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PubMed1987

Oral health and factors related to oral health in Polish schoolchildren.

The oral health and factors related to oral health were surveyed in 168 schoolchildren, aged 10-12 years, attending one school in Warsaw. The children were examined for dental caries and gingival status, dental plaque and salivary Streptococcus mutans and Lactobacillus counts. An interview on dietary habits and use of fluoridated toothpaste was also performed. The results showed a mean DMFT of 4.7 in the sample. Gingival Index 1 and Plaque Index 3 were median scores for the majority of the children. S. mutans was demonstrated in 94% of the children and high numbers were found in 15%. Lactobacillus sp. were present in all examined children, with high counts in 56% of the subjects. The interview revealed that most of the children eat five or six times per day and consume candies or cakes each day. Fluoridated toothpaste was not used regularly by any of the children. In conclusion this study shows a high prevalence of dental disease and an unfavorable combination of etiologic factors.

Child↗
PubMed1988

A 3-year oral health dose-response study of sodium monofluorophosphate dentifrices with and without zinc citrate: anti-caries results.

A 3-yr clinical trial has been conducted on 3000 12-yr-old children in Lanarkshire, Scotland, with the aim of investigating the effects on oral health of toothpastes containing both sodium monofluorophosphate and zinc citrate, the former being present at fluoride levels of 1000, 1500, and 2500 ppm F. No significant difference in caries increments was found between the group of children using toothpastes incorporating zinc citrate and their counterparts using zinc-free pastes. However, a significant anti-caries dose-response was demonstrated over the SMFP range used. This dose-response was evident for boys and girls and also for the various types of teeth and tooth surfaces.

Child↗
PubMed2004

A review of fluorosis in the European Union: prevalence, risk factors and aesthetic issues.

Fluoride has played a key role in caries prevention for the past 50 years but excessive ingestion of fluoride during tooth development may lead to dental fluorosis. Throughout Europe many vehicles have been, and are currently, employed for optimal fluoride delivery including drinking water, toothpaste, fluoride supplements, salt and milk. Several indices, both descriptive and aetiological, have been developed and used for measuring fluorosis. This factor, combined with the lack of use of a standardized method for measurement of fluorosis, has made comparison between studies difficult and assessment of trends in fluorosis prevalence unreliable. Overall the evidence would appear to indicate, however, that diffuse enamel opacities are more prevalent in fluoridated than in nonfluoridated communities and that their prevalence at the very mild level may be increasing. In addition to fluoridated drinking water, risk factors for fluorosis include inadvertent ingestion of fluoride toothpaste and the inappropriate use of fluoride supplements. The risk is of aesthetic concern primarily during the period of enamel development of the permanent central incisors, although this largely appears to be a cosmetic rather than a public-health issue. It is concluded that there is a need to co-ordinate studies measuring fluorosis throughout Europe and that development of a standardized photographic method would be useful. Furthermore, the aesthetic importance of fluorosis needs to be determined in more detail in each country in the light of each country's respective risk factors and dental health policies.

Adolescent↗
PubMed2007

Oral health behaviour and its determinants amongst Iranian dental students.

OBJECTIVES: To study the oral health behaviour (OHB) of Iranian senior dental students in relation to their gender, background characteristics, knowledge of preventive care, and attitudes towards preventive dentistry. MATERIALS AND METHODS: Using a cluster random sampling approach, a questionnaire survey was conducted with 327 senior dental students in seven dental schools. The questionnaire covered age, gender, parents' employment in dentistry, previous academic education in dental hygiene, oral self-care, most recent dental check-up, knowledge of preventive dentistry and attitudes towards it. Attending a dental check-up by a dentist or a classmate within the last year was defined as preventive care use. Chi-square test and logistic regression models were used for statistical analyses. RESULTS: Women reported significantly higher frequencies of tooth brushing (P < 0.001), fluoridated toothpaste use (P = 0.001) and flossing (P < 0.001) compared with men. Respondents who had been previously educated as dental hygienists had lower frequencies of eating sugary snacks (P < 0.001) and paid more attention to preventive care (P = 0.03) than others. Those with more extensive knowledge of preventive care reported higher frequencies of using fluoridated toothpaste (P = 0.05). Reported frequencies of brushing were higher amongst those with more positive attitudes (P = 0.03). In logistic regression models, having at least one parent employed as a dentist was significantly associated with higher frequencies of eating sugary snacks (P = 0.047, OR = 0.3) and more frequent preventive care use (P = 0.048, OR = 2.9). CONCLUSION: Education and training in preventive measures should be effective enough to overcome background characteristics. There is room for improving the OHB of Iranian dental students.

