Showing papers on "Oral hygiene published in 2007"

Oral biofilms, periodontitis, and pulmonary infections

Abstract: Bacteria from the oral biofilms may be aspirated into the respiratory tract to influence the initiation and progression of systemic infectious conditions such as pneumonia. Oral bacteria, poor oral hygiene, and periodontitis seem to influence the incidence of pulmonary infections, especially nosocomial pneumonia episodes in high-risk subjects. Improved oral hygiene has been shown to reduce the occurrence of nosocomial pneumonia, both in mechanically-ventilated hospital patients and non-ventilated nursing home residents. It appears that oral colonization by potential respiratory pathogens, possibly fostered by periodontitis, and possibly by bacteria specific to the oral cavity or to periodontal diseases contribute to pulmonary infections. Thus, oral hygiene will assume an even more important role in the care of high-risk subjects--patients in the hospital intensive care and the elderly. The present paper critically reviews the recent literature on the effect of oral biofilms and periodontitis on pneumonia.

Current topics in the epidemiology of oral cavity and oropharyngeal cancers.

Abstract: Oral cancer incidence rates rose dramatically during the twentieth century in the United States and Europe, especially among individuals under the age of 60 years. Although influenced by age, sex, and country of origin, incidence trends were most strongly affected by elevated risk among individuals born after approximately 1915. This cohort effect was indicative of strong behavioral influences on oral cancer risk. In this article, associations between oral cancer risk and established behavioral risk factors including alcohol and tobacco use are reviewed. Additionally, possible associations between oral cancer risk and oral hygiene, diet, nutritional status, and sexual behavior as well as the influence of genetic factors on oral cancer risk are considered. Special emphasis is placed on evaluating possible risk differences in individuals above and below the age of 45 and in users and nonusers of alcohol and tobacco.

Potential pathogenic aspects of denture plaque

Abstract: Oral health status declines with age and as a result the need for removable prostheses increases. Oral health is a reflection of one's general health, affecting the ability of an individual to eat and speak, and contributes significantly to a sense of confidence and well-being. Currently, there are 15 million denture wearers in the UK, representing a significant consumer base and a special healthcare consideration. The microbiology of denture plaque has received little attention in comparison with dental plaque, yet it differs in location and composition. Denture plaque and poor denture hygiene is associated with stomatitis (Candida infection), may also serve as a reservoir of potentially infectious pathogens, and may contribute to oral malodour and to caries and periodontitis in people who have remaining natural teeth. Oral bacteria have been implicated in bacterial endocarditis, aspiration pneumonia, gastrointestinal infection and chronic obstructive pulmonary disease, among others, and dentures offer a reservoir for microorganisms associated with these infections. An effective oral hygiene regimen is important to control denture plaque biofilm and contributes to the control of associated oral and systemic diseases.

Psychosocial factors and early childhood caries among low-income African-American children in Detroit.

Abstract: Objectives: This study sought to advance knowledge of the social determinants of oral health, by examining how several specific maternal health beliefs, behaviors, and psychosocial factors relate to young children's early childhood caries (ECC) status in a lower-income African-American population. Methods: Data were collected by the Detroit Dental Health Project (NIDCR grant), a population-based study of 1021 African-American families with at least one child under 6 years of age and living in 39 low-income Census tracts in Detroit, Michigan. Analyses were limited to 719 children aged 1-5 years and their biological mothers, and conducted in SUDAAN to account for the complex sampling design. Survey data included health belief scales on mothers' self-efficacy, feelings of fatalism, knowledge about appropriate bottle use and children's oral hygiene needs, brushing habits, psychosocial measures of depressive symptoms (CES-D), parenting stress, and availability of instrumental social support. The child's age, dental insurance status, dental visit history, and 1-week brushing frequency were also included in the model. Children's ECC status, based on a dental examination, was the main outcome. The dental team used the International Caries Detection and Assessment System (ICDAS) criteria for caries detection. Each child was classified as either caries-free or having ECC or severe ECC (S-ECC) based on the case definition of ECC proposed by an expert panel for research purposes with preschool-aged children. Results: The dental team followed a specific examination protocol and established reliable and consistent ratings of ECC based on the ICDAS criteria. The inter-rater reliability kappa was 0.83 overall, and the intra-rater reliability kappa was 0.74 overall. One-third of the children had ECC, and 20% had severe ECC. Age of the child and lower parenting stress scores were each positively associated with ECC, while higher education and income were protective. Maternal oral health fatalism and knowledge of children's hygiene needs were associated with ECC among preschool-aged children. ECC was higher among younger children who had past restorative care. Conclusions: These findings call attention to the high prevalence of ECC in this population and the need to consider psychosocial as well as traditional risk factors in developing interventions to reduce oral health disparities.

