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PubMed2001

Coca chewing in prehistoric coastal Peru: dental evidence.

In this study, we describe the dental health of four prehistoric human populations from the southern coast of Peru, an area in which independent archaeological evidence suggests that the practice of coca-leaf chewing was relatively common. A repeated pattern of cervical-root caries accompanying root exposure was found on the buccal surfaces of the posterior dentition, coinciding with the typical placement of coca quids during mastication. To further examine the association between caries patterning and coca chewing, caries site characteristics of molar teeth were utilized as indicators for estimating the likelihood of coca chewing for adults within each of the study samples. Likelihood estimates were then compared with results of a test for coca use derived from hair samples from the same individuals. The hair and dental studies exhibited an 85.7% agreement. Thus, we have demonstrated the validity of a hard-tissue technique for identifying the presence of habitual coca-leaf chewing in ancient human remains, which is useful in archaeological contexts where hair is not preserved. These data can be used to explore the distribution of coca chewing in prehistoric times. Simultaneously, we document the dental health associated with this traditional Andean cultural practice.

Coca↗
PubMed2002

Aging successfully: oral health for the prime of life.

Aging is a worldwide phenomena. More adults, particularly those in developed countries, are living longer and healthier lives. The average US life expectancy was 47 years in 1900; by 2000, it had increased to 74 years. As the population ages, the number of adults with acute and chronic illnesses increases. The use of medications also increases with age. People over 65 years of age make up about 12% of the US population, but they consume 30% of all prescription medications, many of which can have a negative impact on oral health. Although tooth loss is declining in US adults, the need for various types of dental services in the adult population continues to increase. Data on the use of dental services has shown that dental visits by older adults correlate with the presence of teeth, not age. Research on the epidemiology of periodontal disease in older adults suggests that the disease in older adults is probably not due to greater susceptibility but, instead, the result of cumulative disease progression over time. Data on root caries has shown that exposed root surfaces, in combination with compromised health status and the use of multiple medications, can increase an older adult's risk for root caries. Oral candidiasis commonly occurs in immunocompromised individuals of any age, but in older adults, nursing home residents are particularly susceptible. Oral cancer is a disease of older adults, with a median age of 64 at diagnosis. Tobacco and alcohol use are the most common risk factors. Mental or physical impairments, such as dementing illnesses, or impaired dexterity as a result of arthritis or stroke, can impair an adult's ability to perform adequate oral self-care. Preventing oral diseases in older adults requires an understanding of the risk factors for oral diseases and how these risk factors change over time. Of particular concern are nursing home residents, who remain the most vulnerable of elders. Incorporating preventive oral health strategies into dental treatment and nursing home care will play a critical role in maintaining oral health for a lifetime. Oral health education of family, caregivers, and nursing home staff is essential if oral diseases are to be avoided later in life.

Adult↗
PubMed2005

Fluoride release and secondary caries inhibition by adhesive systems on root dentine.

This study tested the fluoride-release rate and the root caries inhibitory effect of dental adhesives. In phase 1, the fluoride released from samples (n = 5) of the adhesives A (Optibond Solo), B (One-up Bond F), C (Prime & Bond NT), D (Tenure Quick), and also of the controls [+] (glass-ionomer cement) and [-] (non-fluoride releasing adhesive), was quantified on a daily basis during a pH-cycling, caries-simulating phenomenon. In phase 2, restorations were made in bovine root dentine slabs (n = 16) with the same adhesives associated with a non-fluoridated composite. Control [+] restorations were made entirely with glass-ionomer cement. Specimens were thermocycled and submitted to the pH-cycling regimen. Demineralization areas and the presence of the wall lesion (WL) and the inhibition zone (IZ) were determined by polarizing light microscopy in dentine adjacent to the restoration. The highest concentration of fluoride was released by the control [+]; adhesives A, B and C, also released fluoride. No detectable amount of fluoride was released by D or [-]. Smaller areas of demineralization were found with control [+], whereas the demineralization areas of adhesives A-D and [-] did not differ from each other. No WL was detected, and higher percentages of IZ were recorded to [+] and to adhesive A. Although some dental adhesives were able to release fluoride, they could not inhibit secondary caries development as well as the glass-ionomer cement.

Animals↗
PubMed1989

[Anticalculus dentifrices. A new era in preventive dentistry?].

Anticalculus toothpastes are available on the market. Toothpastes with Zinc compounds interfere mainly with the plaque formation. Dentifrices containing pyrophosphate give the highest reductions in calculus formation. The inclusion of pyrophosphate in a fluoride containing dentifrice did not interfere with the cariostatic action of fluoride on tooth enamel. The influence of anticalculus dentifrices on root caries and root hypersensitivity are, so far, not documented. Fundamentally, a lot of doubt still exists about the precise role of supragingival calculus formation in the onset of periodontal disease.

