Oral Health and Preventive Dentistry, 02/2005

Purpose: To analyse the microbial flora in specific sites in 20 dentate (>= 16 teeth) subjects with hyposalivation due to medicines or of unknown origin and in 20 controls matched according to age, sex and number of teeth. Materials and Methods: The microbial samples were analysed for the following micro-organisms: mutans streptococci, Lactobacillus spp. and Actinomyces spp., associated with the development of caries, Fusobacterium nucleatum and Prevotella intermedia/Prevotella nigrescens, associated with plaque accumulation and gingivitis, Actinobacillus actinomycetemcomitans and Porphyromonas gingivalis, frequently found in elevated numbers in periodontitis sites and Candida albicans, Staphylococcus aureus, enterics and enterococci, associated with mucosal infections. The total microbial count was also registered, together with the total number of streptococci, associated with good oral health. Results: In the hyposalivation group, the mean age was 54 ± 8 years and the mean number of teeth 25 ± 3. The unstimulated secretion rate was 0.04 ± 0.04 mL/min and the stimulated secretion rate 0.98 ± 0.51 mL/min. Compared with the controls, the hyposalivation group tended to harbour a lower number and proportion of F. nucleatum on the tongue, and an increased number of enterococci in the vestibular region. In the supragingival plaque, the numbers of Strepococcus mutans and Lactobacillus spp. were significantly increased and the number of C. albicans tended to be increased. Conclusion: The results indicate that subjects with hyposalivation due to medicines or of unknown origin have a supragingival plaque associated with the development of caries. Keywords: hyposalivation, microflora, mutans streptococci, Lactobacillus spp., Fusobacterium nucleatum, Prevotella intermedia/Prevotella nigrescens, Candida albicans, Staphylococcus aureus, enterics, enterococci

Purpose: The purpose of this study was to investigate effects of snuff on the oral health status of adolescent males. Materials and Methods: The participants consisted of 80 adolescent males between 16-25 years, 40 snuff users and 40 non-users. The snuff users and non-users were matched with reference to their age. Data were collected using a questionnaire containing questions on general and oral health, daily oral hygiene and tobacco habits. The clinical examination was carried out in a dental office by two experienced dental hygienists. Snuff lesions were clinically classified on a four-point scale and documented on colour slides. The examination also assessed the number of teeth, restored tooth surfaces, plaque index and gingival index, probing pocket depth and gingival recessions. Results: Out of 40 snuff users, 35 showed snuff incluced lesions. The clinical diagnosis of snuff users' mucosa showed snuff lesions of different severity clinically classified as degree 1, 2 and 3. When explaining snuff lesions of degree 2 and 3, hours of daily snuff use and package form (portion-bag snuff versus loose snuff) was statistically significant. There were no statistical differences between snuff users and non-users regarding restored tooth surfaces, presence of plaque, gingival inflammation and probing pocket depth. Seventeen percent of the cases showed loss of periodontal attachment as gingival recessions. Conclusion: In spite of mucosal lesions caused by snuff there were no statistical differences in prevalence in plaque and gingivitis between snuff users and non-users. However, some cases showed loss of periodontal attachment as gingival recessions. Keywords: adolescent, oral health, tobacco habits, snuff lesions

Purpose: The purpose of this study was to evaluate the shear bond strength of different sealant and filling materials, used in minimally invasive dentistry, to human enamel. Materials and Methods: Thirty-five sound extracted third molars were selected. The crowns were longitudinally sectioned, embedded in polystyrene resin, and grounded until a flat enamel surface was reached. The samples were assigned into seven groups (n = 10), according to the materials: G1-Fluoroshield; G2-Clinpro; G3-Dyract AP; G4-F2000; G5-Vitremer; G6-Fuji IX; G7-Vidrion F. All materials were applied according to the manufacturer's instructions. The samples were stored in distilled water at 37°C for 24 h and submitted to a shear bonding strength test in a universal testing machine with a crosshead speed of 0.5 mm/min. The failure sites were observed in Scanning Electron Microscopy (SEM). The data were submitted to ANOVA and Tukey's tests (p 0.05). Results: The mean values (MPa) of shear bond strength were for Fluroshield (25.92 ± 8.83), Vitremer (20.41 ± 13.34), Dyract AP (17.08 ± 6.38), Clinpro (12.82 ± 8.38), F2000 (8.71 ± 3.74), Fuji IX (7.64 ± 2.57), and Vidrion F (4.54 ± 2.11). Fluroshield resin sealant and Vitremer resin modified glass- ionomer showed statistically higher shear bond strength values than the conventional glass ionomer (GIC) cements. Clinpro and F2000 showed bond strength values with statistical difference only from Fluroshield. The failure mode varied among the groups. The majority of samples presented mixed failure. Conclusion: FluroShield and Vitremer showed better performance of shear bond strength to enamel than conventional GIC. Keywords: shear bond strength, sealants, filling materials, resin modified glass-ionomer

