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Biomedical subjects

K Pienihäkkinen

Publications and source records attributed to K Pienihäkkinen.

At least 19 recordsLinked to original sources
PubMed2003

Frequent exposure to invasive medical care in early childhood and operative dental treatment associated with dental apprehension of children at 9 years of age.

AIM: This was to study prospectively a cohort of children as to whether behaviour at a 3-year examination, exposure to medical care and operative dental treatment are associated with each other, and with the level of dental apprehension at 9 years of age. METHODS: Data were collected at three subsequent dental examinations of 126 children (67 boys, 59 girls). Cooperation, general health condition and operative dental treatment during the preceding 3 years were obtained at dental examinations with 3-year intervals, i.e. at 3, 6 and 9 years of age. Children's dental apprehension was assessed at the age of 9 years. The data were analysed using an ordinal logistic regression model. RESULTS: Dental apprehension at 9 years of age was associated with frequent exposure to invasive medical care (p<0.001) and past experience of operative dental care (p<0.002), but not with cooperation at 3 years of age (p=0.124). CONCLUSION: Frequent invasive medical care in early childhood and operative dental treatment, tooth extractions in particular, are associated with dental apprehension at 9 years of age.

Case-Control Studies↗
PubMed2000

Salivary buffer effect in relation to late pregnancy and postpartum.

We studied the salivary pH, buffer effect (BE), and flow rates of unstimulated and paraffin-stimulated saliva of 8 women in their late pregnancy and postpartum. Salivary samples were collected about 1 month prior to and about 2 months after delivery. In non-pregnant control women, two paraffin-stimulated salivary samples were collected 1 month apart. The salivary BE increased significantly from late pregnancy to postpartum without exception. The increase was 2.04 +/- 1.17 pH units (P < 0.001) on average. The BE increased from 4.79 +/- 1.64 (final pH) to 6.82 +/- 1.01 (final pH). This change was not due to variation in salivary flow rates, since both unstimulated and paraffin-stimulated flow rates remained unchanged. In control women the difference between the 2 BE measurements was only 0.13 +/- 0.47 pH units on average. We concluded that women with high postpartum BE values may have moderate or even low BE values in late pregnancy. In control women, individual variation was found to be low in all variables studied.

Adult↗
PubMed2000

Sealants and xylitol chewing gum are equal in caries prevention.

Sealants and xylitol have been demonstrated to prevent dental decay, but their effect has never been compared in the same study. Regular use of xylitol chewing gum during 2 or 3 school years was compared with application of occlusal sealants in a randomized study. The reliability of the clinical observations was controlled by examining the presence of dental decay in the same teeth from bitewing radiographs in a blind study. After 5 years, no statistically significant differences between the sealant and xylitol groups were found. The results were in line with the results from separate studies with sealants or xylitol. There were no great differences between the costs of the measures. The selection between the compared preventive measures has to be made on the basis of practical aspects such as caries occurrence, availability of personnel and other resources, opportunity costs, cooperation with schools, and other local conditions.

Analysis of Variance↗
PubMed2000

Influence of maternal xylitol consumption on acquisition of mutans streptococci by infants.

Xylitol is effective as a non-cariogenic sugar substitute. Habitual xylitol consumption appears to select for mutans streptococci (MS) with impaired adhesion properties, i.e., they shed easily to saliva from plaque. One hundred sixty-nine mother-child pairs participated in a two-year study exploring whether the mothers' xylitol consumption could be used to prevent mother-child transmission of mutans streptococci. All mothers showed high salivary levels of mutans streptococci during pregnancy. The mothers in the xylitol group (n = 106) were requested to chew xylitol-sweetened gum (65% w/w) at least 2 or 3 times a day, starting three months after delivery. In the two control groups, the mothers received either chlorhexidine (n = 30) or fluoride (n = 33) varnish treatments at 6, 12, and 18 months after delivery. The children did not chew gum or receive varnish treatments. MS were assessed from the mothers' saliva at half-year intervals and from the children's plaque at the one- and two-year examinations. The MS were cultured on Mitis salivarius agars containing bacitracin. The salivary MS levels of the mothers remained high and not significantly different among the three study groups throughout the study. At two years of age, 9.7% of the children in the xylitol, 28.6% in the chlorhexidine, and 48.5% in the fluoride varnish group showed a detectable level of MS. In conclusion, therefore, habitual xylitol consumption by mothers was associated with a statistically significant reduction of the probability of mother-child transmission of MS assessed at two years of age. The effect was superior to that obtained with either chlorhexidine or fluoride varnish treatments performed as single applications at six-month intervals.

