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K G König

Publications and source records attributed to K G König.

At least 19 recordsLinked to original sources
PubMed2004

Caries prevention programs for groups: out of fashion or up to date?

After a caries decline of about 80% in children in Western Europe and other industrialized countries, there should be critical debate about the best way for future caries prevention. Multiple fluoride use played an important role in caries reductions achieved in the 1980s and 1990s, but it also resulted in a polarization of lesion distribution in young people: the majority consists of low-caries or even lesion-free individuals, while a minority is a so-called high caries risk group which seems not to be open to preventive programs. Recent studies indicate that frequent fluoride applications (>6 times/year) in conjunction with effective plaque removal can be a successful approach for effective future caries prevention in high caries risk groups. Health promotion programs that are merely educational and do not provide fluoride do not seem to be effective. Alternatively, preventive measures could be performed at home or in a private practice, but only minimal compliance is reached in high risk groups compared with out-reaching group programs. Thus, group programs are instrumental in providing effective and efficient caries-preventive measures in children. The more expensive time of a dental practice team should be limited to procedures where costly equipment is needed (professional tooth cleaning, sealants, etc.). For efficient caries prevention, measures formerly targeted specifically at either populations, groups, or individuals should be remodeled and aimed to interact in order to achieve optimal oral health in children at a reasonable cost.

Cariostatic Agents↗
PubMed2002

[New recommendations concerning the fluoride content of toddler toothpaste - consequences for systemic application of fluoride].

A group of experts from 4 European countries who gathered at a convention at Basel in November 1998, arrived at the recommendation to increase the fluoride (= F) content of toddler toothpastes from 250 ppm to 500 ppm. It was recommended to make parents brush the children's teeth with a pea-size piece of this toothpaste once a day, starting when the first deciduous teeth were erupting. Routine application of F-tablets would no longer be routinely prescribed, but restricted to individual indications in special high caries risk cases. This recommendation did not consider previous ones and was based exclusively on new scientific, mainly epidemiological evidence. In April 2000 the recommendation was officially issued by the German scientific dental association DGZMK.A careful case-control study resulted in the analysis of the risk to develop mottling of enamel under the influence of fluoridated water (1 ppm F) and fluoride toothpaste (1000 ppm F) when used in early childhood. It was found that excessive use of the fluoride toothpaste doubled the fluorosis risk, whereas when fluoride supplements (tablets, drops) were given the risk was about 20 times higher than without a fluoride supplement. Experiments in Germany and the Netherlands had shown that remineralisation of enamel under influence of 500 ppm F is achieved much more quickly than under application of 250 ppm F. A panel of WHO experts came to the conclusion that there was no evidence for the effectiveness of toothpastes containing less than 500 ppm. Statistics from the Netherlands have shown that the amount of fluoride tablets sold there is barely sufficient for the use by a quarter of all children 0 to 4 years old. In contrast to this low level of acceptance of fluoride tablets, fluoride toothpastes is widely accepted. It is their extensive use which explains the marked improvement of dentitions among the youth in this country during the last 20 years; the influence of topical fluoride gels, varnishes and other preventive measures was much less, and a reduction of sugar consumption (by the way less than 10 % of what it was in 1970) seems to have been the least important factor. The new recommendations based on topical rather than systemic fluoride application are better for preventive, toxicological, psychological and didactic reasons and should be implemented as soon as possible.

Administration, Oral↗
PubMed2000

Diet and oral health.

This review paper looks at the effects of diet on oral health and is concerned mainly with the effects of localised attacks on the dental hard tissues. In analysing the epidemiological evidence, the paper draws distinctions between the rates of diseases entities in developed and developing countries. The author concludes that oral health risks do not necessitate dietary recommendations in addition to, or other than, those required for maintenance of general health. The paper indicates an increasing need for evidence-based, individual tailor-made counselling and for specific programmes directed towards defined, high-risk groups or populations whose oral health problems have been carefully studied and identified.

Beverages↗
PubMed1999

[Dental caries prevalence in youth from the Hague. Have the differences in dental health between social groups closed?].

