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D Bratthall

Publications and source records attributed to D Bratthall.

At least 19 recordsLinked to original sources
PubMed1996

Reasons for the caries decline: what do the experts believe?

The aim of this paper was to describe what experts of today believe are the main reasons explaining the caries decline seen in many westernized countries over the past 3 decades. We have collected the views of a number of international experts, trying to answer the specific question "What are the main reasons why 20-25-year-old persons have less caries nowadays, compared to 30 years ago?". A questionnaire was mailed to 55 experts with a number of thinkable explanations to be scored according to a predetermined scale. The 25 items were divided into main groups under the heading of diet, fluorides, plaque, saliva, dentist/dental materials and other factors. The experts were asked to think of a specific country or area, and also to specify whether the chosen area had water fluoridation or not. The main finding of our study, based on a 95% response rate, was that there is a very large variation in how the experts graded the impact of various possible factors. For the use of fluoride toothpaste, there was a clear agreement of a definite positive effect.

Adult↗
PubMed1996

The caries decline: a review of reviews.

The aim of this paper is to review publications discussing the declining prevalence of dental caries in the industrialized countries during the past decades, focusing on some main conferences addressing this issue. Has there been a real decline in the prevalence of dental caries? Several excellent papers and reviews have been published, and there is a general agreement that a marked reduction in caries prevalence has occurred among children in most of the developed countries in recent decades. This fact has stimulated much debate and attempts to identify the most likely explanations for this change. The conclusion made from this review is that the various authors believe that the use of fluoride in various forms has contributed most significantly to the decline in dental caries prevalence. A number of other factors must, however, also be taken into consideration, and such factors have been extensively discussed in the various publications.

Adolescent↗
PubMed1996

Restoring oral health. On the rise and fall of dental caries in Iceland.

During the last decade, a continuous decrease in dental caries has been observed among schoolchildren in Iceland. In this paper, various epidemiological studies have been reviewed and summarized to illustrate caries prevalence, and how it has changed during the last decades. Furthermore, an attempt has been made to describe some of the factors involved and their possible effects on caries disease. During this period, sugar consumption increased, especially in the form of sweets and soft drinks. At the same time, the import of toothpaste increased, and preventive measures such as fissure sealants and fluoride rinsing programs were intensified. Other factors likely to have had an impact were changes in treatment philosophy and increased personnel resources. There does not seem to be any single factor responsible for the onset of the caries decline. It rather looks as if this was a multifactorial effect due to a number of different preventive measures. During recent years, a change in treatment philosophy, the evident increase in fluoride toothpaste consumption, and possible changes in the oral microbial flora, together with the use of fluoride varnishes, sealants, and increased manpower, may explain the decline.

Adolescent↗
PubMed1996

Dental caries: intervened--interrupted--interpreted. Concluding remarks and cariography.

This paper comprizes a summarizing discussion for a set of 13 papers on the theme caries decline. The complexity of the issue is highlighted, and it is concluded that there is not one single factor explaining the changes observed. Actually, in one and the same population, different explanations may be relevant for different individuals, for different age groups, for different teeth and for different periods of time. A new model for understanding the interaction of various caries etiological factors is proposed. The model can illustrate how in one situation caries activity can increase (or decrease) due to one such factor, while in another situation different factors are more important. As it, in a graphic way, maps the interactions of relevant factors, the author has chosen to call it a cariogram, and the process of preparing such graphs, cariography.

Age Factors↗
PubMed1995

Intrafamilial similarity in immunoblot profiles of salivary immunoglobulin A antibody activity to oral streptococci.

Analysis of the salivary immunoglobulin A (IgA) antibody activity to antigens separated from oral streptococci was carried out on 49 individuals in 11 families. The aim of this study were to i) study the human salivary IgA activity within families to antigens separated from reference strains of Streptococcus mutans, Streptococcus sobrinus and Streptococcus parasanguis and ii) to search for potential differences in the salivary IgA activity to the streptococcal antigens several years apart. The immunoblot revealed similarity in saliva IgA response within the families. A majority of the bands, approximately 7 (median) for each extract was found in both child and parent. A few bands (approximately 3) were found in parents but not in children. Only one to two bands were found in children's saliva without a corresponding band in any of the parents. The antibody activity of saliva samples obtained several years apart was essentially unchanged, especially considering the total number of bands. Differences in the relative intensity of the bands could be seen, and a few bands appeared only in some immunoblots for a specific subject. For 3 of 4 children participating in the longitudinal study, more bands against mutans streptococci appeared with age.

