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Human dental plaque pH, and the organic acid and free amino acid profiles in plaque fluid, after sucrose rinsing.

The relationship between these factors was studied in plaque and plaque fluid samples taken at intervals during the Stephan pH curve following a sucrose mouth rinse. Levels of lactate rose after the rinse, then fell during the pH recovery phase. Levels of acetate, propionate and phosphate fell after rinsing, then rose again. Amino acid concentrations also changed, with many showing a fall followed by a rise; others rising then falling; and some showing a more variable or complex pattern. In resting plaque fluid, only alanine, proline, glutamic acid, glycine and ammonia were present at concentrations above 1 mmol/l. Delta-aminovaleric acid was detected at levels below those that have been found in monkeys. Hydroxyproline and hydroxylysine were consistently detected, levels of arginine were generally low, and those of cystine consistently very low. The results may provide a basis for understanding the complex metabolic interrelations that occur in the course of the Stephan curve and which may reflect or produce the observed pH changes. They suggest that besides the amount of acid produced, the type of acid, buffering power and base production should be considered as determinants of plaque pH.

Acetates↗

Alkali-soluble and insoluble fluoride in erupted and unerupted sound enamel of human third molars in vivo.

The amounts of firmly and loosely bound fluoride were determined in sound enamel of unerupted and erupted teeth which had been exposed in vivo for 1-16 yr to brushing at least once a day, and occasionally to mouth rinsing and the application of sealers. Enamel was sampled by an acid-etch procedure, and the fluoride levels were measured with an adapted fluoride ion-selective electrode. Unerupted enamel was etched significantly (p less than 0.05) deeper than erupted enamel up to a depth of at least 8 microns. Significant differences (p less than 0.05) were found between the mean enamel fluoride concentrations of unwashed and alkali-washed, erupted teeth up to a depth of at least 3 microns and also between unwashed or washed, erupted versus unwashed or washed, unerupted teeth. At a depth of 3 microns, the fluoride treatments of enamel had increased the total amount of fluoride by approx. 78% of which approx. 53% was loosely bound fluoride (like CaF2) and 47% firmly bound (like fluorapatite). No increase in sound enamel fluoride as a result of topical treatments over a period of up to 16 yr could be found at a level deeper than 20 microns.

Acid Etching, Dental↗

Effect of immune bovine milk on Streptococcus mutans in human dental plaque.

The use of a mouthrinse of bovine milk containing antibodies to Streptococcus mutans resulted in an initial reduction in the numbers of recoverable Strep. mutans in a group of 9 individuals. Ten volunteers who used control bovine milk that contained no antibody activity to Strep. mutans had variable levels of plaque Strep. mutans. In addition, after culture on Mitis Salivarius and Gold's agar, the plaque Strep. mutans from subjects who used the immune bovine milk rinse formed smaller colonies than those from pre-treatment plaque and from all plaque samples of subjects who used the control rinse.

Adult↗

Effect of timing of administered calcium lactate on the sucrose-induced intraoral demineralization of bovine enamel.

A number of soluble calcium salts are known to reduce the demineralization of enamel in the mouth. The present study was undertaken to examine the effects of rinses containing different concentrations of calcium lactate, and the time of giving the rinses with respect to sucrose challenges. Subjects wore palatal appliances containing blocks of bovine enamel whose surfaces were covered with Streptococcus mutans IB 1600, and rinsed with 10% sucrose for 1 min. Changes in iodide penetrability of the enamel, and the pH and extracellular ion concentrations of the streptococcal plaque were determined. When added to the sucrose rinse, 100 or 150 mM calcium lactate reduced demineralization by about 35%, although the plaque pH was not affected. Plaque calcium was elevated but diffused away rapidly so that concentrations after 45 min were close to control values. Plaque inorganic phosphate and lactate were not affected. Ongoing demineralization appeared to be stopped when 100 mM calcium lactate was given 15 min after the sucrose rinse. When the lactate was given 15 min before the sucrose rinse, demineralization was reduced by only about 25%, consistent with the rapid diffusion of plaque calcium. The combination of (i) pretreatment with calcium lactate and (ii) admixture of calcium lactate with sucrose was most effective. Demineralization was reduced about 55% with 100 mM calcium lactate under these conditions, and protective effects were seen with as little as 25 mM. In summary, the findings demonstrate the enamel-protective effect of relatively low concentrations of calcium lactate, and point to the need to sustain a high plaque calcium during periods of maximum acidogenicity.

Adult↗

Glucose retention on the surfaces of primary teeth in 3- and 4-yr-old children.

Glucose retention was determined in 38 kindergarten children ages 3-4 yr. The children rinsed their mouths with 10 ml of a 0.5 mol/l glucose solution for 15 s and then spat out. Three minutes after they put the solution in their mouths, a small paper-point was used to collect samples of saliva from the labial and buccal surfaces of the maxillary and mandibular primary teeth. The concentration of glucose in the small amount of saliva collected was measured with an immobilized enzyme system. Glucose retention was highest on the maxillary central primary incisor, second highest on the maxillary first primary molar and third highest on the maxillary lateral primary incisor. An intermediate value was seen on the maxillary and mandibular second primary molars, the mandibular first primary molar and the maxillary primary canine. A lower value was observed on the mandibular primary canine and the lowest on the mandibular incisors. It was concluded that there were site differences in glucose retention on primary teeth of 3- and 4-yr-old children.