Adult↗
PubMed1994

Dental plaque inhibition by a combination of triclosan and polydimethylsiloxane (silicone oil).

It has previously been shown that a toothpaste which contains triclosan and polydimethylsiloxane (silicone oil) improved gingival health in a test panel with established gingivitis more markedly than usually observed when testing commercial triclosan-containing toothpastes. In the present study the mode of action of combinations of silicone oil and triclosan was investigated. An in vitro experiment showed that triclosan was retained in a thin layer of silicone oil on the inner surfaces of test tubes that had been treated with the combination of triclosan and silicone oil. This triclosan was slowly released and inhibited the growth of bacteria in the test tubes. Silicone oil alone and in combination with triclosan was able to inhibit polysaccharide adhesion to the test tubes in the presence of a strain of Streptococcus sobrinus and a sucrose-containing medium. Corresponding in vivo experiments showed similar results; teeth topically treated with silicone oil and triclosan showed a marked plaque reduction, and those treated with silicone oil alone showed a moderate reduction, as compared with a placebo. The silicone oil plus 0.3% triclosan combination inhibited plaque formation also on proximal surfaces. It appears likely that this combination provides a reservoir of triclosan in the thin layer of silicone oil which binds strongly to teeth because of its low surface tension. Triclosan is then slowly released into saliva because of its low solubility in this fluid.

Adult↗
PubMed1993

Inhibition of the formation of oral calcium phosphate precipitates: beneficial effects of Chinese traditional (kampo) medicines.

Screening tests on the formation of calcium phosphate precipitates using 23 different kinds of Kampo medicines (Chinese traditional medicines) were carried out, at concentrations where the effects of chelation are not significant. Four of them, Hochu-ekki-to (TJ-41), Kyuki-kyogai-to (TJ-77), Oren-to (TJ-120) and Inchin-ko-to (TJ-135) showed an inhibitory effect on the formation of amorphous calcium phosphate (ACP). The inhibitory effect on the induction time and the rate of transformation to hydroxyapatite (HAP) varied greatly among the 23 Kampo medicines. We classified them according to their effects on increasing the induction time and/or decreasing the rate of HAP transformation. Ethane-1-hydroxy-1, 1-diphosphonate (EHDP) was used as the standard. This compound is a common toothpaste additive which decreases dental calculus formation. Two of the 23 Kampo medicines showed little or no inhibition either on the induction time or on the rate of HAP transformation. Twelve of them reduced the rate of HAP transformation by 20-40% and with 1.9- to 4.0-fold increases in the induction time. The remaining nine showed even greater activity. Keishi-ninjin-to (TJ-82), Dai-kenchu-to (TJ-100), Toki-to (TJ-102), Rikko-san (TJ-110) and San'o-shashin-to (TJ-113) showed the same inhibitory effect as EHDP. Shigyaku-san (TJ-35;5.2-fold), Dai-kanzo-to (TJ-84;4.9-fold), Oren-gedoku-to (TJ-15;12.7-fold) and Inchin-ko-to (TJ-135;9.5-fold) had a greater effect on the increase of induction time than EHDP and reduced the rate of HAP transformation by 50-60%. These results suggest that these nine kinds of Kampo medicines may have potential as anticalculus agents in toothpastes and mouthwashes.

Calcium↗
PubMed1995

Dentists' views on cervical hypersensitivity and their knowledge of its treatment.

A random sample of 400 Dutch general practitioners was asked to complete a questionnaire dealing with the prevalence, conditions and therapies of cervical hypersensitivity of their patients. According to the 259 responding dentists an average of 10% of their patients suffered from moderate cervical pain. The estimated mode for severe pain was 1%. More than two thirds of the dentists reported inadequate brushing of the teeth to cause the hypersensitivity, about one half acknowledged periodontal causes, well over one quarter mentioned the involvement of dietary acids, and about one sixth implicated psychosomatic factors. Other causal factors were mentioned less often. Of the therapies available, the home-care methods appeared to be promoted most often, i.e. brushing with therapeutic toothpastes (77%), improvement of oral hygiene (51%) and local self-application (with finger) of a therapeutic toothpaste or fluoride preparations before the night (41%). Well over 50% reported to apply occasionally bondings/varnishes and 28% said to make sometimes cervical fillings. Other therapeutic possibilities were not, or very seldom, used.