Enamel Demineralization during Fixed Orthodontic Treatment - Incidence and Correlation to Various Oral-hygiene Parameters

Abstract: To investigate the incidence of white spot lesions (WSLs) around brackets and molar bands during orthodontic therapy, and establish whether a correlation to indices of dental and gingival health, fluoride application and oral hygiene could be demonstrated. Fifty-three patients with fixed orthodontic appliances were included at random in this study at the Department of Orthodontics of Erlangen-Nuremberg University. Dental health (DMFS), plaque index, papillary bleeding index, sulcus probing depth (SPD), gingival recession (GR), clinical attachment level (as sum of SPD and GR), oral hygiene, and fluoride use were evaluated. WSLs were graded from intraoral photographs taken before and after treatment. 97.5% of teeth before and 73.6% after treatment were free of WSLs. Of all teeth, 24.9% developed new WSLs or a rise in their number. New or more numerous WSLs were more common in upper and lower premolars (34.4%) and front teeth (28.1%) than molars (11.8%). WSL incidence during therapy correlated with clinical attachment level, and the oral hygiene and fluoride-use scores. Despite improvements in materials and preventive efforts, orthodontic treatment continues to carry the considerable risk of enamel demineralization. Each patient's prophylactic efforts, including fluoride use, are of paramount importance in preventing WSLs.

The relation between family socioeconomic trajectories from childhood to adolescence and dental caries and associated oral behaviours

Abstract: Objectives: To investigate the influence of family socioeconomic trajectories from childhood to adolescence on dental caries and associated behaviours. Design: Population-based birth cohort. Setting: Representative sample of the population of subjects born in 1982 in Pelotas, Brazil. Participants: Adolescents (n = 888) aged 15 years old were dentally examined and interviewed. Main outcome measures: Dental caries index (DMFT), care index (F/DMFT), tooth brushing, flossing and pattern of dental services use. Main results: Adolescents who were always poor showed, in general, a worse pattern of dental caries, whereas adolescents who never were poor had a better pattern of dental caries. Adolescents who had moved from poverty in childhood to non-poverty in adolescence and those who had moved from non-poverty in childhood to poverty in adolescence had similar dental pattern to those who were always poor except for the pattern of dental services use, which was higher in the first group. In all groups girls had fewer carious teeth, better oral hygiene habits and higher dental services use than boys. Conclusion: Poverty in at least one stage of the lifespan has a harmful effect on dental caries, oral behaviours and dental services use. Belonging to upwardly mobile families between childhood and adolescence only contributed to improved dental care.

Assessment of risk factors for oral squamous cell carcinoma in Chidambaram, Southern India: a case-control study

Abstract: Oral squamous cell carcinoma, the fifth most common cancer worldwide, is a major cause of morbidity and mortality in India. The effect of lifestyle factors, including tobacco chewing, smoking and alcohol drinking, diet and dental care, on the risk of oral cancer was investigated in a case–control st

Oral care in the intensive care unit: a review.

Abstract: Oral care for patients in the hospital's Intensive Care Unit (ICU) is important, but this is usually the responsibility of nurses without sufficient knowledge in oral care or comprehensive protocols to follow. The problems of maintaining oral care with oral intubation, performing oral assessment, guidelines for oral hygiene care, frequency of oral care needed, and suggested mouth care protocol followed by recommendations are presented and discussed in this paper.

Psychological interventions to improve adherence to oral hygiene instructions in adults with periodontal diseases.

