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Showing papers on "Oral hygiene published in 2009"


Journal ArticleDOI
TL;DR: Oral hygiene and gingival disease indexes were associated significantly with IE-related bacteremia after toothbrushing, and improvements in oral hygiene may reduce the risk of developing IE.
Abstract: Background Infective endocarditis (IE) often is caused by bacteria that colonize teeth. The authors conducted a study to determine if poor oral hygiene or dental disease are risk factors for developing bacteremia after toothbrushing or single-tooth extraction. Methods One hundred ninety-four participants in a study were in either a toothbrushing group or a single-tooth extraction with placebo group. The authors assessed the participants' oral hygiene, gingivitis and periodontitis statuses. They assayed blood samples obtained before, during and after the toothbrushing or extraction interventions for IE-associated bacteria. Results The authors found that oral hygiene and gingival disease indexes were associated significantly with IE-related bacteremia after toothbrushing. Participants with mean plaque and calculus scores of 2 or greater were at a 3.78- and 4.43-fold increased risk of developing bacteremia, respectively. The presence of generalized bleeding after toothbrushing was associated with an almost eightfold increase in risk of developing bacteremia. There was no significant association between any of the measures of periodontal disease and the incidence of bacteremia after toothbrushing. The oral hygiene or disease status of a tooth was not significantly associated with bacteremia after its extraction. Conclusion Bacteremia after toothbrushing is associated with poor oral hygiene and gingival bleeding after toothbrushing. Clinical Implications Improvements in oral hygiene may reduce the risk of developing IE.

366 citations


Journal ArticleDOI
TL;DR: Regular and frequent PP intake may help protect against oral cancer, while human studies are needed to confirm the promising preventive activity against periodontal disease and caries.

351 citations


Journal ArticleDOI
TL;DR: The results of the study indicate that local factors such as accessibility for oral hygiene at the implant sites seems to be related to the presence or absence of peri-implantitis.
Abstract: OBJECTIVE: The aim of the present study was to describe some clinical periodontal features of partially edentulous patients referred for the treatment of peri-implantitis. MATERIAL AND METHODS: The 23 subjects involved in this study were selected from consecutive patients referred to the department of Periodontology Sodra Alvsborgs Hospital, Boras, Sweden, for treatment of peri-implantitis during 2006. The patients had clinical signs of peri-implantitis around one or more dental implants (i.e.>or=6 mm pockets, bleeding on pockets and/or pus and radiographic images of bone loss to>or=3 threads of the implants) and remaining teeth in the same and/or opposite jaw. The following clinical variables were recorded: Plaque Index (PI), Gingival Bleeding Index (GBI) Probing Pocket Depth (PPD), Access/capability to oral hygiene at implant site (yes/no), Function Time. The patients were categorized in the following sub-groups: Periodontitis/No periodontitis, Bone loss/No bone loss at teeth, Smoker/Non-smokers. RESULTS: Out of the 23 patients, the majority (13) had minimal bone loss at teeth and no current periodontitis; 5 had bone loss at teeth exceeding 1/3 of the length of the root but not current periodontitis and only 5 had current periodontitis. Six patients were smokers (i.e. smoking more than 10 cig/day). The site level analysis showed that only 17 (6%) of the 281 teeth present had >or=1 pocket of >or=6mm, compared to 58 (53%) of the total 109 implants (28 ITI and 81 Branemark); 74% of the implants had no accessibility to proper oral hygiene. High proportion of implants with diagnosis of peri-implantitis were associated with no accessibility/capability for appropriate oral hygiene measures, while accessibility/capability was rarely associated with peri-implantitis. Indeed 48% of the implants presenting peri-implantitis were those with no accessibility/capability for proper oral hygiene (65% positive predict value) with respect to 4% of the implants with accessibility/capability (82% negative predict value). CONCLUSION: The results of the study indicate that local factors such as accessibility for oral hygiene at the implant sites seems to be related to the presence or absence of peri-implantitis. Peri-implantitis was a frequent finding in subjects having signs of minimal loss of supporting bone around the remaining natural dentition and no signs of presence of periodontitis (i.e. presence of periodontal pockets of >or=6 mm at natural teeth). Only 6 of the examinated subjects were smokers. In view of these results we should like to stress the importance of giving proper oral hygiene instructions to the patients who are rehabilitated with dental implant and of proper prosthetic constructions that allow accessibility for oral hygiene around implants.

