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Biomedical subjects

D Birkhed

Publications and source records attributed to D Birkhed.

At least 91 records · Page 5Linked to original sources
PubMed1993

Root caries susceptibility in periodontally treated patients. Results after 12 years.

The aim of the investigation was to study the individual susceptibility to root caries in periodontally treated patients in a long-term follow-up of 12 years. Age, plaque score, salivary counts of lactobacilli and mutans streptococci, salivary secretion rate and buffer effect, oral sugar clearance time and dietary habit index were tested as possible predictors for root caries incidence. During the whole observation period of 12 years, new root caries lesions were recorded in 24 of a total of 27 patients. In 8 of these, the root caries incidence was between 1 and 5, in 7 between 6 and 9 and in 9, 12 or more new DFS. However, the annual mean number of new DFS was rather low. 13 patients with > 5 new DFS% during the 3rd 4-year period (years 9-12) differed significantly from 14 patients with < or = 5 new DFS% in salivary mutans streptococcus counts (p < 0.01), plaque scores (p < 0.001) and new DFS% during the 2nd 4-year period (years 5-8) (p < 0.001). Simultaneously, risk values among the variables tested at the 8-year examination were about 3 x more prevalent in patients that developed > 5 new DFS% in years 9-12 than in those with < or = 5 new DFS%. During the whole 12-year observation period, smokers had significantly more root caries than non-smokers (p < 0.05).(ABSTRACT TRUNCATED AT 250 WORDS)

Aged↗
PubMed1993

Salivary fluoride clearance after a single intake of fluoride tablets and chewing gums in children, adults, and dry mouth patients.

The aim of the present investigation was to compare the clearance pattern in saliva and the salivary stimulating effect of a new fluoride (F) chewing gum (Fluorette) with three other F products used in Scandinavia for many years for caries prevention. Concentration of F was determined in whole saliva in three groups of subjects: 1) children, 10-12 yr of age (n = 20), 2) adults (n = 20), and 3) dry mouth patients (n = 15), after a single intake of the two tablets, Dentan and Fludent, and the two chewing gums, Fluomin and Fluorette, all containing 0.25 mg F as NaF. Sucking was allowed until the tablets had been completely dissolved in the mouth. The chewing gums were used for 15 min. Saliva samples were collected from subjects expectorating 0.3-0.5 ml at nine different time intervals up to 45 min after the intake. There were some significant differences in the maximum F concentration, the area under the salivary fluoride concentration curve (AUC) when plotted against time, and the salivary stimulating effect among the four products, but as a whole they were small and probably of minor clinical importance. Among the various groups, the dry mouth patients showed the highest salivary F concentration. Thus, the main conclusion from this study is that the F tablets and chewing gums studied, including the new product Fluorette, had approximately the same clearance pattern in saliva and the same salivary stimulating effect. However, there were great variations among the different subjects.

Adult↗
PubMed1993

pH changes in human dental plaque from lactose and milk before and after adaptation.

pH changes in human dental plaque in vivo from lactose and milk have been studied in four separate mouthrinse experiments. (1) pH was measured in plaque samples of 12 subjects before and after 6 weeks of frequent daily mouthrinsing with 10% lactose. The pH decreases were significantly more pronounced after the adaptation period than before (p < 0.001), 4 of the 12 subjects showing about the same low plaque pH from lactose as from glucose. (2) Similar to the previous experiment, frequent daily mouthrinsing with low-fat bovine milk in 10 subjects resulted in more pronounced pH decreases in plaque after an adaptation period of 4 weeks (p < 0.001). (3) Single mouthrinses, without any prior adaptation, with bovine standard milk, human breast milk, lactose-hydrolysed bovine standard milk, 5% lactose and 5% sucrose were compared regarding the effect on plaque pH in 7 subjects. All solutions resulted in pH falls. The most pronounced were found with sucrose, followed by the lactose-hydrolysed milk. (4) Bovine standard milk, 5% lactose and 10% sucrose were compared after a single mouthrinse in 5 subjects using interdental plaque pH wire telemetry. Lactose and milk were fermented more slowly than sucrose. In a separate study, acid production from lactose was also measured in two oral strains each of Streptococcus mutans, Streptococcus salivarius and Streptococcus sanguis. The results from these experiments indicated that at least part of the lactose transport and catabolism in all studied streptococcus strains seems to be regulated by inducible enzymes.