Abstract: Background Adherence to oral hygiene is an important aspect of the treatment of periodontal disease Traditional educational interventions have been shown to be of little value in achieving long term behaviour change Objectives The aim of this review was to determine the impact of interventions aimed to increase adherence to oral hygiene instructions in adult periodontal patients based on psychological models and theoretical frameworks This review considered the following outcomes: Observational measures of oral health related behaviour Self reported oral health related behaviours, beliefs and attitudes towards oral health related behaviour Clinical markers of periodontal disease Search strategy The Cochrane Oral Health Group's Trials Register (2005), the Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library 2004, Issue 4), MEDLINE (from 1966 to December 2004), EMBASE (from 1980 to December 2004), PSYCHINFO (from 1966 to December 2004), Ingenta (from 1998 to December 2004) and CINAHL (from 1966 to December 2004) Reference lists from relevant articles were searched and the authors of eligible trials were contacted to identify trials and obtain additional information No language restriction was applied Selection criteria Randomised controlled trials testing the effectiveness of interventions based on psychological models compared with educational, attention or no active intervention controls to improve adherence to oral hygiene in adults with either gingivitis or periodontitis Data collection and analysis Titles and abstracts of studies that were potentially relevant to the review were independently screened by two review authors Those that were clearly ineligible were rejected For the remaining studies, the full paper was reviewed by two review authors and where necessary further information was sought from the author to verify eligibility Included studies were assessed on their quality using standard criteria Main results The review identified four studies (including 344 participants) in which a psychological model or theory had been explicitly used as the basis for the design of the intervention The overall quality of trials was low Due to the hetereogeneity between studies, both in terms of outcome measures and psychological models adopted, a meta-analysis was not possible The four studies adopted four different theoretical frameworks, though there was some overlap in that three of the studies incorporated elements of Operant and Classical Conditioning Psychological interventions resulted in improved plaque scores in comparison to no intervention groups, and in one study in comparison to an attention control group One study found decreased gingival bleeding in the active intervention group but no change in pocket depth or attachment loss after 4 months Psychological interventions were associated with improved self reported brushing and flossing in both studies which assessed these behaviours Only one study explored the impact of psychological interventions on beliefs and attitudes, the psychological intervention, in comparison to educational and no intervention controls, showed improved self efficacy beliefs in relation to flossing, but no effect on dental knowledge or self efficacy beliefs in relation to tooth brushing Authors' conclusions There is tentative evidence from low quality studies that psychological approaches to behaviour management can improve oral hygiene related behaviours However, the overall quality of the included trials was low Furthermore, the design of the interventions was weak and limited, ignoring key aspects of the theories Thus, there is a need for greater methodological rigour in the design of trials in this area

Randomized Controlled Trial of a One-minute Intervention Changing Oral Self-care Behavior

Abstract: Non-compliance with oral self-care recommendations, despite education and motivation, is a major problem in preventive dentistry. Forming concrete if-then action plans has been successful in changing self-care behavior in other areas of preventive medicine. This is the first trial to test the effects of a brief planning intervention on interdental hygiene behavior. Two hundred thirty-nine participants received a packet of floss, information, and a flossing guide. They were randomly assigned to a control or an intervention group. The intervention took 1.16 minutes and consisted of forming a concrete plan of where, when, and how to floss. Baseline measures and two-week and two-month follow-ups included self-report, residual floss, and theory of planned behavior variables. The intervention significantly affected flossing in that group at two-week and two-month follow-ups, as compared with the control group. This study provides evidence for the effects of a concise intervention on oral self-care behavior.

Caries risk assessment appropriate for the age 1 visit (infants and toddlers).

Abstract: This article discusses caries management by risk assessment for children age 0-5. Risk assessment is the first step in a comprehensive protocol for infant oral care. The program includes opportunities to establish a "dental home" and provide guidance for improved health outcomes. Risk assessment forms, instructions for use, and guidance-related education points have been included. Collaboration among all health professionals regarding early and timely intervention to promote children's oral health and disease prevention is emphasized.

Oral health condition and treatment needs of a group of Nigerian individuals with Down syndrome.

Abstract: Objective: This study was carried out to determine the oral health condition and treatment needs of a group of individuals with Down syndrome in Nigeria. Method: Participants were examined for oral hygiene status, dental caries, malocclusion, hypoplasia, missing teeth, crowding and treatment needs. Findings were compared with controls across age group, sex and educational background of parents. Result: Participants with Down syndrome had poorer oral hygiene than controls, with no significant sex difference. Oral hygiene was similar in the lower age groups but deteriorated with age in the Down syndrome group. Conclusion: Individuals with Down syndrome in Nigeria have poorer oral health and more treatment needs than controls. They would benefit from frequent oral health assessment.

