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Fine-scale specificity of cortical networks depends on inhibitory cell type and connectivity.

Excitatory cortical neurons form fine-scale networks of precisely interconnected neurons. Here we tested whether inhibitory cortical neurons in rat visual cortex might also be connected with fine-scale specificity. Using paired intracellular recordings and cross-correlation analyses of photostimulation-evoked synaptic currents, we found that fast-spiking interneurons preferentially connected to neighboring pyramids that provided them with reciprocal excitation. Furthermore, they shared common fine-scale excitatory input with neighboring pyramidal neurons only when the two cells were reciprocally connected, and not when there was no connection or a one-way, inhibitory-to-excitatory connection. Adapting inhibitory neurons shared little or no common input with neighboring pyramids, regardless of their direct connectivity. We conclude that inhibitory connections and also excitatory connections to inhibitory neurons can both be precise on a fine scale. Furthermore, fine-scale specificity depends on the type of inhibitory neuron and on direct connectivity between neighboring pyramidal-inhibitory neuron pairs.

Action Potentials↗

A study of the effectiveness of oral midazolam sedation for orthodontic extraction of permanent teeth in children: a prospective, randomised, controlled, crossover trial.

OBJECTIVES: To assess the safety, effectiveness and acceptability of o:ral midazolam sedation for orthodontic extraction of permanent teeth in children. DESIGN: A prospective, randomised, controlled, crossover trial. METHODS: A total of 26 children aged 10-16 (ASA I), referred for orthodontic extraction of premolar or canine teeth under sedation, were included in the study. Each child required two treatment sessions for the extraction of equivalent teeth on opposite sides of the mouth. Each subject was sedated with either ora midazolam (0.5 mg/kg) or nitrous oxide and oxygen (30%/70%) at the first visit and the alternative form at the second visit. At each visit two teeth were extracted, one upper and one lower. Heart rate, arterial oxygen saturation, respiration rate, sedation and behavioural scores were recorded every five minutes. Overall behaviour, patient acceptance and patient satisfaction were recorded at the end of treatment. RESULTS: Of the 26 children included in the study there were 12 males and 14 females. The mean age was 12.5 years. The mean heart rate and respiratory rate for both groups were similar and within acceptable clinical limits. The lowest mean arterial oxygen saturation levels for nitrous oxide and midazolam sedation were 97.7% and 95.0% respectively. Although midazolam caused greater oxygen desaturation, the range (91%-100%) was within safe limits for conscious sedation. The mean level of sedation was greater in the midazolam group compared with the nitrous oxide group and all but one case completed treatment. A total of 23 patients (88%) said they would be prepared to have ora midazolam sedation again and 17 (65%) actually preferred oral midazolam to nitrous oxide sedation. CONCLUSION: Oral midazolam (0.5mg/kg) appears to be a safe and acceptable form of sedation for 10-16 year old paediatric dental patients.

Administration, Oral↗

Relationship between enamel etch characteristics and resin-enamel bond strength.

OBJECTIVES: The aim of the study was to investigate the relationship between etch patterns produced on surface enamel by phosphoric acid and the corresponding bond strengths achieved. MATERIALS AND METHODS: Twenty-eight patients had the buccal surface of their teeth etched and replicated for examination under the scanning electron microscope, at the commencement of orthodontic treatment. Histometry was employed to assess the nature and quality of etch patterns using a four-point scale. Twenty of each tooth type (total of 240), were collected and A Company pre-adjusted orthodontic brackets, bonded using Transbond light-cured orthodontic adhesive according to the manufacturer's instructions and 24-hour bond strength testing was undertaken. The Adhesive Remnant Index (ARI) was recorded for the tooth and bracket surface for all specimens. RESULTS: The type of etch was not significantly affected by the side (left or right) of the mouth assessed (p = 0.532). Overall, there was no significant difference between etch types for upper and lower teeth (p = 0.218); however, there were significant differences between specific teeth in the upper and lower arch. The greatest amount of Type A etch (well-defined etched enamel prisms) was found on the lower incisors, yet in all cases this 'ideal' etch was found to occupy less than 5% of the etched buccal surface enamel. The greatest area of etched enamel surface was occupied by Type C (etched but enamel prisms not evident). The mean bond strength values varied significantly between different tooth types, with the lowest bond strength found on the upper first molar(6.5MPa) and the highest on the lower first molar (13.1 MPa). CONCLUSIONS: An ideal etch pattern is not essential in order to produce a strong bond.