Adaptation, Biological↗
PubMed1993

Effects of a 12-month prophylactic programme on selected oral bacterial populations on root surfaces with active and inactive carious lesions.

In 15 caries-active patients, with a total of 770 exposed root surfaces, the effect of fluoride therapy and professional tooth cleaning was studied during a 1-year period. Dental plaque from 92 of the root surfaces and whole saliva samples were analysed at baseline and after 12 months for the presence of specific bacteria. The results showed that the number of active carious lesions had decreased from 99 to 46, while the inactive lesions had increased from 69 to 124. Of the active lesions which had been converted into inactive lesions, most were on the buccal and fewest were located on the distal surfaces. Lower plaque scores were found on sound and inactive root surfaces compared to active surfaces. The salivary concentrations of mutans streptococci and lactobacilli remained constant during the 12-month observation period. There was a tendency for higher levels of Streptococcus mutans in plaque from active lesions compared with sound root surfaces, whereas an inverse relationship was noted for the Streptococcus oralis group. No significant differences in the Actinomyces naeslundii counts were detected. In conclusion, the 12-month prophylactic programme had an effect on the clinical surface characteristics of root caries, but the components of the oral microflora selected for study seemed to be relatively unaffected during the observation period.

Actinomyces↗
PubMed1993

pH measurements of human dental plaque after consumption of starchy foods using the microtouch and the sampling method.

The aim was to study the effect of different starch-containing food items on pH changes in dental plaque. The pH was, in 10 subjects, simultaneously measured at various occasions up to 60 min in: (1) two approximal spaces in the premolar-molar region with the microtouch method, and (2) pooled samples of dental plaque with the sampling method. Six starchy products were tested: (1) spaghetti, (2) macaroni, (3) potato, (4) rice, (5) unsweetened bread, and (6) sweetened bread. A glucose chewing tablet and a mouthrinse with 10% sucrose served as controls. Saliva was collected for HPLC analysis of maltose and maltotriose when testing the spaghetti, rice and unsweetened bread. The glucose tablet and the sucrose solution resulted in the greatest pH drops. However, all starchy products resulted in obvious pH falls, which were most pronounced for sweetened bread, followed, in order, by unsweetened bread and potato. Significantly more maltose and maltotriose were found in saliva after consumption of unsweetened bread compared to spaghetti. There seemed to be a relationship between the amount of starch hydrolysates in saliva and the area of the plaque pH curve (AUC). The microtouch method gave consistently lower pH values than the sampling method. Both methods, however, ranked the eight test products roughly in the same order with respect to minimum pH, maximum pH decrease and AUC.

Adolescent↗
PubMed1993

Factors related to fluoride retention after toothbrushing and possible connection to caries activity.

The aim of the present investigation was to study the brushing and toothpaste technique employed by caries-active and caries-inactive patients in a toothbrushing population. The study consisted of 47 patients at a public dental clinic in the County of Bohuslän, Sweden; 23 with low (group L) and 24 with high caries activity (group H). They were asked to brush their teeth with a fluoride dentifrice at the clinic using an identical technique to that which they employed at home. Various factors, such as brushing time, amount of dentifrice, water consumption and mouthrinsing habits after brushing, were carefully registered. Saliva samples for fluoride analyses were collected up to 45 min after brushing. The members of group L used less rinsing water (0.7 +/- 0.6 dl; mean +/- SD) than those of group H (1.9 +/- 1.0 dl, p < 0.001). Comparing the mouthrinsings with water after the brushing, a significantly higher frequency was observed in group H (3.6 +/- 1.9 rinsings) than in group L (1.5 +/- 0.7 rinsings; p < 0.001). There were no differences between the two groups regarding the amount of dentifrice used and the total brushing time. When the salivary fluoride concentration was plotted vs. time and the area under the curve (AUC) calculated, a significantly higher mean value was found in group L than in group H (p < 0.01). Calculation of the correlation coefficient (r) between the AUC value and the amount of water used gave r = 0.53 (p < 0.001) and between the AUC and the frequency of mouthrinsing r = 0.46 (p < 0.01).(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1993

Comparison of three different methods for measurement of plaque-pH in humans after consumption of soft bread and potato chips.

