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Biomedical subjects

D Birkhed

Publications and source records attributed to D Birkhed.

At least 127 records · Page 7Linked to original sources
PubMed1990

Comparison between saliva stimulants and saliva substitutes in patients with symptoms related to dry mouth. A multi-centre study.

Five saliva stimulants (Salivin, V6, Mucidan, Ascoxal-T and Nicotinamide) and three saliva substitutes (Saliment, Salisynt and an ex témpore solution) were evaluated in 106 patients with a low salivay flow rate and a long history of dry mouth. The study was carried out as a multi-centre study in collaboration with ten different hospital dental clinics. The participants were interviewed about their complaints related to dry mouth. Each patient was then asked to use the eight saliva stimulants and substitutes for 14 days in a randomized order with one week intervals. After the 14-day-periods, the patients were interviewed about the effect of the various products by a dentist using a standardized questionnaire. Paraffin-stimulated whole saliva samples were collected after each test period. The most serious complaints among the patients were, besides dryness of the mouth, difficulty to talk and difficulty to swallow. The results showed that all eight tested saliva stimulants and substitutes relieved the symptoms of dry mouth to some extent. However, V6 chewing gum and Salivin lozenge were ranked as the two best products by the patients. No long-term effect was found with any of the eight products on the flow rate of paraffin-stimulated whole saliva.

Adolescent↗
PubMed1990

Reasons for replacement of Class II amalgam restorations in private practice.

In a series of postgraduate courses in Cariology for dentists in the period 1980-84, a total of 102 private practitioners participated in a study of the reasons for replacing amalgam restorations. Twelve reasons were specified on a form and the dentist was asked to mark one or more of them for each filling replaced. The total number of fillings evaluated was 2033. In 87.9% of the restorations only one reason was given for the replacement; two, three, four and five reasons were registered in 10.5, 1.1, 0.4 and 0.1%, respectively. The six most frequent reasons were: "secondary caries" (34.0%), "fracture of the filling" (15.5%), "primary caries" (12.1%), "fracture of the tooth" (10.2%), "marginal ditching" (7.2%), and "caries under the filling" (5.6%). The restorations replaced for a combination of two reasons (N = 213) were studied separately. The three most frequent combinations were: "secondary caries + fracture of the filling" (17.8%), "secondary caries + marginal ditching" (14.1%), and "secondary caries + caries under the filling" (11.3%). - Thus, the main conclusion from this study is that approximately half of the replacements of class II amalgam restorations were occasioned by caries disease.

Dental Amalgam↗
PubMed1989

Effect on approximal caries in teenagers of interrupting a school-based weekly NaF mouthrinse program for 3 years.

The aim of the present investigation was to follow the caries incidence in 126 13-yr-old children who experienced a 3-yr interruption of a supervised weekly mouthrinse program with 0.2% NaF solution (interrupted rinsing-, IR-group). 143 children, 13 yr old, who continuously participated in the NaF mouthrinse program, served as a comparison group (continuous rinsing-, CR-group). Dental caries and restorations were diagnosed on bitewing radiographs; thus only approximal tooth surfaces were considered. The caries incidence over the 3-yr period was 1.84 DFS in the IR- and 1.77 in the CR-group. The corresponding FS-values were 0.67 and 0.25, respectively. Two years later, i.e. when the children were 18-yr-old and the IR-group had had 2 yr back on the school-based mouthrinse program, they were examined again. The difference in caries incidence between 16 and 18 yr of age was still small, 1.32 DFS in the IR- and 1.22 in the CR-group. The corresponding FS-values were 0.63 and 0.49, respectively. Thus, this study showed that the 3-yr interruption of the NaF mouthrinse program resulted in a small, statistically non-significant increase in caries, mostly as regards the number of fillings, on approximal tooth surfaces.

Adolescent↗
PubMed1989

Per capita consumption of sugar-containing products and dental caries in Sweden from 1960 to 1985.

The aim of the present report was to analyze sugar consumption in relation to dental caries in Sweden from 1960 to 1985. Sugar consumption is based on official statistics from the National Swedish Agricultural Board and is expressed in grams per person and day. Over this quarter-century total sugar consumption decreased approximately 5%, from 116 to 110 g/person/day. A shift occurred from direct consumption to indirect (sugar used by the food industry), the former decreasing from 76 to 50 and the latter rising from 40 to 60 g/person/day. Available epidemiologic data on dental caries in children from the National Swedish Board of Health and Welfare indicate that the frequency of caries decreased dramatically from 1960 to 1985, though comparable data were difficult to obtain for the whole 25-yr period. The conclusion from this study is that these changes in caries prevalence in Sweden cannot be attributed to a corresponding decrease in the per capita consumption of sugar and sugar-containing products. On the contrary, the intake of some products traditionally related to dental caries, such as candy and soft drinks, increased during 1960-1985.