In 1998 a dental survey amongst 6- and 12-year-old schoolchildren in the Hague was carried out. The 1998-survey showed differences in caries experience between SES groups that had increased in the period 1989-1998. The decline in caries experience among 6-year-old children of low SES groups had come to an end after 1983, whereas among 12-year-old children the decrease in mean DMFS values had stopped in the early nineties. However, the survey showed that during 1989-1998, the percentages of caries-free children in medium and high SES groups continued to rise. Of the medium SES 6- and 12-year-old children, In 1998, the percentage of caries-free 6- and 12-year-old children in medium SES group were 79 and 87, respectively. The comparable results in the high SES group were 87 (6-yr-olds) and 93 (12-yr-olds).

Age Distribution↗
PubMed1998

Effect of 6-monthly applications of chlorhexidine varnish on incidence of occlusal caries in permanent molars: a 3-year study.

OBJECTIVES: The aim of this study was to assess the effect of a chlorhexidine varnish on occlusal caries incidence when applied 6-monthly into the fissures of erupting and freshly erupted permanent molars. METHODS: In a double-blind clinical trial, 332 children aged 5/6 and 11/12 years attending a Child Dental Health Centre were randomly assigned to a control and an experimental group. Criteria for inclusion in the study were that all first permanent molars in 5-6-year-olds and all second permanent molars in 11-12-year-olds either had recently erupted, or were in a stage of eruption, or would erupt within half a year. At baseline, counts of dmfs/DMFS and mutans streptococci in saliva were recorded. During a maximum of 3 years, every 6 months the occlusal surfaces of molars in the experimental group received a 40% chlorhexidine varnish application, whereas those in the control group received a placebo varnish application. RESULTS: Data of 316 children were analysed and ANOVA showed no significant occlusal caries reduction in this sample of Dutch 5/6- and 11/12-year-old children. After stratification into low and high caries risk groups, a statistically significant caries-reducing effect on occlusal caries in permanent molars was found in the group of children with > or = 10(6) mutans streptococci per ml saliva (P < 0.05). CONCLUSION: Six-monthly application of chlorhexidine varnish has no caries-reducing effect on occlusal caries in recently erupted permanent molars in a population with low caries prevalence.

Analysis of Variance↗
PubMed1998

Time trends in caries experience of 6- and 12-year-old children of different socioeconomic status in The Hague.

The caries experience among 6- and 12-year-old children in the The Netherlands from the mid seventies showed a continued decreasing trend. A halt in the decline of caries experience of the primary dentition of 6-year-olds occurred after 1983, whereas among 12-year-old children the decrease in mean DMFS values continued in the period 1980-1989. The 1996 survey in The Hague showed that the decline in caries in 12-year-old native children of low socioeconomic status (SES) has come to an end (average DMFT of 1.1). However, in medium- and high-SES groups, the percentages of caries-free children have continued to rise. Of the medium-SES 6- and 12-year-old children, 79 and 89% were caries-free, respectively; in the high-SES children the respective figures were 84 and 86%. A DMFT of 0.3 in 12-year-olds of medium and high SES was found, the general value was 0.7 and 74% with zero caries experience.

Analysis of Variance↗
PubMed1997

Dental fluorosis and the use of a high fluoride-containing trona tenderizer (magadi).

