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PubMed1987

The efficiency of half-mouth examinations in estimating the prevalence of periodontal disease.

Several studies, including the NIDR 1985 national survey of working adults, have used periodontal examinations of only two quadrants of the mouth to estimate the prevalence of periodontal conditions. To investigate the efficiency of half-mouth periodontal examinations, I compared the results from the examination of all teeth in a sample of 477 dentate elderly people with scores that would have been obtained if randomly selected pairs of quadrants had been examined instead. In this elderly dentate population, relatively little information would have been lost if diagonal half-mouth or same-side half-mouth scores instead of whole-mouth scores had been used to estimate the number or proportion of teeth with periodontal conditions. However, the proportion of people with the less prevalent conditions, i.e., deep pocketing and mobility, was underestimated slightly. Slightly less efficiency was also noted for the less prevalent conditions. These findings suggest that half-mouth recording may be useful for prevalence surveys, but cannot be recommended for incidence surveys or clinical trials, where incremental changes may be small.

Aged↗
PubMed2004

[Fluoride mouth-rinsing to prevent dental caries in a Brazilian municipality with fluoridated drinking water].

OBJECTIVE: To compare the prevalence of dental caries in two groups of schoolchildren: (1) schoolchildren participating in a weekly 0.2% sodium fluoride mouth-rinsing program and (2) schoolchildren not participating in the program. METHODS: This cross-sectional study was conducted in the city (municipality) of Londrina, in the state of Paraná, Brazil; the city has fluoridated drinking water. We examined 367 12-year-old children: 190 participants in the weekly mouth-rinsing program (51.8%) and 177 nonparticipants (48.2%). The prevalence of caries was determined based on the scores for decayed, missing, and filled teeth and for decayed, missing, and filled surfaces. The examinations were performed by three examiners, with nearly perfect agreement in their diagnosis of caries (kappa = 0.90). The dependent variable was dental caries. The independent variables were: participation or nonparticipation in the mouth-rinsing program, attending a private school or a public school, frequency of tooth-brushing, amount of toothpaste used, consumption of sweets between meals, and visits to the dentist. RESULTS: The decayed, missing, and filled teeth score (mean and standard deviation) at 12 years of age was 0.85 +/- 0.059 overall, 1.0 +/- 0.058 for program participants, and 0.70 +/- 0.060 for nonparticipants. The decayed, missing, and filled surfaces score (mean and standard deviation) was 1.16 +/- 0.017, with it ranging from a low of 0.34 in one private school to a high of 1.66 in one public school. Bivariate analysis showed an association between caries (P < 0.05) and the following variables: attending a public school, participating in the mouth-rinsing program, and consuming sweets between meals more than once a day. In the multivariate analysis, attending a public school (P = 0.0004) and consuming sweets (P = 0.001) remained associated with the presence of caries. CONCLUSIONS: The weekly mouth-rinsing program was not associated with a decreased prevalence of caries, in either the public schools or the private schools. However, additional research is needed to assess the cost-effectiveness of fluoride mouthrinsing programs in populations with a higher prevalence of caries. Given the caries prevalence that we found in the schoolchildren whom we studied, the resources allocated to the fluoride mouth-rinsing program for them should probably be used to pay for other health-promotion activities with them.

Child↗
PubMed1998

The effect of a 1-stage full-mouth disinfection on oral malodor and microbial colonization of the tongue in periodontitis. A pilot study.

