Biomedical subjects

D Birkhed

Publications and source records attributed to D Birkhed.

At least 19 recordsLinked to original sources

PubMed2004

Human minor and major gland saliva proteins and ability to mediate Actinomyces naeslundii adherence.

Bacteria-binding components and the ability to mediate bacterial adhesion to the tooth surface have been thoroughly studied in major salivary gland secretions. Our knowledge on the bacteria binding activity in minor gland saliva is, however, limited. In this study, proteins were examined in parallel in minor (palatal, buccal and labial) and major (parotid and submandibular/sublingual) salivary gland secretions in one subject using sodium dodecyl sulfate polyacrylamide gel electrophoresis (SDS-PAGE) and immunoblotting. The adherence of early colonizing Actinomyces naeslundii to pellicles formed from the secretions on hydroxyapatite beads was also examined. Amylase, IgA, proline-rich proteins and the high-molecular-weight glycoproteins, agglutinins, were detected in all saliva tested. Carbohydrate-reactive antibodies recognized the low-molecular weight mucin, MUC 7 in submandibular/sublingual saliva only. A. naeslundii strain 12104 adhered to all pellicles and especially to the buccal gland saliva pellicles. Strain LY7 adhered in highest numbers to the submandibular/sublingual saliva pellicles. It also bound in considerable numbers to parotid and palatal saliva pellicles but not to the ones formed from buccal and labial gland saliva. Our findings indicate that several bacteria-binding components are secreted in both minor and major gland saliva. The adherence-promoting ability of the various gland secretions differs, however.

Actinomyces↗

PubMed2003

Minor gland and whole saliva in postmenopausal women using a low potency oestrogen (oestriol).

Many women undergo hormone replacement therapy in order to relieve menopausal and postmenopausal symptoms. Oral discomfort is common among these symptoms and studies have shown that the stimulated whole saliva flow rate is increased after combined oestradiol and progesterone replacement therapy. There is, however, no data regarding the effect of other oestrogens or of oestrogen alone on whole and minor gland saliva. In the present study, the flow rate from minor salivary glands (buccal, labial and palatal) and the secretion rate and buffer capacity of whole saliva was examined in 18 postmenopausal women (61-76 years) prior to, and during 1 year of a low potency oestrogen (oestriol) use. The ability of whole saliva to aggregate and mediate bacterial adherence as well as subjective feelings of dry mouth was also examined. For comparison, the same variables were examined in nine peri- and postmenopausal, non-medicated women (reference group, 53-61 years). During hormone treatment, the labial saliva flow was significantly increased and the complaints of dry mouth reduced. Increased stimulated whole saliva flow was seen in both the hormone and reference groups. This was also true for the stimulated whole saliva buffer capacity, which was increased parallel to the flow rate. The secretion rates were generally lower in the hormone group compared to the reference group throughout the study period. Except for stimulated whole saliva, statistical analysis at baseline revealed no age-related reduction of the saliva flow rates. The ability of whole saliva to mediate aggregation of Actinomyces naeslundii was significantly decreased after hormone treatment. Thus, the present findings indicate that a low dose oestrogen (oestriol) may affect the flow rate of labial salivary glands and the bacterial aggregation activity of whole saliva.

Aged↗

PubMed2002

Intake of sweet foods and counts of cariogenic microorganisms in relation to body mass index and psychometric variables in women.

OBJECTIVE: As a part of the SPAWN (Stockholm Pregnancy and Women's Nutrition) study, the intake of sweet foods (habitual and pre-menstrual intakes) and the number of cariogenic microorganisms in saliva was analysed in relation to body mass index (BMI) and psychometric variables. DESIGN: A cross-sectional study. SUBJECTS: Three hundred and sixty-two women with a median BMI of 24.2 kg/m(2) (range 17.5-47.8) and 45 y of age (range 34-64). METHODS: A questionnaire of sweet food intake, salivary counts of mutans streptococci and lactobacilli and a self-rating scale on psychometric variables (CPRS-S-A). RESULTS: The number of mutans streptococci correlated with BMI (P<0.05), indirectly indicating a higher intake of sweet foods in obese women. The reported energy intake of sweet foods (more specifically the intake of chocolate), correlated with CPRS scores (P<0.01), indicating that women with more severe psychiatric symptomatology have higher intakes of sweet foods. CONCLUSIONS: This study suggests that women with higher CPRS score have higher energy intakes of sweet foods, indicating a possible link between mood regulation and the intake of sweet food. SPONSORSHIP: Karolinska Institute Research Funds.