It has recently been suggested that magadi, a high-fluoride trona, which is added in cooking to tenderize certain vegetables and beans in two villages in Tanzania, significantly contributed to the prevalence and severity of dental fluorosis. This report aims to substantiate the significance of magadi as a determinant of dental fluorosis. Eighteen villages in four geographical areas (districts) with water supplies containing 0.2 to 0.8 mg/L of fluoride were selected. All schoolchildren aged 12 to 17 years (n = 1566) who had been born and raised in these villages were examined for dental fluorosis according to the Thylstrup-Fejerskov Index. Dietary history was recorded. The fluoride content of magadi samples was determined and the urinary fluoride excretion of pre-schoolchildren was assessed. The prevalence of dental fluorosis in nine coastal villages where tea and seafish were regularly consumed ranged from 7% to 46%. Severe (pitting) dental fluorosis was rarely seen. The low fluorosis levels observed in non-magadi consuming communities in coastal villages indicate that a fluoride content of up to 0.8 mg/L in drinking water is acceptable under the prevailing conditions of temperature and diet. In contrast, the prevalence of dental fluorosis in nine villages located inland at 1500 m altitude, where fluoride-containing magadi was consumed, ranged from 53% to 100%, and severe (pitting) fluorosis was highly prevalent, ranging from 18% to 97%. The village with the highest fluoride content in the magadi samples collected showed the highest level of fluorosis. The urinary fluoride excretion of pre-schoolchildren from different villages corresponded with the level of fluorosis and the fluoride content in the magadi samples of the respective villages. Data on dental fluorosis from the magadi-consuming communities provide strong evidence that consumption of magadi was the major determinant of the observed high prevalence and severity of fluorosis in inland villages at 1500 m altitude.

Adolescent↗
PubMed1997

Two types of intraoral distribution of fluorotic enamel.

Different distributions of fluorotic dental enamel within the dentition have been described in the literature. This report describes two patterns of intraoral distribution. In nine Tanzanian low fluorosis communities with a prevalence of pitting fluorosis of less than 2% and in five moderate fluorosis communities with a prevalence of pitting fluorosis of 16-59%, incisors and first molars were the least affected teeth. In four high fluorosis communities with a prevalence of pitting fluorosis of 86-97%, maxillary incisors exhibited lower Thylstrup-Fejerskov Index values than the maxillary canines, premolars and molars. The mandibular teeth exhibited increasing Thylstrup-Fejerskov Index values from the anterior to the posterior region. The curves presenting the intraoral distribution of the severity of dental fluorosis corresponded with the curve presenting the completion time of primary enamel formation of the various tooth types, with the exception of the first molars in high fluorosis communities. The similarity of the curves suggests that the later in life enamel is completed, the higher is the severity of dental fluorosis. This relation seems to be explained by the prevailing feeding and dietary habits, which result in minimal intake of fluoride in the first 18 months of life during breastfeeding, followed by increasing fluoride ingestion in the following years through consumption of tea, seafish and F-containing magadi salt.

Adolescent↗
PubMed1997

[Trends in dental caries prevalence amongst schoolchildren in the Hague. A comparison with the results from a survey in 1996 and previous years].

Starting in 1969, periodic cross-sectional examinations of schoolchildren have been carried out in the city of The Hague (the Netherlands). The results of 1996 show that no further change in caries prevalence has taken place in 5- and 7-year-old Dutch children of low, medium and high SES. In 11-year-old children of medium and high SES a further decrease in caries prevalence could be observed in 1996. Between 1989 and 1996 a significant caries decrease in the deciduous dentition was found amongst 5-year-old children from Turkey and Morocco. No improvement of dental health in 7-year-olds was found. Since 1989 an increase in percentages of caries-free 11-year-olds from Turkey took place whereas this percentage in children from Morocco tended to stabilize (26 and 29% respectively in 1989 and 1996).

Child↗
PubMed1995

Nutritional role of sugars in oral health.

The dental risk of dietary sugars is dependent mainly on the frequency of intake, but the prevalence of caries in a population is strongly modified by other dietary, social, and behavioral factors independent from intake of sugars. Regarding dietary factors, it must be remembered that hidden sugars in fruit as well as polysaccharides are cariogenic. The most important of the other factors is regular tooth brushing, which results in the removal of the bacterial plaque that causes caries and periodontal diseases and makes fluoride (which is contained in every advanced toothpaste) available for maintenance of the hard dental tissues and for remineralization wherever demineralization has occurred. This explains why in most highly developed countries caries prevalence has decreased markedly during the past 20 y although consumption of sugars remained high.

Dental Caries↗
PubMed1995

[Caries and heredity].