Acid Etching, Dental↗

An investigation of paediatric dentists' attitudes towards parental accompaniment and behavioural management techniques in the UK.

OBJECTIVE: Good behavioural management techniques are essential for treating children. Recent research has investigated parental and paediatric attitudes towards various behavioural management techniques. However, in the UK, very little is known about paediatric attitudes towards such issues. Accordingly, the aim of this investigation was to conduct a survey in order to provide insight into the current thinking of paediatric dentists across the UK. STUDY DESIGN: A questionnaire was developed for this study on the basis of previous surveys investigating the attitudes of paediatric dentists towards the use of various behavioural management techniques in Australia and the USA. Areas covered in the questionnaire included: attitudes towards parental accompaniment; attitudes regarding parental expectations; and attitudes towards the use of various different child management techniques. The questionnaire was sent out to all registered members of the British Society of Paediatric Dentistry (n = 304). RESULTS: 245 responses (80.5%) were returned, of which 218 provided valid and useable information (72%). A majority of 80% of respondents supported parental accompaniment of the child during the course of treatment. Separate analysis of variance (ANOVA) procedures revealed significant differences between acceptability of parental accompaniment and the year in which dentists had qualified (P < 0.05). More recently qualified dentists were less accepting of parental accompaniment. Only a minority of dentists reported feeling pressured by parental expectations with regard to their child's treatment. However, an independent sample t-test revealed that male dentists experienced greater perceived conflict between dental and parental expectations, than female dentists (P < 0.05). In terms of specific behavioural management techniques, the most favoured was 'tell-show-do' with 87% of respondents citing this as their most commonly used method. Least acceptable were 'hand over mouth' techniques, followed closely by active restraint and papoose board. CONCLUSION: In general, paediatric dentists in the UK favoured less 'restraining' methods of behavioural management. There was widespread support for parental accompaniment in the dental operatory and a desire to work in participation with parents in order to facilitate the child's good behaviour and more effective dental treatment. Further studies comparing the effectiveness of various techniques used with regard to treatment time and clinical outcomes, are now required.

Adult↗

The long-term benefits of orthodontic treatment.

OBJECTIVE: This study aimed to evaluate post-treatment changes at least five years out of retention in a cohort of 100 consecutively started patients treated by a postgraduate student in a UK orthodontic department. DESIGN: Analysis of study models using recognised occlusal indices. Setting Patients initially treated at Newcastle Dental Hospital were recalled for record collection. MATERIALS AND METHODS: Study models and clinical photographs were taken for each patient attending for post-retention records. Weighted Peer Assessment Rating (PAR) Index and Index of Orthodontic Treatment Need (IOTN) scores were recorded for cases at the beginning, end and at least 5 years post-retention. Main outcome measures Post-treatment changes were evaluated using PAR Index and IOTN to evaluate extent and likelihood of change and to compare treatment modalities. RESULTS: Seventy-eight patients attended for post-retention records. Overall PAR reduction immediately post-treatment was 68.6% and at a mean of 6.5 years post-retention was 55.5%. Dual arch fixed appliance treatments achieved the greatest reduction in PAR score, and maintained the reduction beyond the retention period better than other treatment modalities. Eighty-four per cent of the cohort still had some demonstrable improvement after a mean of 6.5 years post-retention. There was a residual need for treatment in 8% of cases on aesthetic grounds and in 24% of cases on dental health grounds. CONCLUSIONS: Occlusal deterioration after orthodontic treatment is almost universal. Dual arch fixed appliance treatment provides the best post-treatment and post-retention result.

Cohort Studies↗

Attitudes to biopsy procedures in general dental practice.

AIM: To investigate biopsy procedures in general dental practice. OBJECTIVES: To assess the views and attitudes of: specialists on the dental specialist surgical registers; dentists in general practice (GDPs) and patients undergoing biopsy procedures. METHOD: Questionnaires were sent to 98 oral and maxillofacial surgeons and surgical dentists, 335 general dental practitioners and 220 patients attending the Oral Medicine Clinic at the Dental Hospital, Manchester. Participation rates were 68 (74%), 227 (72%), and 158 (76%) respectively. RESULTS: Specialists: 47 (70%) would discourage dental practitioners undertaking biopsies. Concerns were a lack of skills and delays in referral; 20 (30%) considered GDPs should be able to perform simple biopsies for benign lesions. Dentists: 33 (15%) reported they had performed oral biopsies in the last two years; 136 (60%) felt they should be competent to biopsy benign lesions. Their main concerns were lack of practical skills and the risk of diagnostic error. PATIENTS: 112 (65%) worried about their biopsy result, 67 (39%) would feel anxious if their dentist did the biopsy, although 40 (23%) were anxious when biopsied in the oral medicine clinic. CONCLUSIONS: Both specialists on the dental surgical registers and GDPs feel there is a need for further training in biopsy technique for GDPs and better advertised and accessible pathology support. The current fee for biopsies may need upward revision. A main concern of patients is fear of an adverse biopsy report. Whilst patients are satisfied with specialist management any concerns were an insufficient reason for biopsy of a benign lesion not being undertaken in general practice.

