Biomedical subjects

D Birkhed

Publications and source records attributed to D Birkhed.

At least 37 records · Page 2Linked to original sources

PubMed1999

Attitudes to and experience of dental care among 50-year-olds in two Swedish counties.

The aim of this study was to investigate attitudes to and experiences of dental care in a population, born 1942. The following items were studied: opinions of general and oral health, attitudes to and experiences of dental care, dental care habits, experiences of latest visit to a dentist, tobacco habits and use of various dental hygiene articles. A cross-sectional mail questionnaire was sent in 1992 to all 50-year-olds in two Swedish counties, Orebro and Ostergotland, totally 8888 persons; the response rate was 71%. Of the population 89%, indicated good health. Satisfaction with dental care was high, 94%. 26% stated attendance to a dentist twice or more per year, and 64% at least once a year. As to expenses, 78% paid less than 1000 SEK the last year. Concerning the latest visit, 38% reported painless treatment, 37% no inconvenience, and 55% good care. The duration of the latest visit included on an average 27 min in travel time, 7 min in waiting time and 27 min in treatment time. Information about oral hygiene was given to 29% and about cost for treatment to 47% of the interviewed. There were 28% daily smokers. Snuff was daily used by 10% of the males. Toothbrushing twice a day with fluoride toothpaste seemed to be the standard oral hygiene procedure and was reported by 80% of the respondents.

Attitude to Health↗

PubMed1998

The effect of monitored chlorhexidine gel treatment on mutans streptococci in margins of restorations.

OBJECTIVES: The objective of this study was to compare the effect of a monitored chlorhexidine (CHX) gel treatment with a conventional two-day CHX treatment in subjects with well-restored dentitions and high numbers of salivary mutans streptococci (MS). METHODS: In the test group (n = 8), the effect of the CHX gel applications was monitored in margins of restorations and in saliva during a period of 12 weeks. Strip Mutans was used for monitoring and whenever a sample revealed growth of MS, the subject received a 3 x 5 min 1% CHX gel treatment at the clinic. Nine subjects (control group) were only given the baseline (conventional) treatment with CHX gel 3 x 5 min on two consecutive days. RESULTS: The monitored treatment in the test group resulted in a more pronounced reduction of MS both in margins of restorations and in saliva than the conventional treatment. The difference between the level of MS in the margins in the two groups was, however, only significant at the 20-week examination. There was a large individual variation in the effect of the CHX treatment, and three to nine extra CHX gel applications were needed in the test group to keep MS below a detectable level during the 12 weeks. CONCLUSIONS: Our findings illustrate the difficulties to obtain a long-lasting reduction of MS in subjects with a large number of restorations and a high number of MS by antimicrobial treatment only. The results indicate the necessity to combine antimicrobial treatment with, for example, sucrose restriction, in order to keep MS at a low level for a longer period of time.

Adult↗

PubMed1998

Fluoride concentration in the approximal area after using toothpicks and other fluoride-containing products.

The aim of this work was to study the fluoride (F) concentration in the approximal area after using toothpicks and other F-containing products. The exposure time was standardised to 2 min. 24 subjects participated, divided into 4 groups, with 6 individuals per group. In 3 of the groups, the following 4 products were compared: (1) a toothpick impregnated in 4% NaF; (2) a dentifrice containing 0.32% NaF; (3) a mouthrinse solution containing 0.025% NaF; (4) a tablet containing 0.55 mg NaF. In the 4th group, 3 commercial F toothpicks and 2 F dental flosses were compared. In all 4 groups, the F concentration was determined up to 60 min at 4 approximal sites. On each sampling occasion, 3 triangle-shaped paper points were used, absorbing 3 x 1 microl. In general, the toothpick gave similar or somewhat higher F concentrations in the approximal area than the dentifrice, mouthrinse solution and tablet. Comparing the various commercial toothpicks and dental flosses, 2 of the toothpicks gave higher approximal F concentrations than the other 3 products. When comparing the series in which the very first sample was collected from 2-20 min after the F treatment, it was found that the sampling procedure itself reduced the subsequent approximal F concentration. The main conclusion from this study is that an F-impregnated toothpick is a promising vehicle for delivery of fluoride to the approximal area.