Mothers as facilitators of oral hygiene in early childhood

Abstract: Background. Toothbrushing twice daily is a recommended component of oral self-care soon after the eruption of primary dentition. Aim. This study aims to investigate oral hygiene and frequency of oral cleaning in children up to 3 years, in relation to mother-related factors. Design. A cross-sectional study of 504 children aged 12–36 months in Tehran, Iran was implemented. Mothers answered questions about their own oral self-care and their activity in their children's oral hygiene. The child's oral hygiene was assessed on the basis of visible dental plaque on the labial surfaces of the upper central incisors. Data analysis included chi-square test, analysis of variance (anova) and logistic regression. Results. Twice daily oral cleaning was reported for 5% of all children and once daily cleaning for 19% of the 12- to 15-month-old children, 18% of the 16- to 23-month-old children, and 48% of the 24- to 36-month-old children. Of the mothers, 59% stated that they lacked the skill to clean their children's teeth. Dental plaque was observed in 65–76% of the children. Clean teeth were more likely (OR = 1·7, 95% CI 1.3–2.3) in children of mothers who themselves have a higher toothbrushing frequency. Conclusions. To improve oral hygiene in early childhood, more emphasis should be placed on mothers’ own toothbrushing and their skills in their children's oral cleaning.

The prevalence and severity of non-carious cervical lesions in a group of patients attending a university hospital in Trinidad

Abstract: Summary Non-carious cervical lesions (NCCLs) are often encountered in clinical practice and their aetiology attributed to toothbrush abrasion, erosion and tooth flexure. This paper aims to determine the prevalence and severity of NCCLs in a sample of patients attending a university clinic in Trinidad and to investigate the relationship with medical and dental histories, oral hygiene practices, dietary habits and occlusion. Data were collected via a questionnaire and clinical examination. Odds ratios were used to determine the association of the presence of lesions and the factors examined. One hundred and fifty-six patients with a mean age of 40·6 years were examined of whom 62·2% had one or more NCCLs. Forty five per cent of the lesions were sensitive to compressed air. Younger age groups had a significantly lower correlation with the presence of NCCLs than older age groups. Other significant factors included patients who reported heartburn, gastric reflux, headaches, bruxism, sensitive teeth and swimming or had a history of broken restorations in the last year. There was also significant correlation of NCCLs in patients who brushed more than once a day or used a medium or hard toothbrush. Patients with vegetarian diets and those who reported consuming citrus fruits, soft drinks, alcohol, yoghurt and vitamin C drinks were associated with the presence of lesions. Significant associations were also found in patients with group function, faceting, clicking joints or those who wore occlusal splints.

Noninvasive Control of Dental Caries in Children with Active Initial Lesions

Abstract: The aim of this study was to investigate whether DMFS increment can be decreased among children with active initial caries by oral hygiene and dietary counseling and by using noninvasive preventive me

Oral health status of the elderly in a residential home in Turkey.

Abstract: Objectives: To determine the oral health status and treatment needs of elderly residents of a residential home in Ankara, Turkey. Background: Little is known about oral health problems of elderly living in the institutions. Methods: Among 216 elderly, 193 of them were interviewed and were clinically examined according to WHO criteria. Age, gender, educational and occupational status, oral hygiene practices, dental insurance, access to dental care and systemic diseases were recorded using a structured questionnaire. Coronal and root caries, periodontal disease, dental status and related treatment needs were assessed by two calibrated dentists. Results: The mean age of the subjects were 75.2 ± 8.3 in males, 79.1 ± 7.9 in females; 32.6% of subjects were dentate and the mean number of teeth was 3.7 ± 7.0 (median = 0). A functional dentition was present in 7.3% of subjects (≥20). The mean decayed, missing and filled teeth (DMFT) was 29.3 ± 5.8 (median = 32) and mean root caries was 2.2 ± 3.1 (median = 1.0). The major reason for tooth extraction was dental caries. Of the subjects, 20.7% had at least one untreated coronal caries and 18.1% root caries. The assessment of periodontal status according to CPI revealed that only four persons had nine healthy sextants with the score of ‘0’. Edentulousness was 67.4% while 11.9% of them lacked denture in both jaws. Conclusion: The results illustrated poor dental health and showed extremely high demand for the dental health services programmes for the elderly living in these institutions.

Oral health care and status of elderly care home residents in Glasgow.