Adolescent↗
PubMed1989

Sugar substitutes--one consequence of the Vipeholm Study?

One of the main conclusions from the Vipeholm Study is that consumption of sticky sugar-containing between meal products can be associated with high caries activity. Another important result from this study is that there is a great variation in the caries development between different individuals, for example among those who consume 24 toffees a day. Thus, the answer to the question that was raised in the title of this paper: "Sugar substitutes - one consequence of the Vipeholm Study?" is "Yes" for those products that are consumed frequently and "Yes" for those individuals who have a high risk for dental caries, but "No" for those products that are not consumed frequently and "No" for those individuals who do not have a high risk for dental caries. There are many substitutes available on the market today, both non caloric and caloric, which have a low or even no cariogenic potential. Even if some of these products have economic, technologic and toxicologic shortcomings, sugar substitution is an important part of the caries prevention.

Dental Caries↗
PubMed1989

Effects of variously processed starch on pH of human dental plaque.

The aim of this investigation was to study the effect of starch in various cereal products on pH of human dental plaque in vivo as compared to availability to the alpha-amylase of starch in vitro. Three separate experimental series were performed including: 1) rye and wheat products, 2) wheat products processed under both mild and severe conditions, and 3) wheat products with and without added sucrose. The pH drop in dental plaque was studied after a mouthrinse in groups of 10 subjects. Solutions of glucose or sucrose were used as references. No differences were found between boiled rye and boiled wheat, nor between rye bread and wheat bread. Severely popped wheat resulted in the greatest pH drop, followed, in order, by drum-dried and extrusion-cooked products. Mildly steam-flaked and mildly dry-autoclaved products induced comparable small pH falls. Sucrose-sweetened wheat products resulted in lower plaque pH values compared to unsweetened products. This effect was most pronounced with a mildly processed sample. In all three series, the glucose and sucrose reference solutions showed the greatest pH drop. In conclusion, all processing methods increased the fermentability of starch in human dental plaque in vivo. Thus, the more severe the processing conditions the more prominent the pH falls. The pH drop in plaque in vivo correlated (r = 0.96 in Series 1 and r = 0.92 in Series 2) with the rate of starch hydrolysis with alpha-amylase in vitro.

Biological Availability↗
PubMed1989

Quality evaluation of anterior restorations in private practice.

As part of a series of postgraduate courses in Cariology for dentists, a section designed to stimulate the interest in quality evaluation of fillings was included. Thus, 75 private practitioners were asked to evaluate a number of anterior restorations on their own patients. The method used was a modification of the California Dental Association (CDA) quality evaluation system. By use of a four-graded scale the following five properties were evaluated: (1) color of the filling, (2) color of the margin, (3) surface structure and anatomic form, (4) marginal integrity, and (5) caries. The criteria were related to practical-clinical measurements. Altogether 1147 fillings were assessed, most of them 2-4 years old (n = 949). The results showed that 25 different brands had been used, of which 4 composites constituted 68% of all fillings. With the exception for one composite material, no obvious difference in the quality evaluation between the materials was observed. Of the 2-4 year old fillings, approximately every fourth was rated as "not acceptable", i.e. with need for clinical treatment "soon" or "within reasonable time". Our impression was that the system used in this study is suitable for an assessment of the quality of anterior fillings in a private practice and that it should stimulate dentists to a quality thinking in dentistry in general.

Color↗
PubMed1988

Salivary glucose clearance, dry mouth and pH changes in dental plaque in man.