Adult↗

PubMed2001

Dental erosion in deciduous teeth--an in vivo and in vitro study.

OBJECTIVE: The aims of this study were to report on severe dental erosion and its associated etiological factors in deciduous teeth of Saudi children (n=16, X macro=6.5 years, R=5--8) in vivo, and to confirm (or reject) the clinical diagnosis by scanning electron microscopy (SEM). Another aim was to study progression of erosion in vitro using extracted healthy deciduous and permanent teeth. METHOD: For the in vivo study, a questionnaire and clinical examination was completed, medical history obtained and exfoliated eroded teeth (n=8) examined by SEM. For the in vitro study, enamel specimens were prepared from Saudi (n=21) and Finnish (n=19) deciduous teeth as well as Finnish permanent teeth (n=20), immersed in 2% citric acid for 5--30 min, microhardness measurements performed, and the specimens studied by SEM. RESULTS: The in vivo investigation showed that high intake of acidic drinks and fruits, upper respiratory tract problems and frequent medications may constitute possible etiological and/or aggravating factors for severe dental erosion in Saudi children. Deciduous tooth enamel was softer than permanent tooth enamel. SEM showed no clear differences in the ultrastructure of the enamel specimens amongst the three groups. The clinical diagnosis of severe dental erosion in those cases studied was reliable as verified by SEM. CONCLUSIONS: The presence of dental erosion in children is likely to be associated with a number of general health and dietary factors but is also aggravated by the relatively more rapid progression of erosion in the deciduous teeth.

Analysis of Variance↗

PubMed2001

On the retention and effectiveness of fissure sealant in permanent molars after 15-20 years: a cohort study.

The aim of the present study was to clinically evaluate fissure sealants on the occlusal fissures and buccal pits of permanent first and second molars after 20 and 15 years, respectively. The population consisted of 72 children, each of whom had had their four first molars sealed between 1977 and 1980. At the annual examinations, all caries-free, newly erupted second molars were sealed. When sealant was applied to the second molars, the first molars were checked and sealant was reapplied to those that had deficient sealants. At the follow-up, when the subjects were 26-27 years of age, 27 in the original group had moved from the community. Thus, the present result is based on 45 subjects. One hundred and fifty-three sealed first molars and 161 sealed second molars were available for inspection. At the follow-up examination of the first molars 20 years after sealant had been applied, 65% showed complete retention, 22% partial retention without caries, and 13% caries or restoration in the occlusal fissures or buccal pits. At the 15-year follow-up of the second molars, the corresponding figures were 65%, 30%, and 5%, respectively. Of the restored or carious molars, significantly more were found in the mandible than in the maxilla (P<0.001). This longitudinal study showed that pit and fissure sealants--applied during childhood--have a longlasting, caries-preventive effect.

Adult↗

PubMed2001

Stimulation of minor salivary glands by intraoral treatment with the cholinesterase inhibitor physostigmine in man.

A large number of the population, especially the elderly, suffers from dry mouth. The aim of the present investigation was to stimulate the minor salivary glands by the topical application of the cholinesterase inhibitor physostigmine. In eight healthy subjects. 100 microl of the substance, in the concentration interval 2-8 mg/ml, was applied locally to the inside of the lower lip for 1 min. In a separate study comprising 12 dry-mouth patients. 10 ml of 0.4 1.6 mg/ml physostigmine was administered as a mouth rinse solution for 2 min. Secretion from the labial glands. assessed using the Periotron method, increased in a dose-dependent manner in response to physostigmine in both groups. Average peak secretion exceeded baseline by more than 50% throughout the 30- to 45-min observation period; from 1.71 to 2.62 microl cm(-2) min(-1) among the healthy subjects and from 1.17 to 1.84 microl cm 2 min among the dry mouth patients. No systemic effects were registered as reflected by ECG, heart rate or blood pressure. It is assumed that intraorally applied physostigmine diffuses through the oral mucosa and acts by preserving acetylcholine released from the cholinergic, parasympathetic nerves that innervate the minor salivary glands. The topical application of physostigmine to the oral mucosa may, therefore, be an interesting approach for the treatment of dry mouth.