Oral malodor affects a large proportion of the population and may be the cause of a significant social and psychological handicap. This pilot study aimed to examine whether a 1-stage full-mouth disinfection in periodontitis patients (scaling and root planing of all pockets within 24 hours together with the application of chlorhexidine to all intra-oral niches followed by chlorhexidine mouth rinsing for 2 months) resulted in a significant improvement in malodor when compared to a fractionated periodontal therapy (consecutive root planings per quadrant, at a 1 to 2 week interval). The baseline and outcome data concerning oral malodor were linked to the presence of tongue coating and to its roughness (fissures). Twenty-four patients with severe periodontitis were randomly allocated to test and control groups. At baseline and after 1 and 2 months, the concentration of volatile sulfur compounds (VSC) in the mouth was measured and organoleptic ratings (expired air and total mouth air) were given. Plaque samples were collected from the dorsum of the tongue to calculate the number of colony forming units (CFU) per ml (anaerobic culturing) as well as the number of pigmented CFU/ml. Both the baseline organoleptic ratings and the VSC scores correlated well with the presence of tongue coating but not with the tongue roughness. Because a correlation between tongue coating and its microbial load could not be detected, it was hypothesized that the tongue coating per se, and not the bacteria, might be responsible for the malodor. The 1-stage full-mouth disinfection resulted in a faster and additional reduction in the organoleptic ratings of the oral malodor, even after 2 months. This might be explained by the improved periodontal outcome and/or the more significant reduction in the CFU/ml of pigmented species. In contrast to the organoleptic ratings, which were significantly reduced in both treatment groups (when compared to baseline), the VSC levels remained unchanged. This pilot study indicates that a 1-stage full-mouth disinfection has, in comparison to a standard periodontal therapy, additional beneficial effects in the treatment of oral malodor.

Adult↗
PubMed2001

The influence of partial and full-mouth recordings on estimates of prevalence and extent of lifetime cumulative attachment loss: a study in a population of young male military recruits.

BACKGROUND: Previous studies have shown that the use of index teeth may underestimate the prevalence of chronic periodontitis in adults. However, there is little information on the effect of using index teeth to estimate the prevalence of early periodontitis in younger adults and the effect this may have on planning treatment needs and health care resources. The aim of this study was to compare full mouth examination with partial examination using index teeth in a group of young British males. METHODS: One hundred subjects aged between 16 and 20 years (mean 17 years) on entry to the study were examined at baseline, 12 months later, and 30 months later. Lifetime cumulative attachment loss (LCAL) > or =1 mm was measured on the mesio-buccal, disto-buccal, mesio-lingual, and disto-lingual surfaces of all teeth, excluding third molars. All data were entered into a database. The indices used to express LCAL were prevalence, defined as the percentage of subjects with LCAL > or =1 mm, 2 mm, or 3 mm, and extent, defined as the percentage of sites with LCAL > or =1 mm, 2 mm, or 3 mm. Two sets of index teeth were chosen to compare with full mouth recordings, Ramfjord index teeth and the Periodontal Index for Treatment (PIT) teeth. RESULTS: The prevalence of LCAL > or =1 mm was similar (approaching 100%) for the full mouth and both partial mouth recordings. However, as LCAL increased from a minimum of 1 to 3 mm, partial mouth recording resulted in an underestimation of the prevalence of disease. LCAL > or =2 mm was underestimated by up to 22% and LCAL > or =3 mm by up to 36%. The extent of LCAL was less affected by partial mouth recording, in that the percentage of sites with no sign of early attachment loss was underestimated by up to 11%. However, the percentage of sites with LCAL > or =1 mm and 2 mm were overestimated by 11% and, 7% respectively. CONCLUSIONS: These data indicate that the use of index teeth in epidemiological studies which include young adults may result in an underestimation of the prevalence of early periodontitis and an overestimation of the extent.

Adolescent↗
PubMed2003

Mouth and genital ulcerations in the community.

OBJECTIVE: To estimate the prevalence of mouth and genital ulceration in the community and its relationship to rheumatic diseases. METHODS: A house to house survey was carried out over a period of 18 months extending from September 1993 to February 1995, on 5,894 individuals utilizing detailed questionnaires on symptoms of musculoskeletal diseases and associated symptoms including history of mouth, genital ulcers, eye symptoms, and skin changes. After the initial phase, a 2nd phase was completed by trained nurses and paramedical staff, the purpose of which was to explore in detail, the history of those responding positively to any of the questions in phase one. The 3rd stage was conducted by general practitioners and rheumatologist to interview and examine those identified in phase 2 at King Fahad Hospital, Buraidah, Kingdom of Saudi Arabia. RESULTS: We identified 7 (0.1%) cases of genital ulceration, 43 (0.7%) cases of mouth ulceration, 263 (4.5%) cases of reddish eye or blurred vision, and 124 (2.1%) cases of skin rashes. Only 2 cases had both mouth and genital ulceration in addition to eye disease, skin rash and musculoskeletal pain. There was significant correlation between mouth ulcers and skin rash, eye symptoms, genital ulcerations, male sex, single status, weight loss and backpain. CONCLUSION: The vast majority of mouth and genital ulcers are not associated with a known rheumatic disease.