334 citations


Journal ArticleDOI
TL;DR: A successful dental implant osseointegration can be accomplished in subjects with diabetes with good metabolic control in a similar manner as in subjects without diabetes.
Abstract: Background: Implant treatment is an attractive substitute to traditional fixed/removable prosthetic appliances. In patients with diabetes, dental implant therapy has been considered a contraindication. Hyperglycemia augments the severity of periodontal disease, and glycemic control is an essential variable in determining the success of dental implants in subjects with diabetes. Subjects with well-controlled diabetes may not be significantly compromised and can have high dental implant success rates compared to individuals with poorly controlled diabetes. The focused questions addressed in this systematic review were as follows: Can patients with diabetes be good candidates for dental implant therapy? And how does hyperglycemia and glycemic control influence osseointegration? Methods: A systematic literature search of MEDLINE/PubMed articles published from 1982 up to and including July 2009 was independently performed by two investigators. In addition, reference lists of original and review articles were searched. The search strategy was to use the following terms in different combinations: dental implants, immediate implants, osseointegration, periodontal disease, diabetes, hyperglycemia, metabolic control, and glycemic control. The search included studies on humans and diabetes-induced animal models. The selection criteria included all levels of available evidence. Suitable variables included the implant survival rate among individuals with diabetes, effects of hyperglycemia and glycemic control on bone, and maintenance of dental implants in subjects with diabetes. Articles published only in the English language were considered, and unpublished data were not sought. Results: We initially identified 33 studies. Fifteen studies, which did not fulfill the selection criteria, were excluded. The included studies reported that poorly controlled diabetes negatively affects implant osseointegration; however, under optimal serum glycemic control, osseointegration can successfully occur in patients with diabetes. Animal studies have confirmed that osseointegration can be successfully achieved in insulincontrolled rats with diabetes, whereas in uncontrolled rats with diabetes, the bone-to-implant contact appears to decrease with time. The use of antiseptic mouthrinses and oral-hygiene maintenance helps in achieving a successful dental implant osseointegration in subjects with diabetes. Conclusion: A successful dental implant osseointegration can be accomplished in subjects with diabetes with good metabolic control (serum glycemic level and hemoglobin A1c in normal range) in a similar manner as in subjects without diabetes. J Periodontol 2009;80:1719-1730.

271 citations


Journal ArticleDOI
TL;DR: Chlorhexidine, but not toothbrushing, reduced early ventilator-associated pneumonia in patients without pneumonia at baseline, and chlorhexidine significantly reduced the incidence of pneumonia on day 3 among patients who had CPIS <6 at baseline.
Abstract: Ventilator-associated pneumonia (VAP) is defined as pneumonia in patients receiving mechanical ventilation that was neither present nor developing at the time of intubation. VAP increases mortality,1 hospital length of stay,2,3 and health care costs.2,4,5 Oral health can be compromised by critical illness and by mechanical ventilation and is influenced by nursing care.6,7 The effect of oral care interventions on the development of VAP has been of interest to clinicians; however, data from well-controlled experimental research with adequate sample sizes have not been published. Many risk factors for VAP have been identified.8 Major ones include inadequate hand washing by staff, ventilatory circuit management practices, supine positioning of patients without backrest elevation, previous antibiotic therapy, presence of a nasogastric tube, and gastric alkalinization.9,10 Interventions included in the Institute for Healthcare Improvement’s ventilator bundle11 to reduce risk of complications in patients treated with mechanical ventilation include elevating the head of the bed to 30° or more, prophylaxis for peptic ulcer disease and deep vein thrombosis, daily interruption of sedation (sedation vacation), and assessment of readiness to extubate. Another risk factor for VAP is colonization of the oropharynx by potential pathogens such as Staphylococcus aureus, Streptococcus pneumoniae, or gram-negative rods.12–15 Several factors contribute to the association between oral health and development of VAP. Within 48 hours of admission to the intensive care unit (ICU), oral flora of critically ill patients undergoes a change to predominantly gram-negative flora that includes more virulent organisms.16,17 Dental plaque can provide a habitat for microorganisms responsible for VAP, and dental plaque of patients in the ICU can be colonized by potential respiratory pathogens such as methicillin-resistant S aureus and Pseudomonas aeruginosa.18 Because contamination of the oral cavity by pathogenic bacteria is associated with VAP, interventions to reduce bacteria in the oral cavity have been investigated. Several studies19–21 have indicated that application of topical oral chlorhexidine, initiated before intubation, reduces nosocomial infections in patients having elective cardiac surgery. Importantly, however, cardiac surgery patients are generally extubated within 48 hours and thus have a low risk for VAP. However, in a recent meta-analysis, Pineda et al22 found that chlorhexidine did not reduce nosocomial pneumonia or mortality rate. A recommendation for use of chlorhexidine in patients other than those having elective cardiac surgery is not included in national ventilator bundles or in recommendations from the Centers for Disease Control and Prevention because no evidence of the effectiveness of chlorhexidine in general critical care patients is available. Controlled studies of the effects of toothbrushing on VAP have not been reported. Dental plaque can provide a habitat for microorganisms responsible for ventilator-associated pneumonia. Oral care in critically ill adults is now emerging as an important issue but has not been well studied in patients other than those having elective cardiac surgery. We conducted a randomized, controlled clinical trial to test the effects of toothbrushing and/or chlorhexidine in reducing the risk for VAP in adult ICU patients receiving mechanical ventilation. We hypothesized that oral interventions would reduce the incidence of VAP.