Adult↗

PubMed1998

Glucose concentration in parotid saliva after glucose/food intake in individuals with glucose intolerance and diabetes mellitus.

The concentration of glucose in parotid saliva was measured after glucose/food intake in two separate studies (A and B). In Study A, 10 subjects with impaired glucose tolerance (IGT), 10 subjects with newly diagnosed Type 2 diabetes and 12 healthy controls were included. Study B comprised 15 subjects with Type 1 or Type 2 diabetes on insulin treatment, nine subjects with Type 2 diabetes on treatment with oral antidiabetic drugs and 12 healthy controls. After a 10-h overnight fast, the participants in Study A were given a 75 g oral glucose load, while those in Study B received a standardized breakfast. Citric acid-stimulated parotid saliva was collected up to two hours after the intake. Capillary blood and gingival exudate samples were also taken. On the basis of AUC values (area under the curve over baseline), the glucose concentration in parotid saliva increased significantly in individuals with IGT and Type 2 diabetes compared with controls in Study A and in diabetic patients on treatment with insulin and oral antidiabetic drugs compared with controls in Study B. No effect by the glucose/food intake on the glucose concentration in gingival exudate could be demonstrated in any of the studies. The correlation coefficient between the AUC values of glucose in saliva and blood, when all three groups were combined, was 0.38 in Study A and 0.52 in Study B. It is concluded that the concentration of glucose in parotid saliva is elevated at least 2 h after glucose/food intake in individuals with both IGT and manifest diabetes mellitus.

Administration, Oral↗

PubMed1998

Utilization of dental services in relation to socioeconomic and health factors in the middle-aged and elderly Swedish population.

The aims of this study were to describe the change in reported time since the latest visit to a dentist between the years 1980/81 and 1988/89 and the reported use of dental services in relation to age, dental state, and socioeconomic and health characteristics in a sample of the Swedish population in 1988/89. The studies are based on interviews by Statistics Sweden about the living conditions. In the investigations in 1980/81, 14,964 inhabitants between 16 and 84 years of age participated, and in 1988/89, 13,309 inhabitants. In all age groups there was a significantly higher frequency of reported visits to a dentist last year in 1988/89 than in 1980/81. In the age group 50-64 years old this figure increased from 54% to 75%, and in the age group 65-84 years old it increased from 26% to 39%. In the investigation in 1988/89 about 75% of the dentulous women in all age groups up to 75 years reported visiting a dentist last year. The relative risk for not visiting a dentist last year, adjusted for age, gender, and dental state, was higher in dentulous subjects with low income and education, not married, not native-born, living in rural areas, smoking, and low social and physical activity. The results of the logistic regression analysis showed that, among the elderly, functional ability and general health factors have lower significance for time since last visit to a dentist than socioeconomic, social support, and life-style factors.

Activities of Daily Living↗

PubMed1998

Effect of NaF-, SnF2-, and chlorhexidine-impregnated birch toothpicks on mutans streptococci and pH in approximal dental plaque.

The antimicrobial effect of birch toothpicks impregnated with 4% NaF, 8% SnF2, or 2% chlorhexidine was studied both in vitro and in vivo. A non-impregnated toothpick served as a control. In vitro, suspensions of Streptococcus mutans were exposed to the various toothpicks for 20 min and then cultured on blood agar. The results of this susceptibility test revealed the following ranking order with respect to inhibition: chlorhexidine > SnF2 > NaF and non-impregnated; with significant differences in colony-forming units (CFU) between these three groups. In vivo, 12 individuals used the 4 types of toothpick 3 times a day for 5 days in a procedure with a crossover design. Saliva and approximal plaque samples were collected at baseline and on various occasions up to 23 days after the treatment. At the same time, plaque-pH was measured at approximal sites 10 min after rinsing with 10% sucrose. The results of these in vivo experiments revealed lower proportions of mutans streptococci after using all four types of toothpick, but the reduction was significant only after 2 days for the toothpicks impregnated with SnF2 and chlorhexidine (P< 0.05). On the sampling occasions 9 and 23 days after the treatment, the mutans streptococci were more or less back to baseline levels again. In saliva no significant differences in the number of mutans streptococci were found either within or between the four treatments. No significant differences were found regarding decline in the plaque-pH between the NaF-, SnF2-, chlorhexidine-, and non-impregnated toothpicks on any of the sampling occasions.