Adolescent↗
PubMed1995

Effects of glass ionomer cement, resin-based pit and fissure sealant and HF applications on occlusal caries in a developing country field trial.

The aim of this community-oriented study was to evaluate different methods to prevent fissure caries. The following products and measures were tested: 1) glass ionomer cement (GIC) applied by dentist; 2) same material applied by short term (3 days) trained personnel (teachers); 3) application of a 0.5% HF solution three times; 4) an established autopolymerized resin based sealant (Delton). The study was performed in Bangkok, Thailand, a city in a developing country experiencing increasing caries prevalence. Children with at least three sound permanent molars from two age groups, 7-8 and 12-13-yr-olds respectively were chosen from very low to medium socioeconomic level families. 1264 children were systematically assigned to experiment or control groups based on school and DMFT. For the younger age group, the 2 yr mean DFS occlusal increment in the Control group was 0.66 surfaces. Significantly lower increments were observed in the GIC experimental group: 0.17 surfaces applied by the teachers and 0.32 applied by dentist, corresponding to 74% and 52% reductions, respectively. The mean increment in the HF group was 0.44 surfaces, a 33% reduction in relation to the Control group. For the 12-13-yr-olds, the mean occlusal surface DF increment was 0.70 surfaces in the Control group. Almost no occlusal increment was found in the Delton group, 0.05 DFS, a 93% reduction. In the GIC Dentist group, the DFS increment was 0.48 and in the Teacher group 0.56, corresponding to 31% and 20% reduction, respectively. A slight and nonsignificant increase of caries in relation to the Control group was observed in the HF group.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1995

Adding fluoride to sugar--a new avenue to reduce dental caries, or a "dead end"?

A study group was formed in 1989 by the Oral Health Program of WHO, Geneva, to consider the possibility of reducing dental caries by adding fluoride to sugar. Although a few promising clinical reports were available for review, the group found that information was too scarce for field trials to be recommended at this stage. Among the many items to be considered was what concentration of fluoride in sugar could reasonably be regarded as cariostatic. Thus, the committee decided to initiate studies to obtain further background information. Unlike fluoridated salt, the concept of fluoridated sugar does not involve trying to give the individual a certain daily amount of fluoride, since daily consumption varies considerably. Instead, the idea is to elaborate on recent fluoride research showing that low concentrations of fluoride may also be beneficial, particularly for remineralization, if present at the sites where caries occurs. This paper is an introduction to a set of papers describing the background for the project, attempting to define optimal concentrations for a clinical trial, and concluding that, although dental caries prevalence continues to decrease in industrialized countries, the potential for large increases remains in the huge populations in developing countries. All avenues must be searched for a system which optimizes preventive efficiency. However, the possible introduction of fluoridated sugar on the market is not related only to oral health. Safety aspects are of high priority, and several ethical, political, and economic factors must also be considered.(ABSTRACT TRUNCATED AT 250 WORDS)

Cariostatic Agents↗
PubMed1995

A study into the prevention of fissure caries using an antimicrobial varnish.

The aim of this study, performed in Bangkok, was to evaluate the possibility of reducing fissure caries development using an antimicrobial varnish, Cervitec. Children aged 7-8 years and 12-13 years, 251 in each age group, with at least 2 sound contra-lateral permanent molars, were selected. A split mouth method was used with one test and one control tooth within the same jaw. At baseline and after two years all children were investigated for DMFS and DMFT. In addition, the size of any cavities was estimated. From 200 children, plaque samples of test and control occlusal surfaces were collected at baseline and after one year and processed to estimate the number of mutans streptococci. Mutans streptococci in saliva were estimated by the Strip mutans method. Cervitec varnish, containing 1 per cent chlorhexidine and thymol was applied at baseline, after 3-4 and after 8-9 months. The results showed that: Cervitec varnish reduced fissure caries development significantly; the levels of salivary mutans streptococci at baseline were significantly correlated with caries status at baseline and with total caries increment over the two-year period; caries development in a fissure was significantly correlated to the level of plaque mutans streptococci at that same site; three months after the last varnish application, a certain reduction of mutans streptococci in plaque could be seen in the test teeth; comparing the size of the lesions, more large cavities were found in the untreated teeth. It is concluded that varnishes should be considered as further options for prevention of fissure caries, possibly in more individualised programmes or in combination with already established methods.