Administration, Topical↗

PubMed2001

Intake of sweet foods and counts of cariogenic microorganisms in obese and normal-weight women.

OBJECTIVE: To study the intake of sweet foods in obese and normal-weight women, while also taking menstrual cycle effects on eating behaviour into consideration. An objective test of the intake of sugar-containing foods was introduced by measuring salivary counts of mutans streptococci and lactobacilli. DESIGN: A cross-sectional comparison of the intake of sweet foods in obese and normal-weight women. The obese women were also studied longitudinally after 10 weeks in a weight reduction programme. SUBJECTS: Obese (n=72, body mass index (BMI) 42.0+/-5.2 kg/m2) and normal-weight women (n=67, BMI 22.2+/-1.6 kg/m2) participated. RESULTS: Mutans streptococci in saliva were higher in obese than in normal-weight women (P<0.0001), although the reported habitual daily intake of sweet foods did not differ. Of the menstruating women, 80% of the obese subjects and 62% of the normal-weight ones (P<0.05) reported periods during the menstrual cycle with an 'extra large' intake of sweet foods; these intakes were higher in obese than in normal-weight women (P<0.01). The obese women reduced their intake of sweet foods after 10 weeks of weight reduction, although these changes were not pronounced enough to significantly affect the counts of cariogenic microorganisms. CONCLUSIONS: In contrast to most previous cross-sectional studies, this study shows that obese women have a higher intake of sweet foods, especially pre-menstrually. This was indicated by higher salivary counts of cariogenic microorganisms. SPONSORSHIP: Karolinska Institute Research Funds.

Adult↗

PubMed2001

Effects of combined application of antimicrobial and fluoride varnishes in orthodontic patients.

A randomized prospective clinical study, with 220 patients scheduled for fixed orthodontic therapy, was conducted to test the hypothesis that application of an antimicrobial varnish in combination with a fluoride varnish (group 1) is significantly more efficient in reducing white spot lesions on the labial surfaces than application of the fluoride varnish alone (group 2). The effects of the antimicrobial varnish on the occurrence of gingivitis and plaque formation were also studied. A third aim was to investigate whether white spot lesion development could be predicted early during treatment. The antimicrobial varnish significantly reduced the number of mutans streptococci in plaque during the first 48 weeks of treatment. This effect did not result in significantly less development of white spot lesions on the labial surfaces compared with the group receiving only the fluoride varnish application. There was however a clear trend that the combination of the antimicrobial and fluoride varnishes more effectively reduced the increments of new lesions on the maxillary incisors. It was speculated that this could be due partly to an inhibiting effect of the antimicrobial varnish in an area with low oral clearance (with low pH and loss of fluoride) and partly to an inhibiting effect of the varnish on mutans streptococci. No significant differences between the groups with respect to gingivitis and plaque were found. Lesion development was difficult to predict early after bonding, despite a number of caries-relevant parameters of orthodontic importance. The best predictors for white spot lesions at debonding were visible plaque and mutans streptococci (eg, the level of oral hygiene and thus the cariogenic challenge) around the appliance shortly after bonding.

Adolescent↗

PubMed2001

Caries incidence in adolescents with low caries prevalence after cessation of weekly fluoride rinsing.