242 citations


Journal ArticleDOI
TL;DR: Decontamination of the oral cavity with chlorhexidine did not reduce the total number of potential respiratory pathogens, but it did reduce the number of S. aureus in dental plaque of trauma intensive care patients.
Abstract: Dental plaque biofilms are colonized by respiratory pathogens in mechanically-ventilated intensive care unit patients. Thus, improvements in oral hygiene in these patients may prevent ventilator-associated pneumonia. The goal of this study was to determine the minimum frequency (once or twice a day) for 0.12% chlorhexidine gluconate application necessary to reduce oral colonization by pathogens in 175 intubated patients in a trauma intensive care unit. A randomized, double-blind, placebo-controlled clinical trial tested oral topical 0.12% chlorhexidine gluconate or placebo (vehicle alone), applied once or twice a day by staff nurses. Quantitation of colonization of the oral cavity by respiratory pathogens (teeth/denture/buccal mucosa) was measured. Subjects were recruited from 1 March, 2004 until 30 November, 2007. While 175 subjects were randomized, microbiologic baseline data was available for 146 subjects, with 115 subjects having full outcome assessment after at least 48 hours. Chlorhexidine reduced the number of Staphylococcus aureus, but not the total number of enterics, Pseudomonas or Acinetobacter in the dental plaque of test subjects. A non-significant reduction in pneumonia rate was noted in groups treated with chlorhexidine compared with the placebo group (OR = 0.54, 95% CI: 0.23 to 1.25, P = 0.15). No evidence for resistance to chlorhexidine was noted, and no adverse events were observed. No differences were noted in microbiologic or clinical outcomes between treatment arms. While decontamination of the oral cavity with chlorhexidine did not reduce the total number of potential respiratory pathogens, it did reduce the number of S. aureus in dental plaque of trauma intensive care patients. clinicaltrials.gov NCT00123123.

190 citations


Journal ArticleDOI
TL;DR: The aim of this review is to consider the current status as regards novel treatment approaches for control of dental plaque-related diseases, including replacement therapy by which a resident pathogen is replaced with a non-pathogenic bacteriocin-producing variant.

189 citations


Journal ArticleDOI
TL;DR: In this article, a summary of the preventive strategies relevant for patients suffering from dental erosion is presented, including dietary counseling, stimulation of salivary flow, optimization of fluoride regimens, modification of erosive beverages and adequate oral hygiene measures.
Abstract: Dental erosion is defined as the loss of tooth substance by acid exposure not involving bacteria. The etiology of erosion is related to different behavioral, biological and chemical factors. Based on an overview of the current literature, this paper presents a summary of the preventive strategies relevant for patients suffering from dental erosion. Behavioral factors, such as special drinking habits, unhealthy lifestyle factors or occupational acid exposure, might modify the extent of dental erosion. Thus, preventive strategies have to include measures to reduce the frequency and duration of acid exposure as well as adequate oral hygiene measures, as it is known that eroded surfaces are more susceptible to abrasion. Biological factors, such as saliva or acquired pellicle, act protectively against erosive demineralization. Therefore, the production of saliva should be enhanced, especially in patients with hyposalivation or xerostomia. With regard to chemical factors, the modification of acidic solutions with ions, especially calcium, was shown to reduce the demineralization, but the efficacy depends on the other chemical factors, such as the type of acid. To enhance the remineralization of eroded surfaces and to prevent further progression of dental wear, high-concentrated fluoride applications are recommended. Currently, little information is available about the efficacy of other preventive strategies, such as calcium and laser application, as well as the use of matrix metalloproteinase inhibitors. Further studies considering these factors are required. In conclusion, preventive strategies for patients suffering from erosion are mainly obtained from in vitro and in situ studies and include dietary counseling, stimulation of salivary flow, optimization of fluoride regimens, modification of erosive beverages and adequate oral hygiene measures.