The aim was to study the effect of different salivary secretion rates on glucose clearance in saliva and on pH changes in dental plaque in man. Eighteen dental students, 21-33 yr old, participated. Dry mouth was induced by injecting methylscopolamine-nitrate submucosally in the labial sulcus. When dry mouth was established, two variables were measured at 1 h intervals, while the salivary flow was recovering: (1) secretion rate of resting and paraffin wax-stimulated whole saliva, and (2) glucose clearance in saliva after ingestion of a glucose tablet. pH changes in dental plaque were studied in 9 of the 18 subjects after a mouth rinse with 10% glucose at two separate occasions, once before and once after an injection of methylscopolamine-nitrate. Higher glucose concentration levels in saliva were found at low than at normal salivary secretion rate. After logarithmic transformation of the salivary glucose concentration values, a biphasic elimination pattern could be seen, with a steeper initial phase followed by a slower one. A critical value for the secretion rate with respect to the salivary glucose clearance time was found to be 0.14 ml/min for resting and 0.62 ml/min for stimulated whole saliva (mean values). The pH changes in dental plaque after the mouth rinse with glucose at extremely low secretion rate were significantly more pronounced than at normal flow rate. Thus, salivary secretion rate affects both the glucose clearance in saliva and the pH changes in dental plaque in man.

Adult↗
PubMed1988

Cereal fructans: in vitro and in vivo studies on availability in rats and humans.

The bioavailability of cereal fructans (fructooligosaccharides) was investigated both in vitro and in vivo. In vitro studies indicated very slow hydrolysis by human gastric juice and by homogenate of the intestinal mucosa (rat). After intubation of fructans into the stomachs of rats, the recovery of fructans in the small intestine and colon was approximately the same as that of an unabsorbed marker (polyethylene glycol), indicating no or very low disappearance of fructans in the small intestine. In vivo studies of the small intestine in rats showed that the rate of disappearance of fructans was lower than that of mannose, which is known to be absorbed through passive diffusion. In addition the cariogenic effect of cereal fructans was compared to that of glucose. Acid formation from low molecular-weight fructans was found in human dental plaque in vitro. A mouth rinse with unfractionated fructans, containing some quantities of sucrose, fructose and glucose, resulted in relatively low pH values in human plaque in vivo, even if the decrease in pH was somewhat less pronounced when compared with a mouth rinse with glucose.

Adult↗
PubMed1988

Caries predicting factors in adult patients participating in a dental health program.

The main purpose was to study various factors with respect to predicting dental caries. From a population of 442 employees at a shipyard, 68 patients with an average age of 56 yr were selected for the present investigation. They were examined once a year during a 2-yr period with respect to: 1) number of new caries lesions, and 2) a series of caries related factors, i.e., DMFS, oral hygiene status, dietary habits, numbers of Streptococcus mutans and lactobacilli in saliva, and secretion rate and buffer effect of saliva. The median values of all studied variables as found at the baseline examination were more favorable in the caries inactive (n = 30) than in the caries active group (n = 38), but only DMFS (P less than 0.001), dietary score (P less than 0.05), and number of S. mutans in saliva (P less than 0.05) differed significantly between the two groups. Number of S. mutans showed the highest sensitivity value, followed by dietary score. The main conclusion from this study is, however, that in spite of a relationship between caries activity and unfavorable values, especially for DMFS, dietary score, and number of S. mutans in saliva, it would have been difficult to predict the caries active patients on an individual level.

Adult↗
PubMed1988

Dental health in 16-year-old Swedish high school students in 1979 and 1984.

The aim of this investigation was to compare dietary habits, plaque and gingival scores, and the dental caries prevalence of 16-yr-olds in 1979 with those of individuals of the same age 5 yr later, i.e. in 1984. Students from two high schools in Kristianstad, Sweden, participated, 273 in 1979 and 228 in 1984. The same two dentists treated the children in 1979 and 1984. The students were asked to fill in a questionnaire concerning breakfast, school-lunch and between-meal habits. Information about the number of decayed (D) and filled (F) approximal tooth surfaces (Sa), DFSa, dental plaque and gingival bleeding scores was obtained from records at the Public Dental Clinics. The prevalence of caries lesions was also determined on 116 and 110 randomly selected pairs of bitewing radiographs from the participants in 1979 and 1984, respectively. The mean DSa was 0.9 in 1979 and 0.3 in 1984. The corresponding values for FSa were 3.6 and 1.5, respectively. In 1979, the DFSa was zero in 28% of the children, compared to 54% in 1984. All these differences were statistically significant (P less than 0.05). When analyzing the distribution of enamel and dentin caries lesions diagnosed on radiographs, the same tendency was found, i.e. that dental health had improved from 1979 to 1984. The dietary habits, however, were on the whole the same on both occasions, as judged from the answers given in the questionnaire. The distribution of plaque and gingival scores did not change during the 5-yr period.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1988

Secretion of glucose in human parotid saliva after carbohydrate intake.