Although host genes play a certain role, the development of carious lesions is determined predominantly by local influences in the oral cavity, especially by microbial plaque and dietary carbohydrates as substrate for acidogenic bacteria. How strong or weak the influence of the hereditary component on caries really is, has been the subject of discussions for the last decades. The geneticist Professor Sofear is optimistic about prospects to decrease the caries risk by manipulation of genes. However, more detailed analysis of known facts shows that the majority of genetic differences is caused by indirectly operating mechanisms. Furthermore, these genetic factors can be overruled by local protective and compensating influences.

Bacteria↗
PubMed1995

[Relationship between nutrition and dental caries in a scientific perspective].

The consumption of sugars is supposed to be one of the main etiological factors of dental caries. However, in epidemiological studies only a faint relationship is found between nutrition and caries. One reason is the preventive effect of fluoride in modern industrialized countries. In this article attention is paid to factors which can modify the harmful effect of sugars in foods and allied products: the composition and consistency of the product, the way the product is consumed, environmental factors in the mouth such as composition of saliva and plaque, and local availability of fluoride. Results are presented of an epidemiological study into the relationship between consumption of sweet snacks and caries experience of primary school children.

Cariostatic Agents↗
PubMed1995

[Prescription of antibiotics for the prevention of bacterial endocarditis by dentists in the Netherlands].

In 1993 a representative sample of dental practitioners in the Netherlands was questioned on the use of antibiotics for the prevention of endocarditis in the previous year. Most of the responding dentists (67%) reported prescription of antibiotics for patients at risk. Some of them prescribed an antibiotic regimen that differed from the guidelines drawn up by the Dutch Heart Foundation. In 1992 only 47% of the responding dentists prescribed antibiotics for the prevention of endocarditis entirely according to these guidelines.

Anti-Bacterial Agents↗
PubMed1995

[Prescription of antibiotics for periodontitis patients by dental practitioners in the Netherlands].

In 1993 a representative sample of dentists in the Netherlands was questioned on the use of antibiotics in the treatment of periodontitis. It was found dat 50% of the general practitioners had a positive attitude, 15% a negative one and 35% had an indifferent attitude towards the use of antibiotics in periodontal treatment. Almost 40% of them indicated the prescription of antibiotics for periodontal reasons in the previous year. Most of the dentists (71%) prescribed a combination of metronidazole and amoxicillin. The average prescription frequency in 1992 was 18 times. The prescription frequency and the choice of a combination of metronidazole and a broad spectrum penicillin in the treatment of periodontitis is discussed, emphasizing the importance of the traditional mechanical therapy, the disturbance of the colonization resistance by means of antibiotics and the worldwide concern about the usage of antibiotics.

Amoxicillin↗
PubMed1994

Comparison of two indices of dental fluorosis in low, moderate and high fluorosis Tanzanian populations.

This study aimed at comparing the Thylstrup-Fejerskov index (TFI) and the Dean's Index (DI) which were applied on three communities with different severity of dental fluorosis. A total of 1565 children aged between 11 and 18 yr with a mean age of 14.7 were examined for dental fluorosis with the TFI and 1155 of these children were also examined with the DI. The measurement error for the TFI was 0.50 (10 scale point) compared to 0.53 for DI (6 scale point). The Kappa values and the measurement-remeasurement correlation appeared to be better for the TFI. No difficulties were encountered in applying the TFI in contrast to the DI, which caused uncertainties in assessing the "questionable" and "very mild" scores, and this may explain the relatively better reproducibility of the TFI. The correspondence between both indices was determined. TFI 0 corresponded well with DI 0. The conversion values for TFI 1, 2, 3 and 4 into DI scores were 0.3, 0.8, 1.4 and 2.4 respectively. The TFI 5-9 corresponded with DI score 4. TFI could discriminate the severe forms of dental fluorosis which were categorized in Dean's highest score 4. TFI was able to reveal more dental fluorosis than DI in communities with minor and moderate dental fluorosis. In the community with severe dental fluorosis where more than 85% of all teeth exhibited a DI > or = 1, both indices revealed a comparable prevalence of dental fluorosis. The TFI is considered a near ideal instrument.

Adolescent↗