179 citations


Journal ArticleDOI
TL;DR: Schoolchildren with fair/poor oral hygiene were less likely than their counterparts with good oral hygiene to be diagnosed with a midline shift and an open bite, and were associated with environmental factors in terms of caries experience and residing in a less affluent district.
Abstract: SUMMARY The aim of this study was to assess the prevalence of malocclusion and its association with socio-demographic characteristics, caries experience, and level of oral hygiene in 12- to 14-year-old schoolchildren residing in two socio-economically different districts of Tanzania. A total of 1601 children (mean age 13 years, 60.5 per cent girls) attending 16 primary schools in Kinondoni and Temeke districts participated in a clinical examination and were interviewed in school settings. Chi-square and multiple logistic regression models were used to test for statistically signifi cant differences between different groups. The results showed that 63.8 per cent (62.6 per cent in Kinondoni and 66.0 per cent in Temeke) of the subjects had at least one type of anomaly, with a midline shift (22.5 per cent), spacing of at least 2 mm (21.9 per cent), and an open bite (16.1 per cent) being the most frequently recorded. The majority (93.6 per cent) of the children showed a Class I molar relationship. Class II and Class III malocclusions were registered in 4.4 and 2.0 per cent, respectively. Multiple logistic regression analyses, controlling for sociodemographic factors, showed that the odds ratio for having an open bite was 1.8 if residing in a less socio-economically privileged district. Subjects with decayed, missing, and fi lled teeth (DNFT) (>0) were 1.7, 2.1, 2.4, and 1.7, respectively, more likely to be diagnosed with a malocclusion, a midline shift, Angle Class II and III, and an open bite. Schoolchildren with fair/poor oral hygiene were less likely than their counterparts with good oral hygiene to be diagnosed with a midline shift. Malocclusions were prevalent in the Tanzanian children investigated and were associated with environmental factors in terms of caries experience and residing in a less affl uent district. Preventive programmes to combat the prevalence of malocclusion are recommended.

178 citations


Journal ArticleDOI
TL;DR: The findings imply that improvement in health-related behaviors may lessen, but not eliminate socioeconomic disparities in oral health, and suggest the presence of more complex determinants of these disparities which should be addressed by oral health preventive policies.

172 citations


Journal ArticleDOI
TL;DR: It is established that dental fear is associated with more decayed and missing teeth but fewer FT, which underlines the importance of identifying and then reducing dental fear as important steps in improving adult oral health.
Abstract: – Objective: This study aimed to investigate the association between dental fear and both dental caries and periodontal indicators. Methods: A three-stage stratified clustered sample of the Australian adult population completed a computer-assisted telephone interview followed by a clinical examination. Oral health measures were the DMFT index and its components, periodontitis and gingivitis. A total of 5364 adults aged 18–91 years were dentally examined. Results: Higher dental fear was significantly associated with more decayed teeth (DT), missing teeth (MT) and DMFT. There was an inverted ‘U’ association between dental fear and the number of filled teeth (FT). Periodontitis and gingivitis were not associated with dental fear. The association between dental fear and DMFT was significant for adults aged 18–29 and 30–44 years, but not in older ages. Dental fear was significantly associated with more DT, MT, and DMFT but with fewer FT after controlling for age, sex, income, employment status, tertiary education, dental insurance status and oral hygiene. Conclusion: This study helps reconcile some of the conflicting results of previous studies and establishes that dental fear is associated with more decayed and missing teeth but fewer FT. That people with higher dental fear have significantly more caries experience underlines the importance of identifying and then reducing dental fear as important steps in improving adult oral health.

Journal ArticleDOI
TL;DR: High risk for caries is revealed for children with low or moderate attitude towards health, a history of dental visits and a preference for drinking sugary drinks during school hours, while school based health promotion should be implemented focussing on skills based learning and attitudes towards health.
Abstract: In recent decades low-income countries experienced an increasing trend in dental caries among children, particularly recorded in 12-year olds, which is the principal WHO indicator age group for children. This increases the risks of negative affects on children's life. Some data exist on the oral health status of children in low-income countries of Southeast Asia. However, information on how oral health is associated with socio-behavioural factors is almost not available. The aims of this study were to: assess the level of oral health of Lao 12-year-olds in urban and semi-urban settings; study the impact of poor oral health on quality of life; analyse the association between oral health and socio-behavioural factors; investigate the relation between obesity and oral health. A cross sectional study of 12-year old schoolchildren chosen by multistage random sampling in Vientiane, Lao P.D.R (hereafter Laos). The final study population comprised 621 children. The study consisted of: clinical registration of caries and periodontal status, and scores for dental trauma according to WHO; structured questionnaire; measurement of anthropometric data. Frequency distributions for bi-variate analysis and logistic regression for multivariate analysis were used for assessment of statistical association between variables. Mean DMFT was 1.8 (SEM = 0.09) while caries prevalence was 56% (CI95 = 52-60). Prevalence of gingival bleeding was 99% (CI95 = 98-100) with 47% (CI95 = 45-49) of present teeth affected. Trauma was observed in 7% (CI95 = 5-9) of the children. High decay was seen in children with dental visits and frequent consumption of sweet drinks. Missed school classes, tooth ache and several impairments of daily life activities were associated with a high dD-component. No associations were found between Body Mass Index (BMI) and oral health or common risk factors. The multivariate analyses revealed high risk for caries for children with low or moderate attitude towards health, a history of dental visits and a preference for drinking sugary drinks during school hours. Low risk was found for children with good or average perception of own oral health. High risk for gingival bleeding was seen in semi-urban children and boys. Although the caries level is low it causes considerable negative impact on daily life. School based health promotion should be implemented focussing on skills based learning and attitudes towards health.