The aim of this study was to determine whether cessation of weekly fluoride rinsing leads to an increase in caries incidence in a group of adolescents with low caries prevalence. Sixty randomly selected 12- to 14-year-olds were asked to stop rinsing at school (test group). After 3 years caries increment and caries progression were compared with an age- and sex-matched control group (n = 60), who continued to rinse weekly with a 0.2% sodium fluoride solution. All children in both groups had followed a school-based fluoride rinsing program from the age of 6 years. The mean (standard deviation) caries increment, including only open lesions, during the 3 years was 1.58 (1.73) in the test group and 1.48 (1.80) in the control group. The corresponding figures for incipient lesions were 3.13 (3.63) and 4.03 (4.23), respectively. The mean caries progression was 0.92 (1.34) in the test group and 0.72 (1.03) in the control group. None of these differences were statistically significant. Thus, this study showed that a cessation of weekly fluoride rinsing did not lead to an increase of caries incidence in a group of adolescents with low caries prevalence.

Adolescent↗

PubMed2001

Early dental caries risk assessment and prevention in pre-school children: evaluation of a new strategy for dental care in a field study.

The aim of the present field study was to evaluate a new strategy for the dental care of pre-school children which includes an early caries risk assessment and early preventive care. One hundred and sixty-seven children were studied from 1 to 6 years of age (intervention group). A group of 125 children from the same clinic (historical control) was used as a comparison group. On the basis of the clinical examinations of the children and the interviews with the parents when the children were 3 years of age, the children in the intervention group were divided into four different risk groups: no (n = 95), low (n = 33), moderate (n = 30), and high caries risk (n = 9). Only 8 of the 95 children who had been placed in the no caries risk group at 3 years of age developed manifest carious lesions in their primary cuspids and molars by 6 years of age. At 6 years of age 81% in the intervention group were free of manifest carious lesions, compared with 55% in the comparison group (P < 0.001). Furthermore, the mean numbers of defs were 0.6 for children in the intervention group and 2.7 in the comparison group. Thus, this field study indicates that early primary prevention (before the onset of caries attack) and a structured and systematic approach to dental care for pre-school children result in good oral health for the children and may be economically profitable for a society with organized public dental service for pre-school children.

Chi-Square Distribution↗

PubMed2001

Long-term evaluation of a fissure sealing programme in Public Dental Service clinics in Sweden.

The aim of the present study was to evaluate the long-term results of a systematic fissure sealing programme of the occlusal surfaces of newly erupted permanent first molars. All 15-year-olds (n=815) who had been regularly treated at seven Public Dental Service clinics in Jönköping County, Sweden, since the eruption of their permanent first molars participated in the study. Data on fissure sealing and restorative treatment were extracted from the dental records of the patients. When the patients were 15 years of age, it was found that 6% of the original 2456 sealed occlusal permanent first molars had received Class II restorations. Seventy-eight per cent of the remaining 2322 sealed occlusal surfaces were judged to be caries-free by the child's ordinary dentist. This long-term retrospective study indicates that a structured fissure sealing programme is of great benefit for oral health.

Adolescent↗

PubMed2000

An in vitro study of fluoride release from a resin-modified glass ionomer cement after exposure to toothpaste slurries of different pH.

The aim of the study was to evaluate the fluoride release from an aged resin-modified glass ionomer (Vitremer) after exposure to five toothpaste slurries with different pH values. Cylindrical specimens of the material were leached in de-ionized water for 3 months and then exposed for 30 min daily for 10 days to three dentifrice slurries (20 specimens/group) containing 0.05% fluoride with pH values of 2.6, 5.7 and 8.3 and two non-fluoridated slurries with pH values of 2.5 and 5.7. A neutral NaF solution (0.05% F) was used as a control. During the 30 min exposure time, the fluoride concentration was gradually decreased in order to imitate the clinical situation. Thereafter, specimens were immersed individually in de-ionized water and the fluoride release determined. After the first day of exposure, all groups except one without fluoride (pH 5.7) showed significantly (P < 0.05) increased fluoride release. After exposure to the fluoridated toothpaste slurry with pH 5.7, significantly (P < 0.05) more fluoride was released compared to the toothpaste slurry with pH 8.3. Low pH (2.5 or 2.6) of the slurry resulted in a significantly (P < 0.05) higher fluoride release, regardless of whether it was fluoridated or not. The total amount of fluoride released after exposure to the more acidic fluoride toothpaste slurry was greater than that released from the more acidic non-fluoride toothpaste and the less acidic fluoride toothpaste. Our data indicate that the fluoride release from the resin-modified glass ionomer studied may be increased after treatment with an acidified NaF-toothpaste.