Adolescent↗
PubMed2006

Periodontal disease and diabetes metabolic control: a full-mouth disinfection approach.

Some studies demonstrated that local mechanical periodontal treatment and systemic antibiotics might improve the level of metabolic control in patients with diabetes. The aim of this clinical pilot trial was to evaluate if type 1 diabetes patients with periodontitis will experience improvement in periodontal status and glycemic control after a full-mouth disinfection treatment. Ten adult patients with poor metabolic control (mean glycated hemoglobin (HbA1c) = 10.7 %) and periodontitis were included in the study. All patients received a full-mouth disinfection in 24 hours as described by Quirynen et al. (1995) at baseline and 6 months later. The periodontal parameters included plaque index (PI), bleeding on probing, probing depth and clinical attachment loss. Metabolic control was measured by the serum level of HbA1c. All measurements were done at baseline and at 3, 6, 9 and 12 months. The results demonstrated a significantly lower PI, less bleeding on probing, reduction in probing depth and gain of clinical attachment at 3 months and 9 months of the study. Similarly, a significant reduction in the serum level of HbA1c was measured three months after full-mouth disinfection but disappeared 6 months later at the 6- and 12-month check points. We conclude that a full-mouth disinfection approach significantly improves periodontal status and metabolic control in type 1 diabetes patients with periodontitis. However, the results of our study imply that a full-mouth disinfection method has to be applied at least every 3 months to control periodontal status and glycemic control in type 1 diabetes patients. Further studies with greater numbers of diabetes patients are needed to confirm the long-term beneficial effects of a full-mouth disinfection approach on diabetic metabolic control.

Adult↗
PubMed1989

Optimal mouth position for magnetic resonance imaging of the temporomandibular joint disk.

Optimal mouth positioning for magnetic resonance imaging of the TMJ is controversial. This study evaluates the closed mouth position and partial-open mouth position for diagnostic accuracy of anterior displacement of the disk. Sixty-two joints were considered abnormal in at least one position. In the positive joints, the closed mouth position sequences were all abnormal and diagnostic, while 34% of partial-open mouth position sequences were falsely normal. It was found that the closed mouth position provides higher diagnostic accuracy for disk displacement, although optimal examinations include imaging in both positions.

Adolescent↗
PubMed1998

The efficacy of antimicrobial mouth rinses in oral health care.

There is growing public recognition of the importance of oral health, as symbolized by the theme. "Oral Health for a Healthy Life" proposed for the 1994 World Health Day. In this report, the efficacy of antimicrobial mouth rinses, mainly Listerine, was reviewed by three investigators who are working as a microbiologist, a microbiologist, a dentist, and a dental hygienist participating in oral health care. Listerine, an antimicrobial mouth rinse, completely killed microorganisms in 10 to 30 seconds; the microbes includes methicillin-resistant Staphylococcus aureus, Streptococcus pyogenes, Helicobacter pylori, Candida albicans, Streptococcus mutans, Actinomyces viscosus, Porphyromonas gingivalis, Prevotella intermedia, and Actinobacillus actinomycetemcomitans. Listerine was also weakly effective in inactivating human immunodeficiency viruses. Bacteria in samples collected from human dental plaque and saliva were completely killed within 30 seconds when exposed to Listerine. When saliva samples were collected from subjects who had rinsed their mouths with 20 ml of Listerine or 1:50 diluted povidone-iodine, levels of viable anaerobic bacteria in the samples were reduced to 1%. When Listerine was used for oral surgery such as tooth extraction and periodontal surgery, the agent was effective in relieving toothache. This was probably due to a decrease in oral bacteria by the antimicrobial action of Listerine, leading to lowering the inflammatory response of the host. The use of antimicrobial mouth rinse during dental treatments such as endodontic treatment proved effective for more reliable infection control. In Japan, there are an increasing number of elderly and medically compromised hosts who are potentially at risk for developing pneumonia due to silent aspiration of microbes in the oral cavity and throat. For the aged with such potential risk, using of antimicrobial mouth rinse may be effective in preventing dental plaque accumulation when used in addition to the mechanical control of plaque, since they tend to have difficulty in brushing teeth by themselves. Indeed, the use of antimicrobial mouth rinse in these elderly people proved useful not only in preventing bacterial pneumonia, but also in improving their quality of life by preserving their oral health.