Journal ArticleDOI
TL;DR: Dental management of methamphetamine users requires obtaining a thorough medical history and performing a careful oral examination, and the most important factor in treating the oral effects of methamphetamine is for the patient to stop using the drug.
Abstract: Methamphetamine is a highly addictive powerful stimulant that increases wakefulness and physical activity and produces other effects including cardiac dysrhythmias, hypertension, hallucinations, and violent behavior. The prevalence of methamphetamine use is estimated at 35 million people worldwide and 10.4 million people in the United States. In the United States, the prevalence of methamphetamine use is beginning to decline but methamphetamine trafficking and use are still significant problems. Dental patients who abuse methamphetamine can present with poor oral hygiene, xerostomia, rampant caries (‘Meth mouth’), and excessive tooth wear. Dental management of methamphetamine users requires obtaining a thorough medical history and performing a careful oral examination. The most important factor in treating the oral effects of methamphetamine is for the patient to stop using the drug. Continued abuse will make it difficult to increase salivary flow and hinder the patient’s ability to improve nutrition and oral hygiene. Local anesthetics with vasoconstrictors should be used with care in patients taking methamphetamine because they may result in cardiac dysrhythmias, myocardial infarction, and cerebrovascular accidents. Thus, dental management of patients who use methamphetamine can be challenging. Dentists need to be aware of the clinical presentation and medical risks presented by these patients.

Journal ArticleDOI
TL;DR: This article focuses on early childhood caries as an overall proxy for Indigenous childhood oral health because decay during early life sets the foundation for oral health throughout childhood and adolescence.

Journal ArticleDOI
TL;DR: Significant predictors of higher caries increment were higher consumption of soda drinks, older age of child, greater weight-for-age, fewer dental treatment visits, higher baseline caries levels of children and their caregivers, dental fatalism, and neighborhood disadvantage status.
Abstract: The current evidence on the role of the social, behavioral, and community determinants of dental caries is based on cross-sectional analyses. The available evidence has not been based on analysis of multiple determinants within the same population. This longitudinal study addresses both of these limitations. The study included data from 788 dyads of children and their caregivers (77% follow-up), who were examined in 2002-03 and 2004-05. The families were assessed by calibrated dentists for severity of caries at both time periods. Additionally, the caregivers answered questionnaires administered by trained interviewers. The caries increment was adjusted for reversals. Significant predictors of higher caries increment were higher consumption of soda drinks, older age of child, greater weight-for-age, fewer dental treatment visits, higher baseline caries levels of children and their caregivers, dental fatalism, and neighborhood disadvantage status. The selected risk factors in the final model explained about 20% of the variation in the increment.

Journal ArticleDOI
TL;DR: Two contradictory hypotheses on the role of dietary carbohydrates in health and disease shape how dental-systemic associations are regarded and may affect preventive approaches for dental and systemic diseases.
Abstract: Two contradictory hypotheses on the role of dietary carbohydrates in health and disease shape how dental-systemic associations are regarded. On one side, Cleave and Yudkin postulated that excessive dietary fermentable carbohydrate intake led-in the absence of dental interventions such as fluorides-first to dental diseases and then to systemic diseases. Under this hypothesis, dental and systemic diseases shared-as a common cause-a diet of excess fermentable carbohydrates. Dental diseases were regarded as an alarm bell for future systemic diseases, and restricting carbohydrate intake prevented both dental and systemic diseases. On the opposite side, Keys postulated the lipid hypothesis: that excessive dietary lipid intake caused systemic diseases. Keys advocated a diet high in fermentable carbohydrate for the benefit of general health, and dental diseases became regarded as local dietary side effects. Because general health takes precedence over dental health when it comes to dietary recommendations, dental diseases became viewed as local infections; interventions such as fluorides, sealants, oral hygiene, antimicrobials, and dental fillings became synonymous with maintaining dental health, and carbohydrates were no longer considered as a common cause for dental-systemic diseases. These opposing dietary hypotheses have increasingly been put to the test in clinical trials. The emerging trial results favor Cleave-Yudkin's hypothesis and may affect preventive approaches for dental and systemic diseases.