Adult↗

Clinical performance of a compomer and amalgam for the interproximal restoration of primary molars: a 24-month evaluation.

OBJECTIVES: To evaluate the clinical performance of a compomer material (Dyract) in comparison with dental amalgam (Contour) for management of proximal caries in primary molars in young children. SETTING: General dental practice, and a dental hospital paediatric clinic. METHOD: This was a prospective study. A split mouth design was used with identical pairs of minimal Class II cavities, of matched tooth type in the same dental arch, usually diagnosed with the use of bitewing radiographs. Seventy-eight pairs of restorations were completed of which 60 pairs were available for evaluation after 24 months. RESULTS: Comparable retention rates were observed for both Dyract and amalgam. The retention rates were high for both materials, with only four amalgam and two Dyract restorations failing over 24 months. Significantly better marginal integrity (P < 0.05) was observed for Dyract compared with amalgam with no significant differences between the two materials for recurrent caries, wear or surface texture. CONCLUSIONS: Dyract seemed to be a suitable alternative to amalgam for proximal restorations in primary molars of young children for use in general dental practice.

Child↗

Alteration of the horizontal mandibular condyle size associated with temporomandibular joint internal derangement in adult females.

OBJECTIVES: The purpose of this retrospective study was to analyse the relationship between horizontal size of the mandibular condyle and internal derangement (ID) of the temporomandibular joint (TMJ). METHODS: One hundred and thirty-nine joints in 88 women aged over 18 years were included in this study. The horizontal condylar size was measured in the antero-posterior and medio-lateral (ML) dimensions using axial magnetic resonance (MR) images. Radiological findings of ID were also assessed from MR imaging. RESULTS: The condyles in the joints with permanent disk displacement were smaller than those in joints without displacement in both dimensions (Fisher's protected least significant difference, P<0.05). There were statistically significant correlations between horizontal condylar size in the ML dimension and both disk morphology and radiological stage of ID (Spearman's correlation coefficient by rank, P<0.05). CONCLUSIONS: The results of this study suggest a possible relationship between horizontal condylar size and disk displacement. It is also suggested that the condyle becomes smaller in the ML dimension with advancement of ID.

Adult↗

Panoramic-based mandibular indices in relation to mandibular bone mineral density and skeletal status assessed by dual energy X-ray absorptiometry and quantitative ultrasound.

OBJECTIVES: The panoramic-based indices (Mandibular Cortical Index-MCI, the height of mandibular inferior cortex-IC (mm), Panoramic Mandibular Index-PMI, Mandibular Ratio-MR) were used to evaluate their diagnostic efficacy and to determine whether they correlate with bone mineral density (BMD (g/cm(2))) of the mandible and hip, and with ultrasound parameters of the calcaneus and hand phalanges in postmenopausal, edentulous women. METHODS: Basing on MCI women were divided into three subgroups differed in the appearance of the mandibular cortex (C1 n=6, C2 n=16, C3 n=8). BMD of the hip (neck-BMD, Ward's-BMD, trochanteric BMD) and mandible (m-BMD) were measured by dual-energy X-ray absorptiometry (DXA). Calcaneus using Achilles (Speed of Sound-SOS (m/s), Broadband Ultrasound Attenuation-BUA [dB/MHz], Stiffness Index-SI [%]) and hand phalanges (amplitude dependent speed of sound-Ad-SoS (m/s)) using DBM Sonic 1200 were assessed by Quantitative Ultrasound (QUS). RESULTS: There were no significant differences between subgroups in parameters measured except for significant differences in m-BMD (P<0.01). Only m-BMD correlated significantly with DXA (r=0.43-0.45, P<0.05) and QUS (r=0.36-0.55, P<0.05) measurements excluding correlations with calcaneal SOS and trochanteric BMD. The ability of the mandibular variables to discriminate between normal and osteopenic/osteoporotic cases was assessed by calculating: specificity (ranging from 31 to 81%), sensitivity (ranging from 21 to 93%), negative and positive predictive values (ranging from 47 to 83% and 40 to 79%, respectively). CONCLUSION: MCI is a simple three-graded classification of changes in the cortex but is not able to distinguish normal and osteopenic/osteoporotic postmenopausal edentulous women. The efficacy of the panoramic-based mandibular indices in diagnosing osteopenia/osteoporosis is low to moderate.