Purpose: Immigrant junior-field-workers in south eastern Anatolia, Turkey, had an impact on agriculture economy, and to provide an optimal dental service is crucial due to their multiple medical and dental problems. So, a combined preventive-operative method including ART-fissure sealant/restoration and fluoride varnish application was evaluated in terms of caries increment, cariogenic bacteria and lesion behavior at one-year follow-up period. Materials and Methods: A total of 27 children with 147 pit and fissure lesions displaying discoloration were included in this study. Of these, 15 children with 75 lesion and 12 children with 72 lesions were divided as test and control groups, respectively. Baseline caries values of each groups were 3.4 ± 1.4 and 2.5 ± 1.6 for test and control groups respectively (p 0.05). Bacteriologic sampling was undertaken with the dip-slide method (Vivadent). A combined preventive-operative method was performed for the test group but not for the control group. After six months and one year, children were re-examined with respect to cariogenic bacteria in plaque, new caries occurrence and lesion characteristics. Results: Mean caries increment (ΔDMFT) for both the control and the test group were 1.91 ± 1.53 and 0.26 ± 0.43, respectively. The difference was found to be statistically significant (t = 8.35, p 0.0001). More lesions in the control group did progress to cavitation than in the test group. A linear relationship was observed between plaque MS-score and cavitation, indicating that when plaque MS levels are high, cavitation does easily occur in the control group and vice versa in the test group (p 0.0001 for all variables). Conclusion: It could be argued from these findings that a combined preventive-operative method could be applicable not only to treatment of dentinal lesions but also to retard, even prevent, the initial caries on pits and fissures of permanent teeth in rural districts where any other routine dental/preventive care is not feasible, and compliance of the individuals' hygiene is inadequate. Keywords: ART (Atraumatic Restorative Treatment), fluoride varnish, pit and fissure caries, lesion behavior

Dental fear is often associated with experience of pain, unpleasant sounds and uncomfortable vibrations caused by dental drills. Therefore patients welcome alternative, less painful excavating methods such as lasers, sandblasters and chemomechanical systems. The aim of this study was to compare a chemomechanical caries removal system (Carisolv) to traditional drilling with regard to patient acceptance and time consumption as well as the six-month success rate of fillings. Ninety-two primary teeth in 46 children were included in the study. From this study, the following conclusions can be drawn: patient acceptance of Carisolv-treatment compared to drilling is excellent, since 65% would choose Carisolv and no one drilling when treated next time. The dentists rated patients' degree of pain significantly lower in Carisolv situations than in drill situations. Time consumption is significantly higher when excavating with Carisolv (6,7 min.) than with drill (3,3 min.). The durability of fillings six months after treatment is equal in the two groups. Keywords: caries, excavation

Purpose: The aims of this study were to investigate the principal reasons for untimely loss of primary molars and to evaluate the risk factors of early primary molar loss in children aged four to nine years. Materials and Methods: 1150 untimely lost primary molars were analyzed from 546 patients. The early loss of primary molars was analyzed in relation to age, sex, dmf (t), DMF (T) scores, toothbrushing frequency, history of treatment and maternal education. The data were converted to SPSS format. Pearson Chi-square test was used for statistical analysis. Results: Among the investigated subjects, 15.2% of children reported regular toothbrushing. Only 23.1% of subjects had a history of treatment before the tooth extraction and 33% of mothers had a low education level. Untimely loss of primary molars due to pain, caries and sepsis were 30.2%, 31% and 38.8%, respectively. The frequency of 'only one primary molar loss' was significantly higher in group 1 (p 0.05), however the frequency of 'more than one primary molar loss' for group 2 was more than group 1 (p 0.05). Irregular toothbrushing for the children in group 2 was found significantly high than in group 1 (p 0.05). Irregular toothbrushing was associated with number of early primary molar loss in group 2 (p 0.05). The level of maternal education was associated with dmf (t) scores (p 0.05). The caries incidence was associated with number of early primary molar loss in both groups (p 0.05). The mean number of treated teeth before extraction for group 2 was significantly higher than for group 1 (p 0.05). Conclusion: Results of this study suggested that irregular toothbrushing, high dmf (t) scores and untreatment of carious primary molars were significant risk factors in early loss of primary molars. Every effort must be taken into account in restoring rather than extracting carious teeth. Keywords: early tooth loss, primary molars

Purpose: This pilot study was conducted to estimate the prevalence of self-reported toothache, bleeding gums and oral ulcer experiences, reasons for dental visits and associated sociodemographic factors among adults living in Benin City, Edo State, Nigeria. Materials and Methods: This cross-sectional study was based on a convenience sample in an urban setting. Out of the 540 persons surveyed, 508 had complete usable information, 48% males and 52% females, and aged 18 - 54 years. A closed questionnaire was used to collect the data at two large medical outpatient facilities and a university community. Results: The proportion reporting toothache experience in the previous 12 months was 34%; painful/bleeding gums 28%, and oral ulcers/painful spots 14%. Univariate analysis showed that toothache experience was associated with time since last dental visit (p 0.001), age (p 0.001), gender (p 0.001) and education (p 0.001). Experience with bleeding gums was associated with gender (p 0.001), education (p 0.001) and last dental visits (p 0.001). Oral ulcers were associated with gender (p = 0.004), age (p 0.001) and last dental visits (p 0.001). Fewer males than females reported toothache (25% vs. 42%, OR 1.65) but more males reported bleeding gums (37% vs. 19%, OR = 0.34) and oral ulcers (19% vs. 10% OR = 0.33). Conclusions: Toothache experience was the most prevalent oral health problem reported by adults. Oral health problems were associated with age, gender and last dental visits. Keywords: toothache, bleeding gums, oral ulcers, adults

The multiple loss of primary molars due to caries or other reasons in the primary or mixed dentition can lead to severe mutilation of the developing dentition. It is advisable to construct a removable appliance to maintain the relationship of the remaining teeth and to guide the eruption of the developing teeth in order to prevent the child from developing psychological and speech problems. However, parental and patient cooperation are imperative if the pediatric patient is to exercise the necessary care to maintain the denture in a clean and healthy condition. This case report identifies the complications that can arise from the uncontrolled misuse of a pediatric denture. It is concluded that as well as the parents, the pediatric dentists play an important role in the follow-up of the young patients for whom pediatric dentures are constructed. Additionally, patients should be re-called for check-up visits or instructed to refer to the dental clinics in 6-month intervals. Brochures that inform the patients and their parents about the application and care of pediatric dentures and space maintainers should be given. Keywords: pediatric denture, complication