Adult↗
PubMed2000

Occurrence of dental decay in children after maternal consumption of xylitol chewing gum, a follow-up from 0 to 5 years of age.

Studies have shown that prevention of mutans streptococci (MS) colonization in early childhood can lead to prevention of dental decay. In the microbiological part of the present study in Ylivieska, Finland, with 195 mothers with high salivary MS levels, regular maternal use of xylitol chewing gum resulted in a statistically significant reduction in MS colonization in their children's teeth at the age of 2 years compared with teeth in children whose mothers received fluoride or chlorhexidine varnish treatment. The children did not chew gum or receive varnish treatments. For the present study, the children were examined annually for caries occurrence by experienced clinicians who did not know whether the children were colonized with MS. Regardless of the maternal prevention group, the presence of MS colonization in children at the age of 2 years was significantly related to each child's age at the first caries attack in the primary dentition. In children at the age of 5 years, the dentinal caries (dmf) in the xylitol group was reduced by about 70% as compared with that in the fluoride or chlorhexidine group. We conclude that maternal use of xylitol chewing gum can prevent dental caries in their children by prohibiting the transmission of MS from mother to child.

Anti-Infective Agents, Local↗
PubMed1999

The effect of repeated sampling on paraffin-stimulated salivary flow rates in menopausal women.

Paraffin-stimulated whole-saliva samples of 12 post- and perimenopausal women were taken five times over a 7-week period. After 1 min of prestimulation, saliva was collected for 5 min under standardized conditions. Saliva was first collected on three consecutive days, and two additional samples were collected 6 and 7 weeks after the first. Salivary flow rates showed significant variation between samplings. The greatest difference appeared between the first and second collections. The increase in flow rates between these collections was significant (p = 0.003). The third successive collection also gave a significantly (p = 0.005) higher flow rate than the first. The 6-week and baseline samples were similar. The 7-week sample showed a significantly higher flow rate (p = 0.018) compared with the baseline value. These results stress the importance of standardization of sampling intervals when salivary flow rates are studied.

Analysis of Variance↗
PubMed1996

Assessment of single risk indicators in relation to caries increment in adolescents.

Base-line data on a series of risk indicators were related to 11-month caries increment in 181 subjects with a mean age of 13 years and 3 months. A caries increment equalling or exceeding one tooth surface was recorded in 21% of the subjects. The risk indicators consisted of past caries experience, white spot lesions, visible plaque and gingivitis, and six salivary tests: secretion rate, buffer effect, sucrase, mutans streptococci, lactobacilli, and Candida. Significant associations between caries increment and past caries experience (p = 0.002), white spot lesions (p = 0.01), lactobacilli (p = 0.02), Candida (p = 0.006), and sucrase (p = 0.02) were observed. The ensuing odds ratios were thus recorded: past caries experience, 3.6; white spot lesions, 2.9; salivary sucrase activity, 2.9; lactobacilli, 2.5; and Candida, 2.8.

Adolescent↗
PubMed1996

Multifactorial modeling for prediction of caries increment in adolescents.

The purpose of the study was to develop a multifactorial model for the prediction of 11-month caries increment in adolescents. The mean age of the subjects (n = 181) at the base-line examination was 13 years and 3 months. The risk indicators consisted of past caries experience, white spot lesions, visible plaque, gingivitis, salivary secretion rate, buffer effect, sucrase, mutans streptococci, lactobacilli, and Candida. The multifactorial modeling included all the above risk indicators, age, and gender and resulted in different models in boys and girls, indicating the difficulty of caries prediction in adolescents. When boys and girls were combined, the final model included past caries experience, Candida, and salivary sucrase. Although the accuracy of the model was slightly below the 80% level recommended for screening purposes, the results provide clinically valuable information. The risk of caries increases with an increasing number of positive tests within the model.

Adolescent↗
PubMed1995

Susceptibility of Streptococcus mutans and Streptococcus sobrinus to antimicrobial agents after short-term oral chlorhexidine treatments.