Three different techniques for measurement of plaque-pH--the sampling, the microtouch, and the telemetric methods--were compared after subjects had consumed different starch products. Ten volunteers, equipped with partial lower prostheses, incorporating a miniature glass pH electrode, refrained from toothbrushing for 3 days. Four products were tested: (1) soft bread, (2) potato chips, (3) 5% starch, and (4) 5% sucrose. The pH of plaque was measured for 45 min by means of all three of the methods. The results showed that the mean pH at 10 min was 1.5 units lower with the telemetric than with the sampling method and 1.0 unit lower with the telemetric than with the microtouch method. Relatively small differences were found among the effects of the four test products for all three methods, with the clearest distinctions among the pH curves being with the microtouch and telemetric methods. The main conclusions from the present investigation are: (1) that there were large differences in pH levels measured with the sampling, the microtouch, and the telemetric methods, even though they ranked the test products in about the same order, and (2) that the two starchy foods, bread and potato chips, were both easily fermented by dental plaque.

Aged↗
PubMed1993

On the relations between dietary habits, nutrients, and oral health in women at the age of retirement.

Intake of energy, nutrients, food items, and various oral health-related factors were studied in 116 women about 5 months before the age of their occupational retirement. The results were analyzed with oral health aspects as both independent and dependent variables. Edentulous women had higher intake of fat and higher coffee consumption than dentate ones, and dentate subjects with 1-20 teeth had higher body mass index than those with > or = 21 remaining teeth. Individuals with high intake of energy and carbohydrates had more decayed tooth surfaces than those with low, but different intakes of other nutrients were not reflected in the studied tooth variables. Daily consumers of sweet beverages and sugar in coffee/tea had more decayed tooth surfaces than non-consumers. Nineteen of the 116 women with 'inadequate' diet did not differ from the others with regard to any of the studied tooth variables. Women with self-assessed chronic oral dryness had higher intake of energy, protein, iron, thiamine, and vitamin D than those without this problem. Smoking habits were reflected in the DMFS index but not in any of the other studied oral health-related variables. It was concluded that intake of energy- and sugar-rich products, frequencies of intakes, and oral dryness seem to be of greater importance for oral health than intake of specific nutrients, at least in this specific cohort.

Aged↗
PubMed1993

Plaque pH and oral retention after consumption of starchy snack products at normal and low salivary secretion rate.

The effect of plain potato chips, sugar-free cheese doodles, and sweetened crackers on plaque pH and oral retention was tested in 10 volunteers and compared with 5% starch and 5% sucrose, during both normal and low salivary secretion rate. The first 30 min 5% sucrose gave the most and 5% starch the least attenuated pH drop, but the three snack products reached or even passed the level seen by sucrose during the second 30-min phase. All products resulted in greater pH falls and remained at a low level for a longer period during low secretion rate. There were no differences in concentration of carbohydrates in saliva after consumption of potato chips, cheese doodles, and a cracker. However, low secretion rate increased the oral retention for all three products. To conclude, this study showed that low salivary secretion rate accentuated the pH decrease in dental plaque and prolonged the oral retention of carbohydrates.

Adult↗
PubMed1992

Variation of posterior approximal caries incidence with consumption of sweets with regard to other caries-related factors in 15-18-year-olds.

The aim of this study was to analyze the relationships between caries incidence and a number of caries-related factors in 15-18-yr-olds, in order to estimate the explanatory value of consumption of sweets under different conditions. Sixty-nine 18-yr-olds were interviewed about consumption of sweets and other sugar-containing products during the past 3 yr. Data on oral hygiene, salivary counts of mutans streptococci and lactobacilli, salivary flow rate and oral sugar clearance time were collected when the individuals were 15 and 18 yr old. Caries incidence for the 3-yr period was expressed as a percentage of the number of caries-free approximal surfaces of premolars and molars at the age of 15. Simple linear correlations between caries incidence and the different variables showed that lactobacilli count ranked first (r = 0.26), sweets second (r = 0.25), and mutans streptococci count third (r = 0.24). The r value for caries incidence and consumption of sweets increased in subgroups with combinations of poor oral hygiene, a high intake of other sugary products and a low salivary flow rate (r = 0.67-0.70). In conclusion, consumption of sweets should still be considered an important caries-related factor and particularly harmful when oral hygiene is poor and consumption of other sugary products is high.

Adolescent↗
PubMed1992

Progression of approximal caries in primary molars and the effect of Duraphat treatment.