The aims of the present investigation were, first, to follow the secretion of free glucose in parotid saliva in various subjects after a single oral intake of different carbohydrates, and second, to compare the salivary glucose concentration with the concentration in blood. Twenty healthy subjects, three women and 17 men, 20-35 yr of age, participated. They were asked not to eat or drink anything from 10 p.m. the night before the examination. 75 g of carbohydrate (glucose, fructose, or sucrose) dissolved in 300 ml water was ingested the next morning at 8 a.m. One experimental series with glucose was performed in triplicate in 10 of the subjects. Approximately 1.5 ml of citric acid-stimulated parotid saliva was collected before (0 min) and 15, 30, 45, 60, and 120 min after the intake. Salivary concentration of glucose was analyzed enzymatically. Most of the 0-min samples showed a variation in glucose concentration from 5 to 25 mumol/l. After the glucose, fructose, and sucrose intakes, the salivary glucose level increased about 2-4 times, especially in the 30-min samples. A large inter- as well as intra-individual variation was found both in the 0-min samples and in the samples collected after the different intakes. The correlation between the glucose concentration in saliva and blood was higher after than before the carbohydrate intakes.

Adult↗
PubMed1988

Effect of professional flossing with chlorhexidine gel on approximal caries in 12- to 15-year-old schoolchildren.

The aim of the investigation was to evaluate the effect of chlorhexidine gel treatment on caries development of approximal tooth surfaces and on salivary counts of Streptococcus mutans. 220 12-year-old schoolchildren, divided into three groups, participated: (1) chlorhexidine gel group (n = 72), (2) placebo gel group (n = 77), and (3) control group (n = 71). The study was carried out double blind with respect to the two gel groups. Group 1 was treated 4 times/year with 1% chlorhexidine gel and group 2 with a placebo gel. Approximately 1 ml of gel was applied interdentally by means of a flat dental floss. The control group did not receive any gel treatment or flossing. Number of S. mutans in the saliva was estimated on five occasions during the study with the spatula method. After 3 years, the mean approximal caries increment, expressed as new DFS, was 2.50 in the chlorhexidine gel group and 4.30 in the placebo gel group (p less than 0.05). The corresponding figure in the control group was 5.25 (p less than 0.001 when compared to group 1). 44% of the children in the chlorhexidine gel group and 32% in the placebo gel group did not develop any new approximal caries lesion during the 3-year observation period compared to 18% in the control group (group 1-3 p less than 0.001; group 2-3 p less than 0.05). The number of new approximal fillings (FS) was 0.24 in the chlorhexidine gel group, 0.75 in the placebo gel group and 0.82 in the control group (group 1-3 p less than 0.01; group 2-3 p less than 0.05). There was no statistically significant difference between the groups with respect to numbers of S. mutans in saliva. However, there were more individuals with low numbers of S. mutans in the chlorhexidine gel group at the final examination compared to the baseline level (p less than 0.05).

Adolescent↗
PubMed1987

Rate of plaque formation--some clinical and biochemical characteristics of "heavy" and "light" plaque formers.

The purpose of the present study was to give a clinical and biochemical characterization of two groups of individuals with different rates of plaque formation. From 133 individuals, 9 "heavy" and 10 "light" plaque formers were selected. The mean plaque index after 3 days of plaque accumulation, on buccal surfaces of premolars and first molars, was 2.6 for the "heavy" and 0.6 for the "light" plaque formers. The following variables were determined: periodontal status, DFS, dietary habits, salivary secretion rate and buffer effect, S. mutans and lactobacillus counts in saliva, salivary content of IgA, lactoferrin, lactoperoxidase and lysozyme, saliva-induced aggregation of certain oral streptococci, gel electrophoresis of saliva, amino acid composition of saliva and the acquired pellicle and retention depth of the dentogingival area. Comparing the two groups of plaque formers, statistically significant differences were found for the following three variables: parotid saliva-induced aggregation of a strain of S. sanguis, content of glutamic acid in the acquired pellicle and retention depth of the dentogingival area for maxillary premolars. Large variations for all studied variables were found, both within and between the groups. Several factors may be involved in plaque formation and none of the studied variables alone could explain the large difference in the amount of plaque formed after 3 days between the "heavy" and "light" plaque formers.

Adult↗