Effects of three different types of short-term applications (1-3 times during 1 week) of chlorhexidine (1 or 40%) on the susceptibility of 863 clinical isolates of Streptococcus mutans and 53 isolates of Streptococcus sobrinus from 58 subjects were studied. Chlorhexidine-resistant isolates were not found either before or after the treatment. The minimum inhibitory concentrations (MICs) to chlorhexidine of all isolates of S. mutans were < or = 1 microgram/ml, and of S. sobrinus < or = 2 micrograms/ml. S. mutans and S. sobrinus were also susceptible to ampicillin, penicillin, cefuroxime, and tetracycline. In conclusion, different short-term chlorhexidine regimens do not induce resistance in S. mutans or S. sobrinus and, furthermore, these species have so far retained their susceptibility to common antibiotics.

Ampicillin↗
PubMed1995

A simple method for monitoring mutans streptococci in young children.

The study assessed the practicability of the Dentocult-SM STRIP MUTANS test in children, using dental floss to transfer the dental plaque to the strip. The subjects were children of 2-3 yr (n = 365) and 5-6 yr (n = 398). The mutans streptococci count on the strip was found to be a good indicator of infection and was surprisingly accurate in the prediction of the 3-yr caries increment.

Chi-Square Distribution↗
PubMed1995

Comparison of the efficacy of 40% chlorhexidine varnish and 1% chlorhexidine-fluoride gel in decreasing the level of salivary mutans streptococci.

The aim of the study was to compare the efficacy of a 40% chlorhexidine (CHX) varnish (EC40, Certichem, Nijmegen, The Netherlands) with a 1% CHX-0.2% NaF gel in decreasing the level of salivary mutans streptococci (MS). The subjects were screened for a high level of MS using a Dentocult-SM strip method (Orion Diagnostica, Finland). In varnish groups with fluoride (VCHXF, n = 20) and without fluoride (VCHX, n = 19), the CHX varnish was applied on dry teeth using an ampoule and an anesthetic syringe with blunt needle, and removed after 15 min. In group VCHXF an additional 2.26% fluoride varnish (Duraphat, Woelm Pharma GmbH, Eschwege, Germany) was applied. The CHX-NaF gel treatment included the application of the gel with rubber cups and dental tape for 5 min on three occasions during a week in group GCHXF (n = 21). The level of MS (MSB agar) was significantly lower after 4 weeks than at baseline in VCHX (p < 0.001) and VCHXF (p < 0.05), but not after 12 weeks. In GCHXF a significant decrease (p = 0.001) was observed after 4 weeks only with the strip method. In VCHX and VCHXF the strip values for MS were still reduced after 12 weeks. In VCHX and GCHXF a small, although statistically significant, increase was observed in the total number of microorganisms after 4 and 12 weeks. Opinions on taste sensations associated with the treatments were generally negative, but least negative in the VCHXF group; fewer side effects were also reported in the VCHXF group.(ABSTRACT TRUNCATED AT 250 WORDS)

Administration, Topical↗
PubMed1994

Multifactorial modeling for root caries prediction: 3-year follow-up results.

The study was part of a series aiming at the development of caries tests. The initial material (n = 104, age range 47-79 yr, mean 62 yr) was reduced to 96, who were observed for 3 yr. During the follow-up four subjects died, all due to myocardial infarction, and four refused to participate. Thorough oral examinations were conducted at the baseline, 1- and 3-yr registrations; coronal and root surface caries were registered separately according to WHO classification. The tests included salivary mutans streptococci, lactobacilli, candida/yeasts, secretion rate, buffer effect and sucrase activity, and quantitation of visible plaque. The association between prospective root caries increment and several tests was significant. Multifactorial modeling resulted in the combination of Past Root Caries Experience (OR 12.8), Lactobacilli (OR 8.6) and Candida (OR 2.8). At screening, the criterion "two or three positive tests" of these yielded acceptable accuracy (77.1) and a relative risk of 3.3.

Aged↗
PubMed1993

Salivary flow rate, buffer effect, sodium, and amylase in adolescents: a longitudinal study.