Aged↗
PubMed1997

Squamous cell carcinoma of the floor of mouth: a 20-year review.

BACKGROUND: This study retrospectively examines our treatment choices and outcomes with patients diagnosed with squamous cell cancer of the floor of mouth. Because of our division's past strong surgical bias in the treatment of this disease, we have assessed the results of a patient population treated largely by surgical extirpation. This clinical information has been used to draw conclusions and formulate treatment paradigms for patients with floor of mouth cancer. METHODS: Four hundred fifty patients with the diagnosis of squamous cell carcinoma of the oral cavity received their primary treatment at Roswell Park Cancer Center (RPCI) from 1971 to 1991. Ninety-nine had disease originating in the floor of mouth and are the basis of this retrospective review. RESULTS: Forty-three percent of the patients had early-stage disease (stage I or II). Five-year survival for stages I through IV was 95%, 86%, 82%, and 52%, respectively. The incidence of occult cervical metastases for clinical stage I patients was 21%. For clinical stage II patients, the incidence was 62%. Local control of patients treated with surgery alone was 81%. The regional control rate for these patients was 71%. In patients where negative margins were achieved (> or = 5 mm), the local recurrence rate was 13%, regardless of T stage. Eleven percent of the patients underwent a course of postoperative radiotherapy; all had stage IV disease. When compared with advanced-stage patients undergoing surgery alone, there was a significantly improved regional control rate and a trend toward enhanced survival in the patients receiving adjuvant radiotherapy. CONCLUSIONS: There is a significantly high incidence of occult metastatic disease (21%) for T1 lesions or greater in floor of mouth cancer to warrant elective treatment of regional lymphatics. In patients treated with surgery alone with negative margins, the local control rate was 90% versus 62% when the margins were close or positive. Adjunctive radiotherapy showed a statistically significant (p = .005) increased regional control in patients with stage IV disease. Adjunctive radiotherapy is warranted for increased regional control of disease; good local control can be achieved in floor of mouth cancer with surgery alone when negative margins are obtained.

Adult↗
PubMed2002

Metastatic cancer to the floor of mouth: the lingual lymph nodes.

BACKGROUND: The upper level of a cervical lymphadenectomy is anatomically defined at its anterior extent by the lower border of the mandible and, in surgical practice, by the lingual nerve. A neck dissection completed below this level is generally considered adequate for removal of lymph nodes at risk for metastases from oral cavity cancer. Traditional discontinuous neck dissections do not provide for removal of floor of mouth tissue along with the primary and neck specimens. METHODS: A case report presenting biopsies from a T2N2bM0 squamous cell carcinoma of the mobile tongue and adjacent floor of the mouth in a 73-year-old man. RESULTS: Deep biopsy of a ventral tongue and floor of mouth squamous cell carcinoma revealed occult metastatic cancer to lymph nodes located in the superficial floor of mouth associated with the sublingual gland above the lingual nerve. This report identifies floor of mouth lymph nodes that can be involved with cancer and missed through the standard practice of discontinuous neck dissection.Conclusions. This finding offers evidence that, in certain cases, a traditional discontinuous neck dissection may not address all lymph nodes at risk in the treatment of oral cavity cancer. Further investigation into lymph node distribution within the oral cavity is warranted to reappraise the upper limits of cervical lymphadenectomy.

Aged↗
PubMed1975

[Surgery of the tongue and floor of the mouth (author's transl)].

Most carcinomas of the oral tongue and floor of the mouth are presently treated surgically, often combined with pre- or postopervative irradiation. The treatment plan is mainly determined by the primary site and the local and regional extension, desirable are general rules on the basis of the TNM classification. The indications and principles of the most important operative procedures are discussed: Local excision, partial glossectomy, excision of the floor of the mouth with marginal mandibulectomy, composite resection. Operations for removal of the primary and radical neck dissection with preservation of the mandible (e.g. the pull-through procedure) are rarely advised. A radical neck dissection is indicated in each carcinoma of the oral tongue or floor of the mouth with palpable lymph nodes. If no nodes are palpable, an elective neck dissection is advised in view of the high frequency of clinically occult lymph node metastases (between 23 and 43%). Reconstructive measures following radical tongue and floor of the mouth operations are required for regaining a motility of the remaining tongue, for reconstruction of the floor of the mouth and for replacement of the mandible.