The progression of caries lesions over a 2-yr period was studied in 3-6-yr-olds. All 468 children included in the study lived in an area during 1977-85 (Malmö, Sweden) with a low fluoride concentration (0.2 ppm) in the drinking water. Radiographs were taken with a standardized periodic identical technique. Caries lesions were scored on the distal surface of the first and on the mesial surface of the second primary molars (maximum 8 per child) according to Gröndahl et al. Half of the children were treated semiannually with a fluoride varnish (Duraphat). In all, 421 surfaces with caries at baseline were available at the 1-yr examination and 369 at the 2-yr examination. After 1 yr, 34.1% of the shallow enamel lesions remained unchanged, while a progression was seen in 60.9%. 5.1% had been restored. The corresponding figures after 2 yr were 20.6, 52.1 and 27.3%. Of the deeper enamel lesions at baseline, 28.8% remained unchanged after 1 yr and 13.7% after 2 yr. Of the lesions extending into the dentin, 81.5% had been restored after 1 yr and all after 2 yr. When evaluating the effect of Duraphat, only the percentage of individuals with one or more superficial enamel lesions showing progression was determined. After 1 yr, 51.2% in the Duraphat (n = 41) and 82.8% in the control group (n = 29) showed progression (restored surfaces included). The corresponding figures after 2 yr were 66.7 (n = 42) and 91.2% (n = 34). The differences after both 1 yr and 2 yr were statistically significant.(ABSTRACT TRUNCATED AT 250 WORDS)

Child↗
PubMed1992

Longitudinal study of stimulated whole saliva in an elderly population.

The aim of this investigation, which is part of the longitudinal gerontologic population study in Gothenburg (H-70), was to examine the effect of aging on salivary flow. Three 70-yr-old cohorts, born in 1901/02, 1906/07, and 1911/12, were studied both cross-sectionally and longitudinally. Representative subsamples (n = 931) were followed up to 82 yr in the first and up to 75 yr in the second and third cohorts. Whole saliva secretion was stimulated by paraffin wax chewing for 5 min and all sampling was carried out in the morning after an overnight fast. The mean secretion rate was 1.24 for men and 0.94 ml/min for women at the age of 70 (all cohorts pooled). The percentage values for extremely low secretion rate (< 0.2 ml/min) were 2 and 6%, respectively. Neither the cross-sectional nor the longitudinal comparison showed any decrease in secretion rate on a group basis either in the age interval 70-82 yr in the first or between 70 and 75 yr in the other two cohorts. However, an increased prevalence of complaints of mouth dryness was found, especially among women. The main conclusion from this study is that there is no decline on a population basis in paraffin-wax-stimulated salivary flow with increasing age.

Age Factors↗
PubMed1992

Use of palladium touch microelectrodes under field conditions for in vivo assessment of dental plaque pH in children.

The aim of this study was to assess the applicability of palladium touch microelectrodes, connected to battery-run pH meters, for in vivo plaque pH measurements in children. The pH was assessed in 20 7-year-old and in 19 14-year-old caries-active and caries-inactive rural Kenyan children. The resting pH was measured at non-carious interproximal and occlusal sites and in open dentine cavities. Independent repeated measurements were performed at given sites at intervals of 15 s and 5 min and on different days. The resting plaque pH varied widely among the children, and there was no significant difference between caries-active and caries-inactive groups. The most striking feature was the considerable erratic fluctuations of pH at a given site with time, both in resting and in sucrose-challenged plaque. These fluctuations were sensitively recorded by palladium touch microelectrodes. After a sucrose rinse, not all sites in the same mouth behaved in a similar fashion, and thus the classical 'Stephan curve' was not always apparent. In conclusion, the palladium touch microelectrodes are highly applicable for plaque pH measurements in children, even under extreme field conditions.

Adolescent↗
PubMed1992

Effect of sugarcane chewing on plaque pH in rural Kenyan children.