Dental Calculus↗
PubMed2005

The strength of two indicators of social position on oral health among persons over the age of 80 years.

OBJECTIVE: The objective of the present study is to analyze how two dimensions of social position, education and social class, are associated with oral health among generally healthy, community-dwelling persons over the age of 80 years. METHODS: The present investigation is based on a sample of 157 community-dwelling individuals from The Kungsholmen Elders Oral Health Study (KEOHS) and included data from interviews and oral examinations. Social position was measured by education and social class. Oral health was measured by active coronal caries, active root caries, edentulism and use of dental services. RESULTS: The primary findings of the adjusted multivariate logistic regression analysis were that, compared to persons who had been in higher positions, persons who had been blue-collar/ white-collar workers had significantly greater odds of having coronal caries and high, but nonsignificant odds of being edentulous. Further, persons with elementary/ medium education tended to forego regular dental services more than persons with high education. CONCLUSION: The study identified social inequalities in oral health even in a population of independently living, generally healthy very old Swedes and in a country where the public health policies have tried to minimize these inequalities.

Age Factors↗
PubMed2005

Radiation-induced root surface caries restored with glass-ionomer cement placed in conventional and ART cavity preparations: results at two years.

BACKGROUND: There are no published studies comparing the clinical performances of more-viscous glass-ionomer cement (GIC) restorations when placed using conventional and atraumatic restorative treatment (ART) cavity preparation methods to restore root surface caries. METHODS: One dentist used encapsulated Fuji IX GP and Ketac-Molar to restore 72 conventional and 74 ART cavity preparations for 15 patients who had received cervicofacial radiation therapy. Two assessors evaluated the restorations at six, 12, and 24 months for retention, marginal defects and surface wear, and recurrent caries. RESULTS: After two years, the cumulative restoration successes were 65.2 per cent for the conventional and 66.2 per cent for the ART cavity preparations, without statistical or clinical significance (P > 0.50). Restoration dislodgement accounted for 82.8 per cent and marginal defects for 17.2 per cent of all failures. There were no instances of unsatisfactory restoration wear or recurrent caries observed. Teeth with three or more restored cervical surfaces accounted for 79.3 per cent of all failures (P < 0.0001). CONCLUSIONS: For root surface caries restored with GIC, the use of hand instruments only with the ART method was an equally effective alternative to conventional rotary instrumentation for cavity preparation. Larger restorations had higher failures, usually from dislodgement.

Adult↗
PubMed1988

The effect of geochemical factors on prevalences of dental diseases for prehistoric inhabitants of the state of Missouri.

In previous epidemiological studies, it has been suggested that geochemical factors besides fluoride may affect the prevalences of dental diseases. Our objective in this study was to determine whether the prevalences of periodontal diseases, coronal caries, and root caries for prehistoric inhabitants vary between geochemical regions of the state of Missouri. Burial sites were located on unique maps that depict geochemical variation among regions of the state. Data on dental caries and alveolar bone loss were gathered from 179 of the best preserved skeletal remains of the Late Woodland (A.D. 400-900) and Mississippian (A.D. 900-1700) periods. Mean caries scores and proportions of individuals with caries were calculated for these geochemical regions. Average alveolar bone loss was regressed on age for the individuals of these regions. Significant differences in caries and bone loss were found between several regions. These differences cannot be adequately explained by fluoride concentrations or by diet. It is suggested that geochemical factors, in addition to fluoride, may have affected the prevalences of dental diseases.

Dental Caries↗
PubMed1985

Methodological considerations in a dental epidemiologic survey of an elderly population.

The proportion of the US population that is age 65 or over is increasing and edentulism rates are declining. The community's elderly population is becoming an increasingly important constituency for dental public health. Little is known, however, about the actual oral health status of these people. An assessment of oral health in the elderly presents many considerations not found in an assessment of oral health among children. The selection of subjects to represent all the elderly in the community is difficult. Caries assessment is complicated by the need to distinguish between coronal caries and root caries and by the inability to determine accurately the reason for prior tooth loss. Periodontal assessment is more difficult than in younger populations because the conditions tend to be advanced. The recruitment of participants is difficult because each potential subject must be contacted individually. These assessments are needed so the oral status of adult populations can be determined.

Aged↗
PubMed2001

Cariogenic actinomyces identified with a beta-glucosidase-dependent green color reaction to Gardenia jasminoides extract.

The oral bacteria Actinomyces naeslundii and Actinomyces viscosus are known to contribute to the initiation and progression of human dental caries, especially root caries. We report that both A. naeslundii and A. viscosus react with a component in the Gardenia jasminoides extract to produce a distinct green product. This green color reaction was found to be dependent on the bacterial beta-glucosidase. The reaction is specific for cariogenic actinomyces, and it can detect as few as 10(4) cells of A. naeslundii and A. viscosus per ml.