Carcinoma, Squamous Cell↗
PubMed2002

Tenascin and beta 6 integrin are overexpressed in floor of mouth in situ carcinomas and invasive squamous cell carcinomas.

Floor of the mouth squamous cell carcinomas exhibit many characteristics that suggest they represent a distinct biological subset within head and neck tumors. The features of preinvasive lateral intraepithelial spread, high rate of conversion of intraepithelial neoplasia to invasive carcinoma, and high incidence of occult metastases, suggest the importance of motility-associated proteins in the pathogenesis of these lesions. Two such proteins, tenascin and beta 6 integrin, are generally overexpressed in squamous carcinomas, and may play a central role in the invasive process of floor of the mouth lesions. The purpose of this study was to evaluate in situ and invasive squamous cell carcinomas from the floor of the mouth for the expression of tenascin and beta 6 integrin. Twenty lesions each of floor of the mouth in situ carcinomas and squamous cell carcinomas, and 10 normal controls were stained for tenascin and beta 6 using a standard immunohistochemical protocol for formalin-fixed specimens. Sections were assessed for staining intensity, pattern, and co-localization. Tenascin was highly expressed at the keratinocyte-connective tissue interface of both in situ and invasive carcinomas. beta 6 was expressed in basal keratinocytes of all in situ and invasive lesions, but was not evident in any of the control epithelia. There was no significant difference in staining of in situ and invasive carcinomas, but there was a significant difference in staining between these lesions and controls. Staining was colocalized in serial sections, supporting a receptor-ligand relationship. Both tenascin and beta 6 were weakly expressed in dysplastic areas adjacent to carcinomas suggesting that changes in the expression of these proteins occurs prior to the invasive phenotype. We conclude that tenascin and beta 6 are overexpressed in in situ and invasive floor of the mouth carcinomas, but that transgression of the basement membrane by neoplastic epithelial cells requires additional changes to the keratinocyte molecular profile.

Carcinoma in Situ↗
PubMed1989

Site-specific variations in the concentrations of substances in the mouth.

Estimates of the concentration of soluble substances in the oral fluids have generally been obtained by the analysis of whole saliva, either mixed in the mouth or obtained directly from the salivary duct. Such values may give little indication of concentrations at any particular site in the mouth. This is partly because substances do not always move easily about the mouth and also because there are large regional differences between the rates of oral clearance or retention of substances dissolved in saliva. Differential patterns therefore develop and are related, via the patterns of salivary flow, to the anatomy and physiology of the mouth. There are general features in these patterns common to all mouths and variations, which relate to characteristics of the individual, which may influence the rates of reactions occurring at different sites. The patterns may be associated with the site-specific patterns of dental disease, and they may have implications with regard to the best use of pharmaceutical agents. This paper describes some of the more recent data, problems and future possibilities in this hitherto unexplored area of oral physiology.

Fluorides↗
PubMed1994

A longitudinal evaluation of open mouth posture and maxillary arch width in children.

Open mouth posture and maxillary arch width were assessed annually for 4 years in a group of children. While younger children exhibited high levels of open mouth posture, this behavior decreased significantly over time. Racial and sex differences, as well as a race-by-time interaction were also evident. The children displayed a significant increase in maxillary arch width across time with sex and racial differences in this growth pattern. Subjects were classified as exhibiting primarily open mouth or closed mouth posture. Although both groups showed increased maxillary arch widths over time, the closed mouth subjects showed significantly greater maxillary arch growth.

Analysis of Variance↗
PubMed1976

Leukocytes in the edentulous mouth.

Oral leukocytes were estimated in 55 edentulous persons wearing dentures by sequential mouthrinses. Forty-four subjects had clinically healthy-looking mouths and 11 had parital mild inflammation under the dentures. Leukocytes were found in the mouths of all subjects. The migratory rate in 30 sec in 44 subjects was 0.283 +/0 0.082 X 10(6) and in 11 subjects 0.570 +/- 0.147. The difference between the two groups was highly significant, P less than 0.001. The cell counts of the healthy edentulous mouth are comparable with the healthy dentulous mouth. The unexpected results raise the question of the origin of leukocytes in the edentulous mouth.