Abstract: Objectives To investigate variations in reported oral health care provision and unmet dental need within a sample of care homes for the elderly in Glasgow. Basic research design Two-phase study of a 50% random sample of 120 care homes (n = 60). Phase 1: telephone interviews with care home managers. Phase 2: oral examinations of residents and face-to-face interviews with care staff, in a sub-sample of 10 homes. Clinical setting Care homes in Greater Glasgow. Participants Residents and staff. Results Phase 1: data were collected from 58 of 60 care home managers approached (response rate: 97%). Oral assessment of residents on admission was reported for 78% of nursing homes and 24% of residential homes, and annual screening by a dentist for 85% and 76% respectively. Only 58% of nursing homes and 8% of residential homes had a formal mouth care policy. Staff training in mouth care was not universal and often carried out "in-house". All managers believed dental support was available when required. Phase 2: 288 oral examinations and 22 staff interviews took place within 10 homes selected. Examinations revealed high levels of oral disease. When interviewed, staff accepted that mouth care was within their remit but failed to document it within patient care plans. Further training on oral health and disease was requested from all levels of staff. Conclusions Oral disease is common among elderly care home residents in Glasgow. Increased emphasis on implementation of standard oral care protocols and improved education of staff is essential if the oral health of elderly institutionalised residents is to improve.

Self-reported oral hygiene habits and oral health problems of Kuwaiti adults.

Abstract: Objective: The aims of this study were to examine self-reported oral hygiene habits and oral health problems of a sample of adult Kuwaitis. Materials and Methods:

Effects of 11-month interventions on oral cleanliness among the long-term hospitalised elderly

Abstract: Objectives: This trial studied the effects of interventions on the oral cleanliness of the long-term hospitalised elderly. Background: Oral cleanliness is mostly poor in long-term facilities. While many agree on the importance of oral hygiene education for nursing personnel, little information and agreement exists on how to organise this education in geriatric institutions. Materials and methods: This is a longitudinal study with interventions. After a baseline clinical examination, the patient wards were divided into three groups (A, B and C) and the type of intervention was randomly assigned. In group A, dental hygienists provided oral hygiene measures for the subjects once every 3 weeks. In group B, the nursing staff first received hands-on instructions after which they assumed responsibility for the subjects’ daily oral hygiene. Group C served as a control. Denture hygiene and dental hygiene were recorded at baseline and in the end of the 11-month study period. In total, 130 subjects completed the interventions; their mean age was 82.9 years. Results: The best outcome in both denture and dental hygiene occurred when nursing staff at the wards took care of hygiene (group B). The increase in the proportion of those with good denture hygiene was the most prominent in group B (from 11% to 56%). The proportion of subjects with poor overall dental hygiene decreased from 61% at baseline to 57% in the end, for group B from 80% to 48%. Conclusions: Organised oral health education of the nursing staff should receive more attention.

Oral and general health behaviours among Chinese urban adolescents.

Abstract: – Objectives: The objectives of this study were to measure the association of general and oral health-related behaviours with living conditions and to explore the interrelationships between general and oral health-related behaviours in Chinese urban adolescents. Methods: A cross-sectional survey of 2662 adolescents was conducted in eight Chinese provincial capitals. The response rate was 92%. The study population was selected through multistage cluster sampling and comprised three age groups: 11, 13 and 15 years. Data on oral and general health, lifestyles as well as living conditions were collected by means of self-administered structured questionnaires. Several additive indices were constructed from answers to the questions on specific behaviour, and participants were categorized according to scores on each component of health-related behaviour for statistical analyses by frequency distributions, regression analyses and factor analyses. Results: Oral health-related behaviours among adolescents were associated with socioeconomic status of parents, school performance and peer relationships. The odds of a dental visit was 0.63 in adolescents of poorly educated parents and the corresponding figure for regular oral hygiene practices was 0.62. Odds of tobacco use was 3 for adolescents with poor performance in school while odds of consuming sugary foods/drinks was 1.3. Adolescents with high levels of preventive oral health practices also demonstrated general health-promoting behaviours. In factor analysis of general and oral health-related behaviours, three factors were isolated: (a) risk behaviours (loadings 0.48–0.66), (b) health-promoting behaviours (loadings 0.60–0.64) and (c) help-seeking behaviours (loadings 0.56–0.67). Conclusion: The findings support a multidimensional model of health behaviour. Several approaches and multiple methods should be applied in oral health education in order to modify behaviours that affect oral health.