Analysis of Variance↗

Effects of chlorhexidine on human taste perception.

Chlorhexidine gluconate at a dose used to control bacteria in the mouth has a reversible effect on taste perception. Taste-intensity ratings and taste-quality identification for concentration series of sucrose, sodium chloride, citric acid and quinine hydrochloride were obtained from 15 healthy humans. The participants rinsed with 0.12% chlorhexidine for 3 min twice a day. Each individual was tested 3 times: before the 4-day rinse period, 30 min after the final rinse, and 4 days after the rinse period. Chlorhexidine rinses reduced the perceptual intensity of sodium chloride and quinine hydrochloride, not sucrose or citric acid. No effects on taste perception were detected 4 days after the rinse period. The identification of sodium chloride as salty was seriously impaired by chlorhexidine but the identification of quinine hydrochloride as bitter was not affected. Specific sites of action of chlorhexidine on the taste epithelium are not known but its effects on salty taste may be related to its strong positive charge and its effect on bitter taste may be related to its amphiphilicity. Chlorhexidine has promise as a probe of taste transduction, as well as for the management of salty/bitter dysgeusias in humans.

Adult↗

Use of a palatal reservoir in denture patients with xerostomia.

Dentures that included a reservoir for saliva substitute in the palate of the maxillary denture were constructed for three xerostomic patients. Results were obtained through examinations and interviews. All patients found that the reservoir system helped control the xerostomia. Details of design and function were reviewed and general applications were discussed.

Adult↗

Effects of dental medicaments on examination glove permeability.

Dental care providers wear gloves for all clinical procedures. This study was designed to assess the intactness of examination gloves after exposure to commonly used agents. Finger portions from latex and vinyl examination gloves were sealed to syringe barrels and exposed to alcohol, eugenol, a surface disinfectant, cavity varnish, or commercial mouth wash. Tritiated water was introduced into the finger-tip portion, which was suspended in a vacuum flask containing distilled water. Aliquots of water were withdrawn from the flask at intervals of 5 minutes to 8 hours and analyzed for transfer of radioactivity through the glove tip. Treatment with agents such as eugenol and cavity varnish resulted in significant leakage after 5 to 15 minutes. Although some agents apparently quickly damaged the gloves, leaks developed in untreated gloves with time. Results suggest that visibly intact gloves may have developed microleaks and that changing gloves during long clinical procedures may be indicated.

Dental Cavity Lining↗

Gingival enhancement in fixed prosthodontics. Part I: Clinical findings.

This study assessed the efficacy of a 0.12% chlorhexidine gluconate (CHX) rinse on the enhancement and maintenance of gingival health in patients receiving fixed prosthodontic treatment. Thirty patient participants in this examiner blind study were randomly assigned into two groups, one control and another group using CHX 15 ml b.i.d. in addition to normal oral hygiene. The medication was used for 2 weeks prior to crown preparation, 3 weeks during provisional crown placement, and 2 weeks after definitive crown cementation. Plaque and gingivitis indices were measured initially and at the three aforementioned points during the 7-week period. The plaque index for the control group decreased by 0.26 units; CHX decreased by 0.63 units at 7 weeks. The gingival index of the control group decreased by 0.37 units; CHX decreased by 0.87 units. Adjunctive use of chlorhexidine with fixed prosthodontic procedures significantly reduced plaque levels and significantly improved gingival health compared with the control patients. Fixed prosthodontic procedures alone decreased plaque levels and increased gingival health.

Adult↗

Gingival enhancement in fixed prosthodontics. Part II: Microbiologic findings.

This study assessed the changes of the subgingival/marginal microflora during fixed prosthodontic procedures and evaluated the effect of adjunctive rinsing with 0.12% chlorhexidine on the subgingival/marginal microflora during fixed prosthodontic treatment. Thirty patients scheduled for fixed prosthodontics were randomly assigned to either rinsing with 15 ml of tap water b.i.d. (control) or rinsing with 15 ml of 0.12% chlorhexidine gluconate b.i.d. (experimental). Subgingival and marginal plaque was analyzed at baseline, before crown preparation (2 weeks), before crown cementation (5 weeks), and 2 weeks after cementation (7 weeks). The fixed prosthodontic procedures alone altered the subgingival and marginal microbiota toward a more health-associated flora. Adjunctive rinsing twice daily with 0.12% chlorhexidine had a significantly greater effect in reducing putative periodontal pathogens compared with the control regimen. This medication was a useful adjunct to regular oral hygiene during fixed prosthodontic procedures by permitting the establishment and maintenance of a microflora compatible with periodontal health.

Adult↗