Actinomyces↗
PubMed1993

An epidemiologic perspective of saliva flow rates as indicators of susceptibility to oral disease.

Catastrophic hyposalivation significantly increases susceptibility to dental caries in dentate individuals and may cause the expression or exacerbation of other oral diseases/disorders as well. The effect of subcatastrophic hyposalivation on susceptibility to caries or other diseases/disorders is less well understood. The aim of this study (part of a larger study on the prevalence of hyposalivation) was to determine the prevalence and to measure the association of oral pathologic conditions with unstimulated and stimulated whole saliva flow rates. Only 6.3% of all study participants had significantly diminished unstimulated (< 0.05 ml/min) and stimulated (< 0.50 ml/min) saliva flow rates. A total of 15 individuals were encountered with oral pathologic lesions and none of these lesions were associated with hyposalivation. Although the prevalence of coronal caries, root surface caries, abrasion, and erosion tended to increase as salivary flow decreased, when the effect of age was considered no significant differences were present. These data suggest that low saliva flow rates alone, at least from an epidemiologic perspective, do not have a clinically relevant effect on susceptibility to oral diseases/disorders.

Adult↗
PubMed1991

International dental public health.

Dental public health workers around the world are considering the service implications of changing patterns of dental health. In industrialized countries, with few exceptions, caries levels are declining among adolescents and young adults, but there are signs that this may not now be the case in the very young. The situation in developing countries is equivocal. In an effort to target resources more efficiently, efforts to detect those at high risk to caries continue. However, there still seems no better predictor than the caries experience of the individual or group. With reducing levels of dental caries, greater interest is being shown in the epidemiology of periodontal disease. Despite the acceptance by Federation Dentaire Internationale of the Community Periodontal Index of Treatment Needs as a suitable measure of community periodontal health, some workers still have reservations of its value. With increasing numbers of elderly people retaining greater numbers of teeth, investigations into patterns of adult caries, particularly root caries, are increasing. Collaboration among health workers on an international basis would enhance knowledge in these disciplines.

Age Factors↗
PubMed1991

[Restorative therapy with amalgam-indication and long life time].

The pattern of restorative therapy with amalgam of 38 thuringian dentists were checked up over a period of 4 weeks. The indications of the 3644 in these time applicated amalgam restorations were in 42% of all cases primarily caries, in 22% secondary caries and in 24% noncaries caused reasons. Occlusal caries was dominant in adolescents and young adults. Patients older than 24 years had a higher risk of approximal caries and root caries is becoming a clinical problem in patients older than 54 years. 61% of the replaced amalgam restorations have had a function period over 5 years. Prevention, early restorative therapy and consequently a recall system in connection with correct indication are the most important factors for a long time of amalgam restorations and successful dental treatment.

Adolescent↗
PubMed1993

Oral health needs of the elderly--an international review. Commission of Oral Health, Research and Epidemiology Report of a Working Group.

There has been no significant evaluation of the oral health of the elderly on a global or regional basis. As a result of this deficiency in information a working group of the FDI was instituted in 1988. A questionnaire was developed and sent to 44 consultants and 53 national dental associations. Replies were recorded from 31 countries while another 10 countries reported that they had no data on their ageing populations. Most of the replies were from the so-called western industrialised countries and these countries had some data on issues such as life span at birth, life span at 60, dental utilisation data and edentulousness. Beyond these areas data was not representative and scarce. Recommendations are that studies of this size tend not to be very productive and should not be replicated. In the agrarian societies where caries rates in children are still low, preventive services need to be introduced as well as palliative services. In the industrialising countries where caries rates are increasing, the emphasis needs to be on prevention, while in the heavily industrialised countries it needs to be focused on prevention of caries, especially root caries.

Aged↗
PubMed1995

[The orodental situation of aged patients hospitalized at the Hôpital de Gériatrie of Geneva].

The purpose of the present study was to identify the major oral and dental problems and treatment needs among 216 patients who had been consecutively hospitalized at Hôpital de Gériatrie de Genéve. The patients were interviewed and examined during the week following their hospitalization. There were 150 women (73.6%) and 57 men with a mean age of 84 years. Of these 44.4% were completely edentulous. The patients with remaining teeth had on average 11 teeth, of which 24.1% showed active caries. Active root caries was observed in 54.2% of the patients with natural teeth. Of the remaining teeth 27.4% were crowned and three quarters of these had poorly adapted margins. Removable dentures were observed in 81% of the patients. Of the complete dentures 18.5% were poorly adapted and 30.3% of the removable partial dentures were unstable. Denture stomatitis was observed among 20.5% of the denture wearers. It appears from this study that elderly patients have many oral, dental and prosthetic problems and that their treatment needs are generally important. In order to improve the situation it seems necessary to introduce dental care programs for homebound and institutionalized elderly patients.