Adult↗

PubMed1998

A comparison of four home-care fluoride programs on the caries incidence in the elderly.

OBJECTIVE: To estimate the caries preventive effect of 4 fluoride programs over 2 years in the elderly. SETTING: The Public Dental Clinics of Bålsta and Knivsta and the Faculty of Odontology in Göteborg, Sweden. SUBJECTS: One hundred and sixty-four individuals, aged 60 years and older (mean age 71.5 years) who were considered to be at risk from caries. DESIGN: The participants were randomly assigned either to: 1) rinse twice a day with a 0.05% NaF solution (n = 49; rinsing group), 2) suck twice a day on a 1.66 mg NaF tablet (n = 51; tablet group), 3) brush their teeth three times a day using a toothpaste slurry rinsing technique (n = 32; slurry group), or 4) brush their teeth in their usual manner (n = 32; control group). The participants in all 4 groups used a fluoride toothpaste (containing 0.32% NaF) at least twice daily. RESULTS: No new carious lesions were found in 67% of the participants in the rinsing, 43% in the tablet, 25% in the slurry and 16% in the control group over the 2 years. The mean (+/- SD) 2-year caries increment was 0.8 +/- 1.4, 1.4 +/- 1.7, 1.9 +/- 1.9 and 2.3 +/- 2.1 DFS in the rinsing, tablet, slurry and control groups, respectively; it was significantly lower in the rinsing than in the control group (p < 0.01). A lower incidence of DFS was also found in the tablet group than in the slurry group, but only for the lingual surfaces (p < 0.05). CONCLUSION: The type of fluoride program may be of importance in the reduction of new caries lesions in an older population.

Aged↗

PubMed1998

Effect of toothpicks with and without fluoride on De- and remineralization of enamel and dentine in situ.

The aim of this investigation was to study the effect of the interproximal use of fluoride (F)-impregnated and non-impregnated birch toothpicks on the degree of de- and remineralization of enamel and dentine in situ. Ten volunteers with complete dentures in the upper jaw participated. Each subject had four specimens: (1) sound enamel, (2) demineralized enamel, (3) sound dentine and (4) demineralized dentine; placed pairwise at two approximal sites (15/16 and 25/26) of the maxillary prosthesis. The study involved three test periods (A, B and C), each lasting 4 weeks. In A, the subjects used F toothpicks (impregnated in 4% NaF) and, in B, nonimpregnated toothpicks 3 times daily. During period C, no toothpicks were used. Dentifrice or other F-containing products were not allowed during the 4-week periods. Transversal microradiography was used to determine lesion depth (ld) and mineral loss (DeltaZ). The results revealed that all the sound samples lost mineral during the three experimental periods; DeltaZ for both enamel and dentine was less for A and B compared with C (p<0.01) and less for A compared with B and C for dentine (p<0.05, p<0.01). The demineralized samples also lost mineral, apart from dentine, during periods A and B, i.e. when F-impregnated and non-impregnated toothpicks were used; ld for enamel and DeltaZ for dentine were less for A compared with C (p<0.05). Four weeks' use of toothpicks, especially F-impregnated toothpicks, thus reduces the demineralization of enamel and dentine at approximal sites in situ.

Aged↗

PubMed1998

Effect of three months' frequent use of sugar-free chewing gum with and without urea on calculus formation.

Studies on the relationship between gum-chewing and calculus formation have produced contradictory results, and it is not clear whether frequent use of chewing gum promotes or inhibits calculus formation. Also, little is known about whether the addition of a small amount of urea to the chewing gum influences calculus formation. The aim of this investigation was to study the effect of sugar-free chewing gum--with and without urea--on calculus formation and some associated clinical variables. Three three-month periods were studied in a double-blind, crossover design, during which the subjects: (1) chewed 5 pieces/day of a sugar-free, urea-containing chewing gum (20 mg urea/piece); (2) chewed 5 pieces/day of a sugar-free, non-urea-containing gum; or (3) performed no gum-chewing. Twenty-nine persons, all calculus-formers, participated. They were scored for calculus at mesio-lingual, lingual, and disto-lingual sites on the 6 anterior mandibular teeth according to the Volpe-Manhold index. Plaque and gingival bleeding index, stimulated salivary secretion rate and buffer capacity, resting plaque pH, mutans streptococci in saliva and plaque, and lactobacilli in saliva were also determined. No differences in calculus formation were found among the 3 periods. The resting plaque pH was higher after the period with urea-containing gum than after the period with non-urea-containing gum and the no-gum period (p < 0.05). A slight increase in stimulated salivary secretion rate was found after the 2 gum periods (p < 0.05). The plaque and gingival bleeding indices decreased, while resting plaque pH and salivary buffer capacity increased throughout the entire study (p < 0.05). No significant differences in prevalence of the acidogenic micro-organisms were found among the test periods. The main conclusion from this study is that three months' frequent use of sugar-free chewing gum--with or without urea--neither promotes nor inhibits calculus formation.