Journal ArticleDOI
TL;DR: Dental flossing can produce bacteraemia in periodontally healthy andperiodontally diseased individuals at a rate comparable with that caused by some dental treatments for which antibiotic prophylaxis is given to prevent IE.
Abstract: Aims: The aims of this study were to (1) investigate the incidence of bacteraemia following flossing in subjects with chronic periodontitis or periodontal health; (2) identify the micro-organisms in detected bacteraemias; and (3) identify any patient or clinical factors associated with such bacteraemia. Material and Methods: Baseline blood samples were obtained from 30 individuals with chronic periodontitis (17 M:13 F, 29–75 years) and 30 with periodontal health (17 M:13 F, 28–71 years) following a non-invasive examination. Each subject's teeth were then flossed in a standardized manner and blood samples obtained 30 s and 10 min. after flossing cessation. Blood samples were cultured in a BACTEC™ system and positive samples subcultured for identification. Results: Forty per cent of periodontitis subjects and 41% of periodontally healthy subjects tested positive for bacteraemia following flossing. Viridans streptococci, which are commonly implicated in infective endocarditis (IE), were isolated from 19% of positive subjects and accounted for 35% of microbial isolates. Twenty per cent of subjects had a detectable bacteraemia at 10 min. post-flossing. No patient or clinical factors were significantly associated with post-flossing bacteraemia. Conclusions: Dental flossing can produce bacteraemia in periodontally healthy and periodontally diseased individuals at a rate comparable with that caused by some dental treatments for which antibiotic prophylaxis is given to prevent IE.

Journal ArticleDOI
01 Aug 2009-Chest
TL;DR: The findings suggest that the addition of electric toothbrushing to standard oral care with 0.12% chlorhexidine digluconate is not effective for the prevention of VAP.

Journal ArticleDOI
TL;DR: In this article, the authors evaluate the effectiveness of an individually tailored oral health educational program for oral hygiene self-care in patients with chronic periodontitis compared with the standard tr...
Abstract: Aim To evaluate the effectiveness of an individually tailored oral health educational programme for oral hygiene self-care in patients with chronic periodontitis compared with the standard tr ...

Journal ArticleDOI
TL;DR: The frequency of patients with PD with untreated caries was high at Hoehn and Yahr stage II and above, and frequency tended to increase in patients who had low compared to high mini-mental state examination scores.

Journal ArticleDOI
TL;DR: The degree of denture hygiene was significantly associated with age, sex, education, general health status, smoking status, self-perception of halitosis, overnight denture removal and denture immersion habits.

Journal ArticleDOI
TL;DR: periodontal treatment completed before the 35th week appeared to have a beneficial effect on birth weight and time of delivery.
Abstract: There is growing evidence that chronic periodontitis may be a risk factor for pre-term birth. The goal of this intervention study was to determine the effect of periodontal treatment on the pregnancy outcome in women with threatening pre-term birth and initial localized chronic periodontitis. Forty-one women with a singleton pregnancy were enrolled in the study. For this treatment group, oral hygiene instruction and periodontal therapy were provided in the third trimester, while those in the control group (42 persons) did not receive any periodontal treatment. In the treatment group, the mean weight of newborns was 3079.0 g, compared with the control group mean of 2602.4 g. The incidence of pre-term birth and low birthweight in the treatment group was significantly less than in the control group (p = 0.015). Periodontal treatment completed before the 35th week appeared to have a beneficial effect on birth weight and time of delivery.

Journal ArticleDOI
TL;DR: The present study highlighted that the oral health status of this mentally retarded population was poor and was influenced by aetiology of the disability, I.Q. level, and parent's level of education.
Abstract: The aim of the study was to determine the oral health status and investigate the association of oral health status with various socio-demographic (age, gender, parent's education, income) and clinical variables (aetiology for mental disability and IQ level) among mentally disabled subjects. The study sample comprised 225 mentally retarded subjects aged 12-30 years attending a special school in Udaipur, India. Caries status, oral hygiene status and periodontal status were assessed by DMFT Index, Simplified Oral Hygiene Index (OHI-S) of Greene and Vermillion and Community Periodontal Index, respectively. Chi-square test, one way analysis of variance (ANOVA), multiple linear stepwise regression analysis, and multiple logistic regression analysis were employed for statistical analysis. There was a statistically significant difference (P = 0.001) between all the age groups in all the variables of Oral hygiene index and DMFT index. The oldest age group had the highest scores for all the indices measured. Having Down's syndrome, parents with lower educational status and low I.Q. were the most important predictors for poor oral health status. The present study highlighted that the oral health status of this mentally retarded population was poor and was influenced by aetiology of the disability, I.Q. level, and parent's level of education. (J Oral Sci 51, 333-340, 2009)