Tooth loss and associated factors in long‐term institutionalised elderly patients

Abstract: Objective: To compare partial and total tooth loss in dependent institutionalised elderly patients and identify any associated factors. Background: A poor oral health status, together with a reduction of autonomy can seriously affect the general health and increase the risk of death in elderly people. Those with total tooth loss and in need of assistance are the most at risk. Materials and methods: In 2004, a cross-sectional study of 321 elderly patients was conducted in long-term hospital services provided in Montpellier, France. Socio-demographic, behavioural, medical and oral health information was recorded for each patient. Multivariate logistic regression models were performed to test the relationship between those covariates and partial or total tooth loss. Pearson chi-squared tests were used for bivariate analyses. Results: The proportion of edentulousness was 26.9%; among these12.6% had no dentures. The factors significantly associated with edentulism were: an age ‘older than 87 years’ [odds ratio (OR) = 9.4], the presence of a nephropathy (OR = 6.8), and inadequate oral hygiene (OR = 0.1). The factors most significantly associated with partial tooth loss (at least 21 missing teeth) were ‘cancerous disease’ (OR = 9.9), the presence of a nephropathy (OR = 5.6) and the presence of a neurological disease (OR = 4.1). The factors significantly related to dentate status (20 or more natural teeth retained) were ‘hypertension treatment’ (OR = 2.4), and ‘cortisone treatment’ (OR = 0.2). Conclusion: General health problems as well as a poor oral condition were significant risk indicators for tooth loss among the long-term institutionalised elderly. This suggests that the number of remaining teeth has a strong effect on oral health-related quality of life.

Provision of mouth‐care in long‐term care facilities: an educational trial

Abstract: – Objectives: This randomized clinical trial aimed to assess the effectiveness of a pyramid-based education for improving the oral health of elders in long-term care (LTC) facilities. Methods: Fourteen facilities matched for size were assigned randomly to an active or control group. At baseline in each facility, care-aides in the active group participated with a full-time nurse educator in a seminar about oral health care, and had unlimited access to the educator for oral health-related advice throughout the 3-month trial. Care-aides in the control group participated in a similar seminar with a dental hygienist but they received no additional advice. The residents in the facilities at baseline and after 3 months were examined clinically to measure their oral hygiene, gingival health, masticatory potential, Body Mass Index and Malnutrition Indicator Score, and asked to report on chewing difficulties. Results: Clinical measures after 3 months were not significantly different from baseline in either group, indicating that education neither influenced the oral health nor the dental hygiene of the residents. Conclusions: A pyramid-based educational scheme with nurses and care-aides did not improve the oral health of frail elders in this urban sample of LTC facilities.

Appropriate oral hygiene motivation method for patients with fixed appliances.

Abstract: Objective: To determine the most appropriate oral hygiene motivation method (OHMM) for orthodontic patients with fixed appliances. Materials and Methods: A total of 150 orthodontic patient...

Oral Health of Children and Adults in Latino Migrant and Seasonal Farmworker Families

Abstract: Oral health is one of the greatest unmet health needs of immigrant farmworkers. This paper describes use of dental services and current oral health problems of children and parents in farmworker families. Interviews were conducted with 108 women in Latino farmworker families in western North Carolina and southwestern Virginia. Dental care had been received in the past year by 73% of children, 47% of mothers, and 37% of spouses. Children were most likely to have received care on a regular basis, while adults usually received no care or emergency care. In general, children’s teeth were in better condition than parents’ teeth. Children’s receipt of dental care and their teeth condition were predicted by being born in the US. No family member’s care was related to acculturation or mother’s education, typical predictors of health behavior. Differences among family members suggest that access to services, not lack of education, is the primary barrier facing farmworker families.

Predisposing factors to dental caries in children with cleft lip and palate: a review and strategies for early prevention.

Abstract: Objective: To review predisposing factors contributing to dental caries in patients with cleft lip, cleft palate, or both (CUP). Design: Patients with CUP have a higher susceptibility to caries compared with the population group without clefts. A review of the literature was undertaken to determine factors that could account for the compromised oral hygiene and the high caries prevalence in patients with CUP. Results: After a literature review, modern strategies for the prevention of early childhood caries were developed and should be considered for integration into the overall management protocol of patients with CUP. Conclusions: Preventive dental care is ever more so important in patients with CUP compared with patients without clefts.

Effect of antiasthmatic medication on dental disease: dental caries and periodontal disease.