Adult↗

PubMed1998

Explanatory models for oral health expressed as number of remaining teeth in an adult population.

OBJECTIVE: To develop explanatory models for oral health expressed as the number of remaining teeth. METHOD: Socio-economic attributes, health factors, dental attitudes and behaviours were used as explanatory variables in a logistic regression. Cross-sectional validated questionnaire data from all 50-year-old residents in two Swedish counties were collected from 8,888 persons, a response rate of 71.4% (n = 6,343). Adjusted number of teeth and three dichotomies of edentulousness and remaining teeth in various combinations were used as the dependent variables. RESULTS: Social class was unrelated to edentulousness, while individual and health factors were covariants. Individuals with < or = 8 teeth had a social class and education gradient, while those with > or = 25 teeth had class and education gradients as well as a relation to dental care utilisation. There were only three variables showing a consistent and stable relation to the various dependent variables, these were use of tobacco, having only junior high school education and satisfaction with dental care. The multiple and logistic regression models revealed different results. CONCLUSIONS: The main conclusions from this study were, first, that there were different mechanisms for different states of the dentition, interpreted as signs of disease and signs of health, corresponding to the ideas of patho- and salutogenesis, and secondly, that number of teeth present is not usable as a continuous variable, since it does not reflect the same mechanisms across the whole scale.

Adult↗

PubMed1998

Replacements of restorations in the primary and young permanent dentition.

The present study focused on the type of restorative material used and the reasons for replacements of restorations in the primary and the young permanent dentition. All patients with restorations and who were 8 and 19 years of age in 1995 and were regularly treated at 11 Public Dental Health clinics in Jönköping County, Sweden, participated in the study. Data were extracted from the records for all types of restorations in canines and molars for the preceeding of 5 years for the 8-year-olds (i.e. from 3 to 8 years of age; n = 546) and for approximal restorations in premolars and molars for the preceeding 13 years for the 19-year-olds (i.e. from 6 to 19 years of age; n = 606). In all, 6012 restorations were evaluated. The two most common restorative materials used in the primary dentition were compomer and glass ionomer cement and in the young permanent dentition composite and amalgam. In the primary dentition, 29% of the restorations had been replaced and 4% of the teeth with restorations had been extracted. Thus, 33% of the restorations in the primary dentition failed. The corresponding figure for the young permanent dentition was 13%. The most common reason for replacements in the permanent dentition was secondary caries. That restorations often fail because of caries and that the development of secondary caries is not prevented by replacement of an old restoration indicate that more attention should be paid to preventive dental care for patients with restorations in the primary as well as in the young permanent dentition.

Adolescent↗

PubMed1997

Antimicrobial effect of a chlorhexidine-thymol varnish (Cervitec) in orthodontic patients. A prospective, randomized clinical trial.