The study aimed to provide information on salivary secretion rate, buffer effect, sodium, total protein, and amylase in adolescence. Paraffin-wax-stimulated saliva was collected annually in 69 initially 10-yr-olds and in 98 initially 15-yr-olds. During the 5-yr follow-up, the rate of flow increased in both sexes in the younger age group. In the older age group there was only a slight increase in the flow within the 2-yr follow-up. In both age groups, girls tended to have lower secretion than boys. In cross-sectional analyses, the rate of flow correlated positively with buffer effect and sodium, and negatively with proteins. These findings are in line with earlier observations. However, with age, the buffer effect did not parallel the flow. At the base-line examination the buffer effect was lower in the 15-yr-old than in the younger age group. In line with that, a decrease was found at the final examination in the initially 10-yr-olds. This decrease was stronger in girls than in boys. The observed change in the buffer effect was not related to a parallel change in the flow rate or total protein and amylase content of saliva. In girls the change was, however, associated with a small, but statistically significant drop in the salivary sodium level. The variation in the buffer effect increased from the age of 12 to 15, especially in girls. This effect could not be demonstrated for the other flow-rate-associated variables used to monitor the functioning of the salivary glands.

Adolescent↗
PubMed1992

Multifactorial modeling for root caries prediction.

The study was part of a series of investigations aiming at the development of diagnostic caries tests for screening of risk subjects. The material consisted of 100 adult subjects (mean 62 yr, range 47-79 yr), 50 of these under chronic medication. The series of tests included two chairside registrations, i.e. incipient demineralization of exposed root surfaces without cavitation (RD 1) and quantitation of visible plaque (VPT%), three microbiological tests for mutans streptococci, lactobacilli, and candida/yeasts and three tests on stimulated saliva, i.e. secretion rate, buffering capacity and sucrase activity. A thorough clinical examination was conducted at the baseline and 1-yr registration phases, caries being registered at a tooth surface level according to WHO recommendations separately for coronal and root caries. Considerably more root caries than coronal caries developed during the observation period. For coronal caries increment, the predictive value of any of the tests was not significant. For root caries, however, the association between several tests and prospective caries increment was significant. Subsequent multifactorial modeling yielded the highest predictive value to the combination of Past Root Caries Experience (OR 25.0, Visible Plaque (OR 4.2), Candida (OR 8.0) and Lactobacilli (OR 5.8). A positive finding of Past Root Caries (RDFS) or the combination of the other three tests (Can, LB, VPT%) as criteria for selection in screening for root caries produced good accuracy (84.0) and a relative risk of 5.5.

Aged↗
PubMed1992

[The assessment of the caries risk in young adults].

Several factors for caries prediction have been proved in a one-year follow-up study on 73 patients. The white-spot lesions have proved to be a good criteria for caries prediction in this population. These lesions could be combined with the microbiological tests Dentocult SM and Oricult N or with the determination of the buffer capacity (Dentobuff), which did not much improve the prediction.

Adult↗
PubMed1991

Effects of low-dose oral contraceptives on female whole saliva.

The composition and flow rate of paraffin-stimulated whole saliva were analysed in 22 women, of whom 11 used oral contraceptives and 11 did not. Ten men served as the controls. The salivary samples were collected during one month (oral contraceptive users and men), or during one menstrual cycle (non-users). The saliva analyses included flow rate, pH, buffer effect, sialic acid, thiocyanate, peroxidase, lysozyme, amylase, immunoglobulins A, G and M, total protein, mutans streptococci, lactobacilli, yeasts and total numbers of aerobic bacteria. The salivary buffer effect of oral contraceptive users was significantly (p less than 0.005) higher than that of non-users. All the other constituents showed intra- and interindividual variation in all groups, but with no apparent hormone-dependency.

Adult↗
PubMed1988

Salivary lactobacilli and yeasts in relation to caries increment. Annually repeated measurements versus a single determination.

The purpose was to compare annually repeated measurements with a single determination of salivary lactobacilli and yeasts in distinguishing subjects with high and low caries increments. The determinations were carried out using Dentocult and Oricult chair-side methods in connection with a 3-year oral health preventive program. The subjects were institutionalized Hungarian children (n = 257), ranging from six to eleven years of age. The data were analyzed by comparing the age-adjusted means of caries increment in subjects with positive and negative microbiological findings. In comparison with a single determination, two or three annual measurements of the tests proved to increase the ability to distinguish subjects with respect to the 3-year caries increment. The analysis of the repeated measurements providing longitudinal information of these microorganisms probably included the time factor required for development of caries.

Child↗