Abstract: The prevalence of asthma has been increasing since the 1980s. Asthma and tooth decay are the two major causes of school absenteeism. There are few studies present in the literature. The objectives of the present study were to know the severity of dental caries and periodontal problems in children before and after taking antiasthmatic medication. The present study was conducted on 105, six- to fourteen-year-old asthmatic children to determine the condition of their dental caries and their periodontal status before and after taking antiasthmatic medication, for a period of 1 year and these were matched with their controls. The results showed that salbutamol inhaler shows increased caries rate with high significance over other groups, which was followed by salbutamol tablets and beclamethasone inhaler respectively. It has been concluded that antiasthmatic medication has its effects on dental caries and periodontal disease and asthmatic patients are recommended to adopt more precautionary oral hygiene practices and keep their caries activity and periodontal health under constant check.

The effect of oral health education on dental plaque development and the level of caries-related Streptococcus mutans and Lactobacillus spp.

Abstract: The aim of this study was to determine the influence of oral hygiene instruction (OHI) on oral hygiene status and on the reduction of inducing bacteria (Streptococcus mutans and Lactobacillus spp.) in 30 subjects (12 males and 18 females) with an age range from 10 to 14 years. The patients were instructed on how to carry out effective oral hygiene close to brackets and ligatures, and in the use of dental floss for cleaning spaces around brackets, between the teeth and under archwires. The plaque index (PI) was used to measure oral hygiene status, and the level of S. mutans and Lactobacillus spp. was determined using the colour reaction time test before and after 1 month of OHI. Statistical analysis included a Student's t-test and chi-square test. The results showed that OHI significantly improved oral hygiene. The percentage of patients with a PI exceeding 1 decreased from 23.3 to 10 per cent and for those with a PI below 0.1 it increased from 20 to 60 per cent. The level of S. mutans and Lactobacillus spp. was not reduced. The percentage of subjects with excessive levels of S. mutans (above 10(6) bacteria in 1 ml of saliva) decreased after OHI but only from 73.3 to 70 per cent. For Lactobacillus spp., a level above 10(5) of bacteria in 1 ml of saliva was found for all subjects at both time points. Patients with fixed appliances, trained in scrupulous tooth cleaning, remain at risk of developing caries and should be carefully monitored.

Influence of tobacco use in dental caries development.

Abstract: This review article describes different forms of tobacco usage and its direct relationship with the prevalence of dental caries. Smoking along with co-existing factors like old age, bad oral hygiene habits, food habits, limited preventive dental visits and over all health standards, can be associated with high caries incidence. However, a direct etiological relationship is lacking. Environmental tobacco smoke (ETS) causes dental caries in children but no studies have been reported in adults. Existing findings are not sufficient and conclusive enough to confirm that ETS causes dental caries. Oral use of smokeless tobacco (ST), predominantly tobacco chewing, is presumably a positive contributing factor to higher incidence of dental caries. Unfortunately, published studies are not converging towards one single factor through which tobacco usage can have direct relationship to dental caries.

Hand Function and Oral Hygiene in Older Institutionalized Brazilians

Abstract: OBJECTIVES: To evaluate whether the oral hygiene of institutionalized older people differs significantly between groups of participants with different degrees of hand function. DESIGN: Cross-sectional study. SETTING: Residents of a long-term institution of Porto Alegre, Brazil. PARTICIPANTS: Forty-nine institutionalized older people. Subjects restricted to bed or with Mini-Mental State Examination (MMSE) scores less than 15 were excluded. MEASUREMENTS: Dental (Silness and Loe Index) and denture plaque (Modified Ambjornsen Plaque Index) scores were assessed as a measure of oral hygiene. Hand functions were assessed using the Jebsen-Taylor and the Purdue pegboard tests. Participants were grouped according to their levels of hand function (regarded as good if test values were at the median or higher in the case of Purdue pegboard test and below the median in the case of Jebsen-Taylor test). Existence of differences between groups was checked using univariate analysis of variance, adjusting for age, sex and cognitive status according to MMSE. RESULTS: Dentate participants with poor hand function according to the Dominant Hand Purdue test harbored significantly more dental plaque after adjustment for age, sex, and cognitive status. Complete denture wearers with poor hand function according to the Dominant Hand and Sum of Three Steps Purdue tests and the total Jebsen-Taylor test also had significantly more denture plaque after adjustment. CONCLUSION: The results support the notion that hand function plays a central role in oral hygiene, mainly removal of dental and denture plaque, in institutionalized older people.