Absorptiometry, Photon↗

Association and linkage studies between bipolar affective disorder and the polymorphic CAG/CTG repeat loci ERDA1, SEF2-1B, MAB21L and KCNN3.

Several reports have suggested the presence of anticipation in bipolar affective disorder (BPAD). In addition, independent studies using the RED (repeat expansion detection) have shown association between BPAD and longer CAG/CTG repeats. Therefore loci with large CAG/CTG repeats are plausible candidates in the inheritance of BPAD. The present study assesses the length of the repeats in four loci: the ERDA-1 locus which is known to account for most of the long CAG repeats detected by RED, the SEF2-1b locus which is placed in a region where positive linkage results have been reported and the loci MAB21L and KCNN3 as functional candidate genes. A Brazilian case-control sample with 115 unrelated BPAD patients and 196 healthy control subjects and 14 multiply affected bipolar families was investigated. With the case-control design the distribution of alleles between the two groups did not approach statistical significance. The extended transmission disequilibrium test (ETDT) performed in our families did not show evidence for linkage disequilibrium. Parametric and non-parametric linkage analysis also did not provide support for linkage between any of the four loci and BPAD. Our data do not support the hypothesis that variation at the polymorphic CAG/CTG repeat loci ERDA-1, SEF2-1b, MAB21L or KCNN3 influence susceptibility to BPAD in our sample.

Adolescent↗

Platelet serotonergic markers as endophenotypes for obsessive-compulsive disorder.

Although compelling evidence has shown that obsessive-compulsive disorder (OCD) has a strong genetic component, its genetic basis remains to be elucidated. Identifying biological abnormalities in nonaffected relatives is one of the strategies advocated to isolate genetic vulnerability factors in complex disorders. Since peripheral serotonergic disturbances are frequently observed in OCD patients, the aim of this study was to investigate if they could represent endophenotypes, by searching for similar abnormalities in the unaffected parents of OCD patients. We assessed whole blood serotonin (5-HT) concentration, platelet 5-HT transporter (5-HTT) and 5-HT2A receptor-binding characteristics, and platelet inositol trisphosphate (IP3) content in a sample of OCD probands (n = 48) and their unaffected parents (n = 65), and compared them with sex- and age-matched controls (n = 113). Lower whole blood 5-HT concentration, fewer platelet 5-HTT-binding sites, and higher platelet IP3 content were found in OCD probands and their unaffected parents compared to controls. Whole blood 5-HT concentration showed a strong correlation within families (p < 0.001). The only parameter that appeared to discriminate affected and unaffected subjects was 5-HT2A receptor-binding characteristics, with increased receptor number and affinity in parents and no change in OCD probands. The presence of peripheral serotonergic abnormalities in OCD patients and their unaffected parents supports a familial origin of these disturbances. These alterations may serve as endophenotypic markers in OCD, and could contribute to the study of the biological mechanisms and genetic underpinnings of the disorder.

Adolescent↗

A study of the relationship between the position of the condylar head and displacement of the temporomandibular joint disk.

OBJECTIVES: To examine the possible relationship between condylar position and disk displacement in the TMJ. METHODS: Forty-eight joints with no disk displacement (NDD), 84 joints with a reducible displaced disk (RDD) and 99 joints with a permanently displaced disk (PDD) were selected. The positions of the condyle and TMJ disk were calculated from lateral MR images. RESULTS: There were significant differences in condylar position between the joints with NDD and RDD, while there was no difference between those with NDD and PDD (Kruskal-Wallis and post-hoc test, P<0.05). There was also a significant correlation between the position of the condylar and the displaced disk (Spearman's rank correlation, P<0.05). The condyle was located more anteriorly with advancing disk displacement. CONCLUSIONS: We suggest that if the disk displacement is slight, the condyle is displaced posteriorly: as the disk displacement becomes more severe (i.e. more anteriorly displaced), the condyle returns to the concentric position.

Adolescent↗

Impact of JPEG lossy image compression on quantitative digital subtraction radiography.