Aged↗
PubMedDate not supplied

Clinicopathological factors in early squamous cell carcinoma of the tongue and floor of the mouth, in Biscay (the Basque Country, Spain).

OBJECTIVES: A study is made of the main clinicopathological factors in squamous cell carcinoma (SCC) of the tongue and floor of the mouth in the province of Vizcaya (Biscay) (The Basque Country, Spain), and their relation to patient prognosis. DESIGN: A retrospective study was made of 40 patients with early (clinical stage I/II) SCC of the tongue and floor of the mouth. A previously designed protocol was used to record the clinical and histopathological data, which were subjected to descriptive and comparative bi- and multivariate statistical and survival analyses. RESULTS: There were 34 males and 6 females, with a mean age of 55.7 years (range 33-81). In 23 cases the SCC was located in the tongue, and in 17 cases in the floor of the mouth. The average tumor diameter was 2.6 cm; 65% of the neoplasms were ulcerated. The mean clinical course was 3.4 months, with an average tumor growth rate or velocity of 268 (Evans formula). Thirty-four patients were smokers and 33 consumed alcohol. All SCC of the floor of the mouth, and all regional recurrences, were diagnosed in smokers and drinkers. Survival at 5 years was 65%. Well differentiated SCC were diagnosed in 52.5% of cases. The average histological malignancy grade was 1.96, and was higher in males, tongue malignancies, T2 lesions, tumors with growth velocities above 200, and in recurrent neoplasms. CONCLUSIONS: Early SCC of the tongue and floor of the mouth in Vizcaya affects mainly male smokers and drinkers of alcohol under the age of 60 years. A relationship is observed between the histopathological findings (particularly invasion mode and stage) and patient prognosis.

Adult↗
PubMed1998

Diagnostic value of full-mouth radiography in cats.

OBJECTIVE: To determine the diagnostic value of full-mouth radiography in cats. SAMPLE POPULATION: 115 cats referred for dental treatment without a previous full-mouth radiographic series available. PROCEDURE: In a prospective nested case-control analysis of multiple outcomes in a hospital cohort of cats referred for dental treatment, full-mouth radiography was done prior to oral examination and charting. After treatment, the clinical and radiographic findings were compared, with reference to presenting problems, main clinical findings, additional information obtained from radiography and unexpected radiographic findings. Importance of the radiographic findings in therapeutic decision making was assessed. RESULTS: The main clinical findings were radiographically confirmed in all cats. Odontoclastic resorption lesions, missed on clinical examination, were diagnosed in 8.7% of cats. Analysis of selected presenting problems and main clinical findings yielded significantly increased odds ratios for a variety of other conditions, either expected or unexpected. Radiographs of teeth without clinical lesions yielded incidental or clinically important findings in 4.8 and 41.7% of cats, respectively, and were considered of no clinical value in 53.6%. Radiographs of teeth with clinical lesions merely confirmed the findings in 13.9% of cats, but yielded additional or clinically essential information in 53.9 and 32.2%, respectively. CLINICAL RELEVANCE: The diagnostic yield of full-mouth radiography in new feline patients referred for dental treatment is high, and routine use of full-mouth radiography is justifiable.

Animals↗
PubMed1962

Defined medium for growth of foot-and-mouth disease virus.

Pledger, Richard A. (Plum Island Animal Disease Laboratory, Greenport, N. Y.) and Jerome Polatnick. Defined medium for growth of foot-and-mouth disease virus. J. Bacteriol. 83:579-583. 1962.-Foot-and-mouth disease virus, grown in primary bovine calf-kidney cell layers with a defined medium containing glucose as the only organic substrate, produced virus titers equivalent to those obtained with complex media containing serum and lactalbumin hydrolyzate. Mannose was the only other substrate examined that could replace glucose. Krebscycle intermediates did not or only partially supported viral replication. Phosphate was also found essential for reproduction of foot-and-mouth disease virus. The rate of heat inactivation of foot-and-mouth disease virus in defined medium was more than twice that in complex medium. This, however, did not interfere with the usefulness of the defined medium for short-term biochemical investigations.

Animals↗