related to severity and duration of condition

Abstract: Aim This study was designed to examine the oral health status of asthmatic children and to compare the oral health condition and habits of different groups of asthmatic children. Methods 140 asthmatic children were involved in the present study. Of those, 30 were younger than 7 years of age, 73 were between 7 and 12, 37 were older than 12. Dental caries was scored according to the guidelines of the BASCD. No radiographs were taken. The gingival health and the amount of plaque were assessed using the bleeding index described by Muhleman and Son (1971) and the plaque index of Silness and Loe (1964) respectively. To differentiate between the asthmatic children three explanatory variables were used: the time the asthmatic symptoms had lasted, the exposure time to the medication and the severity of the asthmatic condition. Finally the parents and children were asked to fill in a questionnaire referring to oral health habits. Results The mean dmft was 1.99 (SD±2.74) and the mean DMFT was 1.10 (SD±1.98). Non-parametric correlation and multiple logistic regression analyses showed no significant difference between the caries (dmft/s, DMFT/S), the gingival health (bleeding index) and plaque indices and the three explanatory variables. The impact of possible compensatory factors as oral hygiene and dietary habits was of no significant importance. Conclusion This analysis revealed that neither the period (of the disease and the medication) nor the severity of the asthma had a significant influence on the risk of caries and gingivitis in asthmatic children. No reported oral health and dietary habits could explain this lack of correlation.

Chlorhexidine with an Anti Discoloration System. A comparative study.

Abstract: Correct oral hygiene is believed to be the basis of primary and secondary prevention. Sometimes, using a toothbrush or other mechanical instruments for oral hygiene may be difficult and it may become necessary to use an antiseptic. Chlorhexidine is an essential component in many available preparations on sale, because of its marked antiseptic qualities. One of the most frequent side-effects is the appearance of stains on the teeth and mucous membranes, which particularly disturbs the patient. A new mouthwash containing chlorhexidine has recently become available, besides maintaining its antiseptic qualities, also avoids the side-effect of staining. Objectives: The aim of this study was to check the capacity of the new mouthwash, which contains chlorhexidine and Anti Discoloration System (ADS), not only to prevent plaque formation like the other mouthwashes containing chlorhexidine but also to avoid staining that is one of the most frequent side-effects. Study design: The comparative study was carried out on a sample of 15 patients treated with two mouthwashes both containing 0.2% chlorhexidine, but different in that the first does not contain ADS, which is instead present in the second, a new product. The results obtained show that in the 15 patients treated, there is no statistically significant difference in the ability of the mouthwash to prevent bacterial plaque, however evidence of the stain was much less with the new mouthwash.