OBJECTIVES: The aim of the study was to evaluate the impact of JPEG lossy image compression on the estimation of alveolar bone gain by quantitative digital subtraction radiography (DSR). METHODS: Nine dry domestic pig mandible posterior segments were radiographed three times ('Baseline', 'No change', and 'Gain') with standardized projection geometry. Bone gain was simulated by adding artificial bone chips (1, 4, and 15 mg). Images were either compressed before or after registration. No change areas in compressed and subtracted 'No change-Baseline' images and bone gain volumes in compressed and subtracted 'Gain-Baseline' images were calculated and compared to the corresponding measurements performed on original subtracted images. RESULTS: Measurements of no change areas ('No change-Baseline') were only slightly affected by compressions down to JPEG 50 (J50) applied either before or after registration. Simulated gain of alveolar bone ('Gain-Baseline') was underestimated when compression before registration was performed. The underestimation was bigger when small bone chips of 1 mg were measured and when higher compression rates were used. Bone chips of 4 and 15 mg were only slightly underestimated when using J90, J70, and J50 compressions before registration. CONCLUSIONS: Lossy JPEG compression does not affect the measurements of no change areas by DSR. Images undergoing subtraction should be registered before compression and if so, J90 compression with a compression ratio of 1:7 can be used to detect and measure 4 mg and larger bone gain.

Alveolar Process↗

The difference in condylar position between centric relation and centric occlusion in pretreatment Japanese orthodontic patients.

This study investigates the differences in condylar position between centric relation (CR) and centric occlusion (CO) in Japanese orthodontic patients before treatment. We employed 150 consecutive cases (age range: 6-57 years) for the study. Dental casts were mounted on a Panadent articulator with a power centric CR bite record. The differences in condylar position between CR and CO in all three spatial planes were measured using the Panadent Condyle Position Indicator (CPI). The subjects were divided into groups by age, gender, mandibular plane angle or angle classification. No significant differences in the magnitude of CPI measurements were found among the groups. The three-dimensional distances of condylar displacement on both sides were almost identical, and the superoinferior displacement (S-I) was greater (P < .0001) than the anteroposterior displacement (A-P). The S-I was greater (P = .02) on the left side than on the right side, while the A-P displacement was smaller (P < .0001) on the left side than that on the right side. Significant condylar displacement (2.0 mm for S-I and A-P, 0.5 mm for the lateral displacement, L) was found frequently in L (31.3%), S-I, and A-P, in that order. Fifty-eight (38.7%) of the subjects had significant displacement in L, S-I, or A-P. Moreover, Angle Class III subjects tended to have significant condylar displacement toward the left side. The results suggest that orthodontists should be aware of a high incidence of condylar displacement in Japanese orthodontic patients and measure condylar displacement before the start of comprehensive orthodontic treatment to unmask real jaw relationships and avoid possible misdiagnoses.

Adolescent↗

Reproducibility of characteristics assessing the occlusion of young adults.

The aim of the present investigation was to analyze the reproducibility in the assessment of six morphological and three functional characteristics included in a new method evaluating the occlusion in young adults. These characteristics comprised coincidence of midlines, overjet, overbite, canine relationship, crossbite, scissors bite, recurrent deviation on opening, guided lateral excursions, and discrepancy between the centric relation and the intercuspal position. The study was conducted in three stages: (1) five observers assessed the occlusions of five volunteers, (2) seven observers assessed nine volunteers, and (3) five observers assessed nine volunteers. Two calibrated orthodontists were used as references. For numerical variables, the nonparametric method for repeated measurements (Friedman's test) was used to test the significance of differences, while the proportion of agreement was calculated for categorical assessments. The results were analyzed using two precision levels: within a measurement unit/the same category and an acceptable/nonacceptable dichotomy. The magnitude of systematic differences was small and of minor clinical importance except in measurements of recurrent deviation on opening. The proportional agreement for acceptance was good in the assessment of overjet, coincidence of midlines, crossbite, scissors bite, open bite, and discrepancy between the centric relation and the intercuspal position. Moderate agreement was achieved in the assessment of overbite, canine relationship, recurrent deviation on opening, and guided lateral excursions. Among the nonacceptable cases, the agreement ranged from poor to good. The results indicated that noncalibrated observers assess categorical characteristics inconsistently.

Adolescent↗

Effects of instrumentation, irrigation and dressing with calcium hydroxide on infection in pulpless teeth with periapical bone lesions.