The aim of the present investigation was to study the effect of combined application of a fluoride varnish (Fluor Protector) and an antimicrobial varnish (Cervitec) on the oral microflora, caries and gingival condition in patients receiving treatment with fixed orthodontic appliances. A total of 198 individuals (12 to 15 years old), scheduled for fixed orthodontic treatment, were randomized into 2 groups. Prior to bonding, the Cervitec and the control group received one application with Cervitec or a placebo every week for 3 weeks, respectively. In the Cervitec group. Fluor Protector was applied at bonding and Cervitec at the next visit, 6 weeks later. Each varnish was then applied every 12 weeks for 24 weeks. In the control group, the fluoride varnish was applied only at bonding and every 12 weeks. The Visible Plaque Index (VPI), the Gingival Bleeding Index (GBI), the White Spot Lesion Index (WSL) and the level of mutans streptococci in plaque and saliva were recorded 3 weeks prior to bonding and after 24 weeks. At bonding and after 12 weeks, only VPI, GPI, plaque and salivary mutans streptococcus counts were recorded. During the 3-week prebonding period, the mean VPI, GBI and mutans streptococci in plaque decreased in both groups. At bonding, the mean level of mutans streptococci in plaque was significantly lower in the Cervitec group than in the control group. The mean level of mutans streptococci was significantly lower after 12 weeks' bonding in the Cervitec group than in the control group. No effects on the other parameters were found during the 24 weeks.

Adolescent↗

PubMed1997

Effects of frequent mouthrinses with palatinose and xylitol on dental plaque.

The aim was to evaluate the effects of frequent mouthrinses with palatinose, xylitol and a mixture of palatinose and xylitol on plaque pH, plaque formation and cariogenic microorganisms. 15 subjects refrained from toothbrushing during 3 test periods and rinsed 15 x daily for 4 d with 10 ml of: (1) 50% palatinose, (2) 37.5% palatinose + 12.5% xylitol, or (3) 50% xylitol. A contrast period with no mouthrinses was also carried out. The 4 periods were carried out in a randomized order with a cross-over design. After the 4-day periods, 3 parameters were measured: (1) plaque pH during the first 30 min after a mouthrinse with palatinose, a mixture of palatinose and xylitol or xylitol alone, directly followed by a 2nd rinse with 10% sucrose; (2) number of mutans streptococci and lactobacilli in plaque and saliva; (3) plaque index. The most pronounced pH drop for the sugar substitutes was found when rinsing with 50% palatinose after the palatinose period, and the least pH drop with 50% xylitol after the xylitol period. The sucrose rinse gave similar pH fall after all 4 periods. The microbial data showed no differences between the 4 periods, but the mutans streptococcus counts in saliva decreased after the xylitol period in contrast to the 3 other periods. Regarding the plaque index, xylitol gave lower scores compared to the other 3 periods.

Analysis of Variance↗

PubMed1997

Saliva and marathon running.

The aim of this study was to follow changes in saliva and serum after strenous prolonged exercise. Twenty individuals, three women and 17 men, 24-62 years old, well-trained but not at elite level, participating in the Stockholm Marathon, were selected for the study. Two of the subjects broke the race after 20 km. Three samples of saliva were collected, i.e. (i) just before the race, (ii) directly after the race, and (iii) 1 h after the race. Paraffin-stimulated whole saliva, resting non-stimulated whole saliva and citric acid-stimulated parotid saliva were investigated. In all three types of saliva, there was a decrease in secretion rate and only 14 of the 18 participants could produce resting non-stimulated whole saliva directly after the race. The salivary concentration of chloride, phosphate, potassium, amylase, hexosamine, sialic acid and salivary peroxidase were significantly higher after than before the race. There were no significant changes in salivary pH and buffer capacity. The total protein concentration was increased in all types of saliva after the race. To conclude, there were several changes in the saliva composition just after the marathon, but most of the values were back to baseline after 1 h of rest. However, the values for sodium, calcium, phosphate, salivary peroxidase, amylase and salivary IgA were still elevated 1 h after the race.

Adult↗

PubMed1997

Oral glucose clearance in nonagenarians in relation to functional capacity, medication and oral variables.

OBJECTIVES: To study oral sugar (glucose) clearance and to examine some factors which were believed to either influence or be dependent upon oral glucose clearance. DESIGN: Cross-sectional, clinical study with analysis of records. SETTING: Göteborg gerontological and geriatric population studies, Göteborg University, Sweden. SUBJECTS: 71 community-dwelling individuals, 27 men and 44 women, of a representative sample of 260 92-year-old persons. INTERVENTION AND MAIN OUTCOME MEASURES: Glucose concentration was measured in saliva after chewing of a glucose tablet and the clearance was assessed by three different variables: (i) the initial salivary glucose concentration, (ii) the area under the curve (AUC) and (iii) the clearance time. RESULTS: The glucose clearance showed a wide inter-individual variation, which could be explained partly by differences in oral state, chewing time, stimulated salivary secretion rate and medication use. A positive correlation was found between the clearance variables and the number of lactobacilli and mutans streptococci in saliva and the percentage of untreated root caries lesions of the total number of exposed root surfaces. CONCLUSIONS: A slow oral sugar clearance is more common among 92-year-olds than younger adults earlier reported in other studies, particularly in those who have uncompensated functional impairments and a high medication history. A decreased oral glucose clearance was associated with high counts of salivary lactobacilli and mutans streptococci and a high proportion of untreated root caries lesions.