Analysis of Variance↗

PubMed2000

Explanatory models for clinical and subjective indicators of periodontal disease in an adult population.

BACKGROUND: The aim of this study was to analyze indicators of periodontal disease using: (1) community periodontal index of treatment needs (CPITN), (2) subjectively reported change of front teeth position, and 3) subjectively reported gingival bleeding. METHOD: These 3 indicators were used in models with explanatory variables from 4 domains: (A) socio-economic attributes, (B) general health and health-related lifestyle, (C) dental attitudes and behaviors, and (D) dental status expressed as (number of teeth and DFT) for the clinically-determined dependent variables. In 1992, the study was carried out cross-sectionally in all 50-year olds in 2 Swedish counties using a questionnaire (n=6343) and clinical investigation of a 20 % sub-sample (n= 1040). RESULTS: Multiple and logistic regression analysis showed that explanatory patterns varied for the clinical and subjective indicators. Use of tobacco had strong effects in all models as did high care utilization. There were few associations with socio-economic attributes. The 2 subjective indicators "changed front position" and "gingival bleeding" associated with attitudes, behaviors and subjective health. Number of teeth and DFT covaried with clinical indicators. CONCLUSIONS: The main conclusions from this study are: (1) that it is possible to find multivariate models with acceptable goodness of fit for prediction of occurrence of periodontal indicators, and (2) that the lack of relation between social attributes and the disease gives arguments for a biological provenance of periodontitis.

Attitude to Health↗

PubMed2000

Fluoride release in vitro from a resin-modified glass ionomer after exposure to NaF solutions and toothpastes.

The aims of the present investigation were: (i) to study the release of fluoride from a resin-modified glass ionomer cement (Vitremer) after exposing ("recharging") the material with NaF toothpastes and NaF solutions with different fluoride concentrations, and (ii) to study the effect of covering the material with a sealant layer (glaze) in this respect. Totally 160 specimens were made, which were placed in water for 13 weeks to receive a low fluoride release value. The specimens were then randomly divided into 10 groups with 16 discs each. Five of the groups were exposed once a day for 7 days to one of the following fluoride agents: 0.05, 0.2 or 2% NaF solutions and slurries of two NaF toothpastes (Acta and Pepsodent). The other five groups received the same treatment twice a day. All treatments had a recharging effect. However, the 2% NaF solution resulted in significantly more fluoride release than the other solutions and toothpastes. Treatment twice a day gave higher total release than once a day, but the difference were only significant for the 0.2 and 2% NaF solutions. With glaze material covering the specimens, almost no fluoride release was observed. However, when the glaze was removed, a burst of fluoride occurred.

Analysis of Variance↗

PubMed1999

Retention of fluoride/triclosan in plaque following different modes of administration.

The aim of the present investigation was to compare: (i) de novo plaque formation, and (ii) fluoride and triclosan concentration in approximal plaque, when a NaF/triclosan/Gantrez-containing dentifrice slurry or a mouthrinse were administrated during a 2-week period of no mechanical plaque control. 10 subjects rinsed for 60 s, 2x daily, for a 14-day period with one of the following 3 test products: (A) a dentifrice slurry including 1 ml of a NaF/triclosan/Gantrez dentifrice mixed with 10 ml of tap water, (B) 10 ml of a NaF/triclosan/ Gantrez mouthrinse, or (C) 10 ml of a NaF mouthrinse. De novo plaque formation was assessed on days 4, 7 and 14 using the Turesky's modification of the Quigley and Hein index system. Samples of approximal plaque were obtained immediately after clinical examination on day 14. The samples were analyzed with respect to concentration of fluoride and triclosan using an ion-specific electrode and a HPLC system, respectively. The 14-day period was repeated using another test product until all 10 subjects had used all 3 test products in a randomized order. The results showed that: (i) significantly more fluoride was retained in the approximal plaque following periods A and B than period C, and (ii) less plaque was formed during period B than periods A and C.

Anti-Infective Agents, Local↗

PubMed1999

Recolonisation pattern of mutans streptococci after suppression by three different modes of chlorhexidine gel application.