Adolescent↗
PubMed1994

Immunoglobulin A antibodies to mutans streptococci in human saliva and serum comparing fresh and subcultivated strains and activity in repeated saliva samples.

The aims of this study were i) to characterize and compare the sodium dodecyl sulfate-polyacrylamide gel electrophoresis protein patterns of reference Streptococcus mutans and Streptococcus sobrinus strains, subcultivated for years, with fresh isolates of the same serotype; ii) to study possible differences between the human salivary immunoglobulin A (IgA) activity to reference strains and to fresh bacterial isolates of the saliva donors; iii) to examine for potential differences in the salivary IgA activity to the streptococcal antigens during 1 week; and iv) to map, in the same individuals, the serum IgA activity against the selected bacteria. S. mutans reference and fresh isolated strains showed a similar protein pattern with few exceptions. The immunoblot also revealed similarity in saliva IgA response, with only one subject's saliva displaying clearly one band's difference. For S. sobrinus a larger discrepancy was seen. The antibody activity during the one week interval was essentially unchanged. When incubated with serum, a different immunoblot profile was seen compared with saliva, although most bands revealed by saliva were also displayed by serum.

Adult↗
PubMed1994

Mutans streptococci in a Thai population: relation to caries and changes in prevalence after application of fissure sealants.

The aims of this study were to evaluate the level of mutans streptococci in two groups of Thai (Bangkok) children; to relate the findings to caries prevalence and to the caries increment over 2 years, and to study whether different sealant and fluoride programmes affected levels of mutans streptococci over a 2-year period. The baseline survey comprised 1,114 children aged 12 years. For the sealant project, a minimum of three caries-free permanent molars was required; 752 children aged 12-13 and 512 children aged 7-8 years were distributed into five groups: control group, Delton fissure sealant group, glass ionomer fissure sealant applied by dentist (GIC-dentist group) or by school teachers given a 3-day course (GIC-teacher group), and an HF group (0.5% HF solution applied 3 times). The WHO standard criteria were used to record caries. Prevalence of mutans streptococci was estimated using the Strip mutans test. Mean DMFT (n = 1,114) of 12-years-olds was 2.96; 17% had Strip mutans class 0 (low level), 32% class 1, 33% class 2 and 18% class 3 (the corresponding mean DFT +/- SD for each mutans streptococci class was 1.84 +/- 2.33, 2.23 +/- 2.14, 3.18 +/- 2.75, and 3.59 +/- 3.01 respectively). For the 7- to 8-year-olds (n = 512), mean df teeth at baseline was 5.36 (d = 5.19; f = 0.17); 5% had Strip mutans class 0, 17% class 1, 33% class 2 and 45% class 3 (the corresponding mean df teeth was 3.19 +/- 2.5, 4.13 +/- 2.84, 4.89 +/- 2.94 and 6.39 +/- 3.16 respectively).(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1992

Immunoglobulin A antibody activity to mutans streptococci in parotid, submandibular and whole saliva.

Antigen extracts of 9 strains of Streptococcus mutans, Streptococcus sobrinus, Streptococcus salivarius and Streptococcus mitis were separated in acrylamide gels by electrophoresis. Strains of the same genotype of mutans streptococci were found to have virtually identical sodium dodecyl sulfate-polyacrylamide gel electrophoresis patterns but differed clearly from other genotypes of mutans or with the reference strains S. salivarius and S. mitis. Immunoglobulin A (IgA) antibody activity to antigens of S. mutans, S. sobrinus and S. mitis in the parotid, submandibular and whole saliva of 12 people was detected by Western blotting. IgA antibodies reacted with several of the antigens, and the reaction pattern was unique for each of the individuals. To certain antigens, all the salivas blotted bands if both clear and questionable bands were counted. Significantly more blotted bands were revealed with antigens from S. mutans than S. sobrinus. The results of the 3 different salivas of the same individual had a high degree of resemblance but in a few individuals, more blotted bands were obtained with parotid saliva to S. mutans and S. sobrinus antigens.