Journal ArticleDOI
TL;DR: When a school-based oral health intervention involves parents it may result in a significant improvement in the gingival health of preadolescents with poor gingiva health at baseline.
Abstract: Objectives: Evaluation of the effectiveness of a school-based oral health promotion intervention on preadolescents' gingival health. Methods: A community trial designed for a 3-month intervention study in a representative sample of 9-year-olds (n = 457) in 16 schools in Tehran, Iran. The schools were randomly assigned to three intervention groups and one control group, each group comprising two boys' and two girls' schools. The first group of children (n = 115) received intervention via class work, solving a set of puzzles containing oral health messages, under supervision of their health counsellor. The second group (n = 114), intervention via parents, included an oral health education leaflet and a brushing diary for supervising the child's tooth-brushing; the third group (n = 111) received a combination of both these interventions. The control group (n = 117) had no intervention. Effects of the intervention were assessed as changes in dental plaque and gingival bleeding. Improvements in gingival health were recorded when half of the index teeth with plaque at baseline became clean (acceptable oral hygiene) or when all index teeth with bleeding at baseline became healthy (healthy gingiva). Statistical analysis included chi square, anova, t-test, Number Needed to Treat (NNT) and generalized estimating equations (GEE). Results: At baseline, none of the children were free of plaque and all except for three boys had bleeding. After the trial, acceptable oral hygiene was more frequent in the parental-aid (P < 0.001) and the combined groups (P < 0.05), and healthy gingiva in both groups (P < 0.001) in comparison with the control group. Outcomes in the class- work group did not differ from those in the control group. The GEE models confirmed a strong intervention effect on healthy gingiva in both groups where parents were involved: parental-aid group (OR = 7.7, 95% CI: 2.2-27.7) and combined group (OR = 6.6, 95% CI: 2.0-22.1). In all intervention groups more girls than boys achieved healthy gingiva (OR = 2.5-2.6). Parents' education showed no impact on the outcome. Conclusions: When a school-based oral health intervention involves parents it may result in a significant improvement in the gingival health of preadolescents with poor gingival health at baseline.

Journal ArticleDOI
TL;DR: The objective of this article was to review the literature on the importance of the oral environment in the development of nosocomial pneumonia.
Abstract: Nosocomial pneumonia, especially ventilator-associated pneumonia, is a common infection in ICUs. The main etiologic factors involve colonizing and opportunistic bacteria from the oral cavity. Oral hygiene measures, including the use of oral antiseptic agents, such as chlorhexidine, have proven useful in reducing its incidence. The objective of this article was to review the literature on the importance of the oral environment in the development of nosocomial pneumonia.

Journal ArticleDOI
TL;DR: The subjects in the oral health-promotion group and in the risk-strategy and promotion group in Pori tended to show greater improvement in most of their Oral health-related behaviors than those in the reference group, and children in the RCT experimental group showed greater improvement.
Abstract: The aim of our study was to compare the changes in children's oral health-related behavior, knowledge, and attitudes obtained using an oral health-promotion approach, a risk-strategy and promotion approach, and reference area, and to report changes in the behavior of children between the experimental and the control groups of a randomized clinical trial (RCT). The study population consisted of all fifth and sixth graders who started the 2001-2002 school year in Pori, Finland (n = 1,691), where the RCT and program of oral health promotion were implemented for 3.4 yr. Children with at least one active caries lesion were randomly assigned to experimental (n = 250) and control (n = 247) groups. Children in Rauma (n = 807) acted as the reference. Changes in children's self-reported behavior, knowledge, and attitudes were compared between groups. The subjects in the oral health-promotion group and in the risk-strategy and promotion group in Pori tended to show greater improvement in most of their oral health-related behaviors than those in the reference group, and children in the RCT experimental group showed greater improvement in most of their oral health-related behaviors than those in the RCT control group. Children can be helped to improve their oral health-related behavior by intervention, including oral hygiene and dietary counseling, or by implementing a multilevel-approach oral health-promotion program.

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TL;DR: Parental attitudes toward children's oral health were significantly associated with their own oral health behavior and understanding the importance of development of oral hygiene skills in their children.
Abstract: Background. For many years, poor oral hygiene and frequent consumption of sugars is known as key behavioral risk factors for oral diseases, such as dental caries and periodontal disease. Parental attitudes toward children’s oral health could be associated with their own oral health skills. We aimed to analyze associations between parental skills and attitudes toward caries development and possibilities to control positive oral health behavior in their children. Material and methods. A cross-sectional study involved 550 parents of 3- to 4-year-old children. A 40-item questionnaire was developed from the Theory of Planned Behavior, Health Belief Model and the Health Locus of Control model, and parental attitudes toward dental caries in their children were analyzed. Results. A total of 397 filled-in questionnaires were collected; the response rate was 72%. Parents with good own oral hygiene skills significantly more often understood the importance of brushing their children’s teeth (χ2=29.8; df=1; P<0.001). Study results highlighted also significant differences in importance to prevent tooth decay (χ2=3.1; df=1; P=0.051), importance to control sugar snacking (χ2=10.6; df=1; P=0.001), and parental perceived seriousness of tooth decay in children (χ2=9.2; df=1; P=0.002) comparing parents with poor and good oral hygiene skills. Differences in parental efficacy to control proper toothbrushing and parental efficacy to control sugar snacking in children were not significant comparing both groups. Conclusions. More than half (61%) of the parents have reported appropriate own oral hygiene skills. Parental attitudes toward children’s oral health were significantly associated with their own oral health behavior and understanding the importance of development of oral hygiene skills in their children.