Aged↗
PubMed1987

Root surface caries subsequent to gingivectomy in rats inoculated with Streptococcus sobrinus (mutans) and Actinomyces viscosus.

We studied the effect of oral infection with cariogenic micro-organisms on alveolar bone loss and root surface caries subsequent to gingivectomy in rats. Thirty-six rats were fed diet MIT 200 (67% sucrose); one-half, the controls, had antibiotics added to the diet. At ages 18, 19, and 21 days, the experimental group was orally infected with streptomycin-resistant Streptococcus sobrinus (mutans) 6715 and Actinomyces viscosus M-100. At age 30 days, all animals were subjected to a gingivectomy on maxillary and mandibular left quadrants. The experimental group was re-inoculated at age 36 days. Animals were killed seven weeks after surgery. Jaws were stained, and planimetric measurements of exposed root surface area and caries on lingual/palatal surfaces of 1st and 2nd molars were made from video images with a computer/digitizer. Compared with the non-operated contralateral quadrants, gingivectomy significantly increased exposed root surface area in the maxilla and in the mandible in both the control and experimental groups. Oral inoculation significantly increased exposed root surface in mandibular (but not maxillary) quadrants which had received a gingivectomy, but had no effect on non-gingivectomized quadrants. There was no caries in the control group, whereas ten rats in the experimental group had root surface caries lesions, all in quadrants which had received a gingivectomy. This rat model should prove useful in further studies of root surface caries.

Actinomyces↗
PubMed1985

Inhibition of root surface caries in rice rats: use of a sodium fluoride dentifrice.

A sodium fluoride-containing dentifrice (Gleem) was evaluated for its efficacy to inhibit root surface caries in the rice rat. The dentifrice was diluted 50/50 with water so that the slurry contained 500 ppm fluoride. This slurry, a solution of 5000 ppm fluoride, and demineralized water were applied to the molar teeth twice daily for 10 weeks. Another group of rats was given 50 ppm fluoride in the drinking water. There was significantly less root surface caries in all groups of rats which received fluoride than in the demineralized water control animals. However, none of the fluoride preparations inhibited the loss of alveolar bone.

Alveolar Process↗
PubMedDate not supplied

Ten-year incidence of tooth loss and dental caries in elderly Swedish individuals.

There has been a significant reduction in edentulism and the elderly retain more teeth into old age. The 10-year incidence of tooth loss, coronal and root caries was studied in a random sample of inhabitants of Göteborg, who were 55, 65 and 75 years old at baseline. Of the 208 persons examined at baseline, 102 (49%) participated in the follow-up examination: 56, 37 and 9, respectively, in the different age groups of 65, 75 and 85 years. In addition, for the purpose of time-trend comparisons, a new random sample of 98 individuals aged 55 years was examined. The mean numbers of remaining teeth were 24, 23, 17 and 14, respectively, in the age groups of 55, 65, 75 and 85. The corresponding mean numbers at baseline were 23, 19 and 17, respectively, in those subjects who were then 55, 65 and 75 years old. Forty-eight percent had lost no teeth during the 10-year period, while 13% had lost more than 2 teeth. The major reason for tooth extraction was dental caries and it was found in 60% of all cases. The incidence of coronal caries decreased, while that of root caries increased with age (p < 0.01). Comparing the same age groups, the frequency of root caries had decreased during the 10-year period. It could be concluded from this study that elderly people were determined to retain their teeth for as long as possible, but dental caries may be a problem among the very old.

Age Factors↗
PubMed1989

Microradiography of experimental root surface caries in man.

The aim of this study was to describe the pattern and rate of mineral loss during experimental root surface caries in situ without giving frequent sucrose rinses as a supplementary cariogenic challenge. Six elderly persons carried at total of 18 specimens of unerupted human root surface in recessions of lower partial dentures for 1, 2 and 3 months. Another six root surfaces served as controls. No cleaning of the specimens was allowed during the experimental period whereas the natural dentition was cleaned with a nonfluoride toothpaste. All the specimens, as observed by quantitative microradiography, exhibited subsurface caries lesions. Despite variation between individuals the depth of subsurface demineralization increased linearly with time, the average depth of the lesions being 240 microns after 1 month and 630 microns after 3 months. Delta MC, calculated as the difference in total mineral content between control and test specimens throughout the lesions, increased linearly with time from 2,000 to 8,400 vol% microns after 1 and 3 months, respectively. Preparation for microradiography induced a certain shrinkage of the lesions which resulted in an underestimation of the actual loss of mineral. It is concluded that this experimental model is suitable for studying the etiology and prevention of root surface caries provided the interindividual variation is taken into account.

Aged↗