Adult↗
PubMed1992

Caries, views and perspectives.

This paper describes some advances in caries research in the last century. A tremendous body of knowledge about the disease as well as several possibilities for caries prevention and treatment have been obtained. This knowledge is not used by people in developing countries and certain obstacles for implementation of the procedures under such conditions are identified. Research aimed at finding practical means and methods that can help prevent caries and other oral diseases for the majority of the world's population must be intensified.

Dental Caries↗
PubMed1992

Prevalence of mutans streptococci and dental caries in Pakistani children.

The caries status of two hundred and eighteen 12 year old school children from four schools of Karachi and Lahore was determined through a WHO pathfinder survey. In addition, the levels of mutans streptococci in the sample were estimated in order to define the proportion of children with high and low mutans levels. A mean DMFT of 1.82 (1.67-0.03-0.12), for decayed and filled teeth respectively; 42% were caries free. Four mutans streptococci; 22% had mutans class 0, 22% class 1, 31% class 2 and 25% class 3. The mean DMFT was respectively, 1.0 + 1.23, 0.98 + 1.52, 2.03 + 2.36 and 3.04 + 3.08. The difference was statistically significant. Twenty four children had 5 or more DMF all except two of them, belonging to mutans classes 2 or 3.

Child↗
PubMed1992

WHO pathfinder caries survey in Beijing extended with data for prevalence of mutans streptococci.

A pathfinder caries survey was carried out in Beijing, People's Republic of China, using WHO standard methodologies, in order to estimate the trend by comparing the results with the 1981 caries survey, performed in the same area. Simultaneously, the levels of mutans streptococci in the group were estimated in order to define the proportion of children with high and low mutans levels. Twelve-year-old children were randomly selected from schools in five districts within the city limits. Examinations for caries were performed according to 'WHO Oral Health Surveys' by two calibrated examiners. A total of 178 children were examined for caries and 156 of them were randomly selected for saliva sampling of mutans streptococci, using the 'Strip mutans' method. The number of colonies adhering to the strips were compared with a chart, supplied by the manufacturer, and given a score between 0 and 3, indicating low to very high saliva mutans counts, respectively. The results showed a mean DMFT of 1.87 (1.61-0.06-0.20, for decayed, missing and filled teeth respectively); 66.3 per cent of the children were affected. Fourteen per cent had mutans class 0, 28 per cent class 1, 35 per cent class 2 and 23 per cent class 3. The mean DFT, for each mutans class was 0.82, 1.48, 2.09 and 2.69, respectively. The differences were statistically significant (P = 0.0015). In the lowest mutans class, 50 per cent had caries and the mean number of teeth requiring conservative care was 0.68. For the high mutans group, the corresponding values were 72 per cent and 2.11 teeth.(ABSTRACT TRUNCATED AT 250 WORDS)

Child↗
PubMed1991

Intraindividual variations in counts of mutans streptococci measured by "Strip mutans" method.

Intraindividual variations in the mutans streptococci measured by Strip mutans, in a 1-day and a 5-day period, as well as the effect of toothbrushing, were investigated. 30 subjects participated, and their levels of salivary mutans were estimated by a scale containing four steps. With the exception of three comparisons, time intervals of different lengths did not cause a deviation of more than one step. Comparisons made before and after toothbrushing yielded the same score in 22 cases, whereas two subjects showed a discrepancy of two steps. Clearly, in a short-term perspective, variations can certainly be found, but more pronounced discrepancies are rare.

Adult↗
PubMed1991

Mutans streptococci -dental, oral and global aspects.

The evaluation of the levels of mutans streptococci have been used for many years in some countries, in clinical work to monitor patients during treatment of dental caries, based on the observations that teeth, and patients, with elevated levels of mutans streptococci are at higher risk for caries. Other studies have focussed on attempts to select high caries risk groups based on salivary levels. Several methods to estimate the bacteria have been developed, among them being the "Spatula method" and the more recent "Strip mutans" method. Both methods are based on observations made in studies aimed at determining factors of importance for the transfer of these bacteria between persons. This paper gives a background to saliva sampling for mutans streptococci and describes some studies that have evaluated the role of these bacteria for caries. Such background information is important for the correct use of bacterial tests in the clinic and for interpretation of the results.

Dental Caries↗