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TL;DR: The present study highlighted that the oral hygiene and periodontal status of the present study population is poor and was influenced by medical diagnosis, IQ level, disabled sibling, parent's level of education and economic status.
Abstract: Aim: To assess the impact of socio-demographic and clinical variables on the oral hygiene and periodontal status in a sample of mentally disabled subjects. Materials and Methods: Study sample comprised of 171 mentally disabled subjects attending a special school in Udaipur, India. Oral hygiene status was assessed by Simplified Oral Hygiene Index (OHI-S) and periodontal status by Community Periodontal Index. Results: Stepwise linear regression analysis revealed that the best predictors in the descending order for oral hygiene index were disabled sibling, medical diagnosis, IQ level, education of mother and father. Having Down syndrome, less educated parents, poor economic status and a disabled sibling were the most important predictors for poor periodontal status. Conclusions: The present study highlighted that the oral hygiene and periodontal status of the present study population is poor and was influenced by medical diagnosis, IQ level, disabled sibling, parent's level of education and economic status.

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TL;DR: For both age groups, impacts were mostly on eating performance; toothache and Oral ulcers were the two important perceived causes reflecting needs for oral health promotion and treatment of dental caries and oral ulcers.
Abstract: – Objective: To assess the prevalence and characteristics of oral impacts on daily life, and the relationship between certain dental conditions and impacts attributed to them, in a nationally representative population of Thai school children aged 12 and 15 years. Methods: A cross-sectional study on a representative sample of children in Sixth Thailand National Oral Health Survey. Sample included half the children aged 12- and 15-year-old selected in Bangkok and all participants in 8 of 16 provinces included in national survey. Children were individually interviewed using the Child-OIDP (12-year-old) and OIDP indices (15-year-old), and two questions for overall subjective assessments. Results: A total of 1066 12-year-olds and 815 15-year-olds were interviewed. Some 85.2% of 12-year-olds reported experiencing oral impacts during the past 3 months. Child-OIDP scores ranged from 0 to 68.0 (mean = 7.83, SD = 7.8). Eating was the most commonly affected performance (64.4%), followed by cleaning teeth (51.7%) and maintaining emotional state (49.1%). Among 15-year-old children, 83.3% had oral impacts during the past 6 months. OIDP scores ranged from 0 to 39.5 (mean = 5.47, SD = 6.0). The three most commonly affected performances were eating (64.0%), cleaning teeth (55.3%) and maintaining emotional state (53.1%). Toothache and oral ulcers were the two most important perceived causes in 12-year-olds. Impacts from toothache were the most prevalent (39.2%) and had a condition-specific (CS) Child-OIDP score of 7.0, while oral ulcers affected 24.7% of children; mean CS-score of 8.0. Among 15-year-olds, oral ulcers ranked first in terms of both prevalence (36.2%) and CS-score (6.0), followed by toothache (prevalence 33.9% and CS-score 5.0). For both age groups, problems with gums were of less concern. Conclusions: Oral impacts were common but not severe in Thai children and adolescents. For both age groups, impacts were mostly on eating performance; toothache and oral ulcers were the two important perceived causes reflecting needs for oral health promotion and treatment of dental caries and oral ulcers.

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TL;DR: Results showed that patients who experienced the intervention had better behavioral, cognitive, and clinical outcomes, but clinical outcomes were significantly better only in the Cluster RCT, suggesting that the impact of trial design on results needs to be further explored.
Abstract: Considerable resources are expended in dealing with dental disease easily prevented with better oral hygiene. The study hypothesis was that an evidence-based intervention, framed with psychological theory, would improve patients' oral hygiene behavior. The impact of trial methodology on trial outcomes was also explored by the conducting of two independent trials, one randomized by patient and one by dentist. The study included 87 dental practices and 778 patients (Patient RCT = 37 dentists/300 patients; Cluster RCT = 50 dentists/478 patients). Controlled for baseline differences, pooled results showed that patients who experienced the intervention had better behavioral (timing, duration, method), cognitive (confidence, planning), and clinical (plaque, gingival bleeding) outcomes. However, clinical outcomes were significantly better only in the Cluster RCT, suggesting that the impact of trial design on results needs to be further explored.