Clinical studies have shown conflicting results for the reduction of approximal caries when chlorhexidine gel has been applied either in trays or by flossing. To investigate whether these modes of treatment affect the colonization of mutans streptococci (MS) differently, we quantified MS in saliva and on various tooth surfaces before and after a single chlorhexidine gel application. Twenty-one schoolchildren (15-16 yr old), with high numbers of salivary MS, were randomised into three groups. The subjects were treated with a 1% chlorhexidine gel applied either by: 1) interdental flossing; 2) individually designed mouth trays; or 3) a combination of polishing and flossing. Analysis of saliva and of dental plaque from 12 sites over an 8-wk period showed a greater reduction of both salivary MS counts and total number of colonised sites in the tray group than in the flossing group. The effect on MS in the polishing-flossing group approached that obtained in the tray group. In the interdental areas, more sites had no detectable MS (score 0) after tray treatment than after flossing, whereas the reduction of heavily colonised sites (scores 3+/-4) was higher in the flossing group. The reappearance of sites with score 3+/-4 after the gel treatment was more rapid in the flossing group than in the other two groups. In conclusion, the results showed a transient reduction of MS colonisation by all three methods, and that the application of the chlorhexidine gel both in mouth trays or as a combination of polishing and flossing was more effective in reducing the MS population than flossing alone.

Administration, Topical↗

PubMed1999

Explanatory models for clinically determined and symptom-reported caries indicators in an adult population.

The aim of the present study was to analyze possible indicators of: (i) relative number of decayed and filled teeth, (ii) relative number of decayed teeth, (iii) subjectively reported toothache, and (iv) sensitive teeth, and to find explanatory models for these phenomena. Independent variables from three domains were used: (i) socio-economic factors, (ii) general health and health-related lifestyle, and (iii) dental attitudes and behaviors. The study basis was validated questionnaires from all 50-year-olds in 2 Swedish counties (n = 8888), response rate 71% (n = 6343). For a 20% subsample (58% participation) the DFT and DT were determined by calibrated dentists. Analyses were done with logistic and multiple regression. The variables born outside Sweden, gender, education, shift work, satisfaction with dental care, fear and care utilization were associated with DFT/number of teeth. For DT/number of teeth, the direction of association was reversed for the variables born outside Sweden and gender. Social class, education, general health, and use of tobacco were further covariates. Good oral hygiene gave a lower ratio of DT. For the logistic regression model of toothache, residence in cities and satisfaction with dental care had lower probability for toothache reports, while born outside Sweden, mouth dryness, use of pharmaceuticals, tobacco, fear, and high utilization increased this probability. In general, the association pattern was as could be expected: immigrants, working class, low education, smoking, dissatisfaction with dental treatment and low utilization all appeared as risk factors for both the clinically determined caries indicators, but not necessarily for subjective symptom reports. Only fear of dental treatment showed a consistent positive association with all the indicators.

Attitude to Health↗

PubMed1999

Effect of professional flossing with NaF or SnF2 gel on approximal caries in 13-16-year-old schoolchildren.

The aim of this study was to evaluate the effect of professional flossing with NaF and SnF2 gels on caries development on approximal tooth surfaces. Two-hundred-and-eighty 13-year-old schoolchildren were divided into 3 groups: (1) NaF (n = 97), (2) SnF2 (n = 85), and (3) placebo gel group (n = 98). The investigation was carried out double-blind. The children were treated 4 times a year for 3 years with 1% NaF gel, 1% SnF2 gel, or placebo gel. The treatment was carried out by dental nurses and the time required per visit was approximately 10 min. After 3 years, the mean approximal caries increment, including initial caries lesions, was 2.8 in the NaF, 2.4 in the SnF2, and 4.0 in the placebo gel group (P< 0.05 for SnF2 vs placebo); a reduction compared to the placebo of 30% and 39% in the NaF and SnF2 groups, respectively. Thus, professional flossing with NaF or SnF2 gel carried out 4 times a year may be considered as an interesting caries-preventing method for large-scale application in schoolchildren.

Adolescent↗