Aged↗

PubMed1997

Salivary fluoride concentration and plaque pH after using a fluoride-containing chewing gum.

The aim was to study the salivary fluoride (F) concentration and plaque pH recovery on the chewing and the non-chewing side of the dentition during and after chewing 1 piece of chewing gum containing 0.25 mg F as NaF. Ten subjects refrained from toothbrushing for 3 days. On the fourth day, they rinsed for 1 min with 10 ml of a 10% sucrose solution. When plaque pH had reached a low value, they started to chew for either 5, 10, 15, 20, 30 or 45 min. Measurements of F concentration in saliva and of pH of approximal plaque were carried out at 2 contralateral sites for up to 60 min. In each individual, the chewing and non-chewing side were registered. Two to 3 times higher salivary F concentrations (expressed as area under the curve, AUC) were found on the chewing than on the non-chewing side (p < 0.05 or p < 0.01). The most pronounced recovery of plaque pH after the sucrose rinse was also registered for the chewing side, but the difference between the chewing and the non-chewing side was not so obvious as for the salivary F concentration. Significantly higher values of plaque pH (expressed as AUC) were found during prolonged chewing (p < 0.05 or p < 0.01), while only small numerical differences in salivary F concentration were noted between short and long chewing times. Thus, this study showed: (1) that the F concentrations in saliva after chewing a F-containing chewing gum were highest on the chewing side, and (2) that a prolonged chewing time increased the plaque pH recovery after a sucrose rinse, but had only a minor effect on the salivary F concentration.

Adult↗

PubMed1997

Dental erosion associated with soft-drink consumption in young Saudi men.

This study reports on the causative factors of dental erosion in selected high- (n = 19) and low-erosion (n = 19) subgroups of a larger random sample (n = 95) of young male Saudi military inductees. By means of a questionnaire, the role of various possible factors related to oral health in general, and to dental erosion in particular, was assessed for each participant. Clinical examination included recordings of severity of dental erosion and fluorosis, presence of buccal cervical defects and first permanent molar 'cuppings', DMFT and DMFS, visible plaque index, and gingival bleeding index. In addition, bitewing radiographs, study casts, and intraoral color transparencies were obtained for each individual. Logistic regression analysis showed a strong correlation between the presence of dental erosion and a high level of consumption of cola-type soft drinks. Other statistically significant associated factors, although of less predictive strength, were type of cleaning aid and gingival bleeding index. In subgroup comparisons, dental problems (primarily pain), number of buccal cervical defects, and number of missing teeth were significantly greater in the high- than in the low-erosion subgroup.

Adult↗

PubMed1997

Dental caries and related factors in 88- and 92-year-olds. Cross-sectional and longitudinal comparisons.

Our aim was to compare two groups of 88- and 92-year-olds (n = 92 and n = 40), respectively, with regard to teeth, caries, and salivary and microbial conditions. Oral variables were analyzed in relation to functional capacity and use of cardiovascular agents and psychoactive drugs. Untreated root caries, plaque score, and counts of lactobacilli increased between the ages of 88 and 92 years (P < 0.01). Nine of the 24 longitudinally followed up subjects had lost 1-5 teeth over 4 years, and 17 subjects had developed new caries (DFS). The mean caries increment over 4 years was 1.3 coronal and 3.6 root surfaces, and new DFS per 100 surfaces at risk was 4.3 coronal and 17.5 root surfaces. Plaque score and final pH of buffer capacity increased (P < 0.05 and 0.01, respectively), whereas saliva flow, independent of gender, was unchanged. Use of cardiovascular agents and psychoactive drugs was associated with a deteriorated dental status.

Activities of Daily Living↗