In 5 rural Kenyan children, the effect of sugarcane chewing on plaque pH was compared with the effect of a mouthrinse with 10% sucrose at various intraoral sites. They all had poor oral hygiene and at least two carious cavities in occlusal surfaces of molars. pH measurements were conducted under field conditions using paladium touch microelectrodes connected to a battery-operated pH meter. There was a marked difference in pH response of non-carious approximal sites between maxilla and mandible, with the lowest values in the maxilla. However, the pH recovery following the instantaneous drop occurred in parallel even if most pH values had not returned to baseline values 30 min after the sucrose rinse. Following the sugarcane chewing, the pH fall was less pronounced on all sites, and within 5-10 min the values had returned to resting pH and even exceeded this. In carious cavities, a similar pattern was observed, although the acidity in these sites was more pronounced, also reflected in a lower resting mean pH. The main conclusion from this study is that sugarcane chewing yields a less pronounced pH drop and a quicker pH recovery in dental plaque than is seen following a mouthrinse with 10% sucrose. This difference probably results from stimulation of salivary flow associated with the chewing.

Adolescent↗
PubMed1992

Oral sugar clearance and root caries prevalence in rheumatic patients with dry mouth symptoms.

The relationship between root caries, oral sugar clearance, salivary flow rate, and salivary counts of mutans streptococci, lactobacilli and candida has been studied in a group of 22 rheumatic patients (age range 40-72 years). The study group comprised all subjects volunteering for a clinical trial on relief of dry mouth symptoms. The median salivary flow was 0.09 ml/min at rest and 0.9 ml/min during chewing stimulation. The median sugar clearance time was about 5 min in the sublingual area and 16 min in the lower buccal vestibule. For subjects with 0-2 root caries lesions the clearance time at both sites was shorter than for subjects with 3 or more lesions (p < 0.05). A long oral clearance time was significantly correlated with age, root caries (DS and DFS), low resting salivary flow, and high salivary counts of mutans streptococci. It is concluded that root caries in rheumatic patients with low salivary flow is significantly related to oral sugar clearance time.

Adult↗
PubMed1992

Prediction of root caries in periodontally treated patients maintained with different fluoride programmes.

The aims of the investigation were to evaluate the effect of different fluoride programmes, as adjuncts to professional plaque control every 3-4 months, on root caries incidence in periodontally treated patients and to identify risk factors for root caries development. Ninety-nine individuals, 33-76 years old, who had been treated for periodontal disease were subjected to one of three fluoride programmes during a 2-year period: (1) professional application, 3-4 times/year, of Duraphat (n = 34) or (2) of a 0.4% stannous fluoride gel (n = 33), or (3) daily mouthrinsing with a 0.05% sodium fluoride solution (n = 32). A number of clinical recordings and laboratory tests, used as presumptive risk indicators for root caries, were carried out before and on three different occasions after the periodontal treatment. No statistically significant differences were found between the various fluoride programmes. During the 2-year period, a total of 246 new decayed or filled surfaces (DFS) were recorded, 72 (29.3%) of which were diagnosed as active and 124 (50.4%) as inactive root caries lesions; 50 (20.3%) of the surfaces had been restored. Individuals with > or = 1 new root DFS during the 2 years (n = 50) differed significantly from those with 0 new root DFS (n = 49) as concerns salivary counts of mutans streptococci and lactobacilli, root plaque scores and percentage of exposed root surfaces. Baseline root caries prevalence (r = 0.43) and root plaque scores (r = 0.36) showed the highest correlations with new root DFS.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1992

An individual training programme for speeding up prolonged oral sugar clearance in hospitalized elderly patients. A pilot study.

The aim of this pilot study was to evaluate an individual programme for speeding up prolonged oral sugar clearance in hospitalised elderly patients. Six patients at a university hospital for geriatric medicine, aged 67-85 years, completed a 6-week study. Every second week one of the authors gave: 1) information on the importance of oral sugar clearance for oral health, 2) instruction in oral hygiene, and 3) professional tooth cleaning. Moreover, the staff responsible for each patient provided 1) massage and training of the lips, cheeks and tongue shortly before each main meal, 3 times daily, 2) supervision of chewing on a sugar-free chewing gum for at least 20 min, 4 times daily, and 3) support and encouragement of the patients throughout the day. Salivary glucose clearance was measured both sublingually and vestibularly in the lower jaw after chewing a glucose tablet and after a mouth rinse with 10% glucose solution. There was a clear tendency that the oral sugar clearance was reduced after the 6-week period and some of the reductions in the clearance variables were statistically significant. All patients, especially those suffering from cerebral haemorrhage, reported an improved ability to chew while proceeding with the programme, which was also confirmed by the staff. The main conclusion from this pilot study is therefore that it might be possible to speed up prolonged oral sugar clearance in elderly hospitalised patients using an individual training programme.

Aged↗