AIM: The aim of this study was to evaluate the fate of microorganisms in root canals of teeth with infected pulps and periapical bone lesions with and without the use of calcium hydroxide medication. METHODOLOGY: Endodontic samples were cultured and microorganisms were counted and identified in 43 teeth before (sample 1) and after (sample 2) treatment during the first visit and before (sample 3) and after (sample 4) treatment during the second visit. In the first visit teeth were instrumented and half of the teeth were filled with a thick slurry of calcium hydroxide in sterile saline. The other teeth were obturated with gutta-percha and AH-2 6 sealer. After 4 weeks the teeth with calcium-hydroxide were accessed again and after microbiological sampling they were obturated with gutta-percha and AH-26 sealer. RESULTS: The mean total colony forming unit (CFU) counts of positive samples dropped significantly as a result of canal preparation during the first visit from 1.0 x 10(6) to 1.8 x 10(3) (between samples 1 and 2) but increased to 9.3 x 10(3) in the period between the two visits (sample 2 and 3). There was no difference in mean total CFU counts of positive samples between the end of the first (sample 2) and the end of the second visit (sample 4). The most frequently isolated species were Prevotella intermedia, Capnocytophaga spp.. Actinomyces odontolyticus. Propionibacterium acnes and Peptostreptococcus micros. CONCLUSIONS: Although a calcium hydroxide paste was placed in the prepared canals, the number of positive canals had increased in the period between visits. However, the number of microorganisms had only increased to 0.93% of the original number of CFU (sample 1). It is concluded that a calcium hydroxide and sterile saline slurry limits but does not totally prevent regrowth of endodontic bacteria.

Actinomyces↗

Oral yeast carriage in patients with advanced cancer.

The aim of this study was to investigate oral yeast carriage amongst patients with advanced cancer. Oral rinse samples were obtained from 120 subjects. Yeasts were isolated using Sabouraud's dextrose agar and CHROMagar Candida, and were identified using a combination of the API 20 C AUX yeast identification system, species-specific PCR and 26S rDNA gene sequencing. Oral yeast carriage was present in 66% of subjects. The frequency of isolation of individual species was: Candida albicans, 46%; Candida glabrata, 18%; Candida dubliniensis, 5%; others, < 5%. The increasing isolation of non-Candida albicans species is clinically important, since these species are often more resistant to antifungal drugs. Oral yeast carriage was associated with denture wearing (P = 0.006), and low stimulated whole salivary flow rate (P = 0.009). Identification of these risk factors offers new strategies for the prevention of oral candidosis in this group of patients.

Adult↗

Dental fluorosis and caries experience in relation to three different drinking water fluoride levels in South Africa.

OBJECTIVES: The purpose of this study was to determine the relationship between caries experience, degree of fluorosis and different concentrations of fluoride in the drinking water of children. SAMPLE AND METHODS: The study included 282 children aged 10-15 years, who lived continuously since birth in three different naturally fluoridated areas (Leeu Gamka, 3.0; Kuboe 0.48 and Sanddrif 0.19 p.p.m. F), with virtually no dental care or any fluoride therapy The teeth of the children were examined for caries using the DMFT index according to th WHO criteria and for fluorosis, using Dean's criteria according to the WHO guidelines. RESULTS: The prevalence of fluorosis (scores 2, 3, 4 and 5) among the school children was 47% in Sanddrif, 50% in Kuboes and 95% in Leeu Gamka. Almost half the children in the two low fluoride areas had no fluorosis (scores 0 and 1), whereas only 5% in Leeu Gamka had no fluorosis. Of the children in Sanddrif, 42.5% had very mild/mild (scores 2 and 3) fluorosis, 44.3% in Kuboes and 34.1% in Leeu Gamka. Except for one individual in Kuboes, severe fluorosis (score 5) was only observed in the high fluoride area in 30% of the children. According to the Bonferroni adaptation for multiple comparisons, the degree of fluorosis in Leeu Gamka differed significantly from both those of Sanddrif and Kuboes. The mean DMFT for the children in Sanddrif and Kuboe was similar (164 +/- 0.30 and 1.54 +/- 0.24, respectively) but the caries experience of Leeu Gamka (198 +/- 0.22) was significantly higher (P < 0.05) than that of both the other two areas. A strong positive correlation (P < 0.05) was found between the caries experience and the fluorosis scores of children in the high fluoride area (Leeu Gamka) but no correlation could be found in the other two areas. Significantly (P < 0.01) more children had decayed teeth in the high F area (Leeu Gamka) than in the other two areas. CONCLUSION: The results suggest a positive association between high F levels in the drinking water and dental caries. Furthermore, a low caries experience and no difference in DMFT and fluorosis between the two low fluoride areas were found.

Adolescent↗