Attitude of Health Personnel↗
PubMed2006

Oral health knowledge and practices among Dar es Salaam institutionalized former street children aged 7-16 years.

OBJECTIVES: To find out level of knowledge on causes and prevention of dental caries and bleeding gums, oral hygiene and eating practices among institutionalized former street children. METHODS: A structured standardized questionnaire was used to collect data for this study. Chi-square test was used to test for significant differences. RESULTS AND CONCLUSIONS: Eighty-eight per cent and 83% of the children knew the cause of tooth decay and bleeding gums respectively and 17-68% were aware of preventive measures. At the institutions visited, 92% of the children said they brush their teeth but 74% brushed when living on the streets, this difference was significant (chi2=4.40, P=0.05). About half did not use toothpaste during street life, whilst 8% do not use toothpaste at institutions, the difference was significant (chi2=5.081, P=0.025). Almost 22% use sweets and biscuits at institutions, about 44% used the snacks when living on the streets, the differences were significant (chi2=3.798, P=0.04, and chi2=3.893, P=0.04). Only 6% use sodas and sweetened juices at institutions, while 32-36% used the drinks during street life, the differences were significant (chi2=4.38 P=0.05 and chi(2)-12.87, P=0.01). The findings of this study show that most former street children are aware of the causes of dental caries and bleeding gums but have poor knowledge on prevention of the two diseases. Furthermore, children living on the streets are more likely to eat cariogenic foods and have poor oral hygiene practices.

Adolescent↗
PubMed2000

The surface effect of dentifrices.

The aim of this study was to evaluate clinically three commercially available dentifrices and to determine any surface effects on tooth or gingival surfaces. Sixty-four participants were included in this study and were allocated randomly to one of four treatment groups by an independent person to ensure the investigators were unaware of the brushing material used. All toothbrushes and dentifrices were distributed by this independent person. The treatment groups were: Group 1--brush with water; Group 2--brush with Colgate (Baking Soda and Peroxide); Group 3--brush with Macleans (Whitening); Group 4--brush with Colgate (Sensation Whitening). All participants were requested to brush both morning and evening in their customary fashion using only the designated toothpaste, or water, for four weeks. All participants were required to use the same toothbrush type. No other oral hygiene products such as mouth rinses or dental floss were used during the trial period. Prior to commencement of the brushing period, all participants received a full clinical examination recording the status of the soft and hard tissues including a gingival index (Löe and Silness) to record gingival condition. A polyvinyl siloxane impression was taken of the six anterior teeth and gingival tissues at the commencement of the trial. After four weeks, a second full clinical examination was made and further silicone impressions were taken of the anterior teeth. All impressions were cast in epoxy resin for investigation with light and electron microscopy. Participants were also asked to answer a questionnaire relating to the toothpaste used. The results of this study indicated that no significant clinical differences were recorded for any dentifrice or water and there was no significant difference in gingival index scores over the four week period. Patient responses to each dentifrice varied according to individual patient preferences and expectations and no consistent findings could be determined. Light and electron microscopy indicated that tooth and gingival surface changes that occurred over the four week period with any of the dentifrices were similar to, and not significantly different from, changes seen with the use of water alone. These results indicate that none of the dentifrices tested was harmful to teeth or soft tissues.

Adolescent↗
PubMed2003

Oral health knowledge, attitudes and behaviour of children and adolescents in China.

OBJECTIVES: A national representative study to describe oral health behaviour, illness behaviour, oral health knowledge and attitudes among 12-year-old and 18-year-old Chinese, to analyse the oral health behaviour profile of the two age groups in relation to province and urbanisation, and to assess the relative effect of socio-behavioural risk factors on dental caries experience. METHODS: The total number of 4,400 of each age group were selected and data were collected by clinical examinations (WHO criteria) and self-administered structured questionnaires. RESULTS: 44.4% of the respondents brushed their teeth at least twice a day but only 17% used fluoridated toothpaste. Subjects who saw a dentist during the previous 12 months or two years were 31.3% and 35.3% for 12-year-olds and 22.5% and 20.2% for 18-year-olds, respectively. Nearly one third (29%) of 12 year-olds and 40.5% of 18-year-olds would visit a dentist in case of signs of caries but only when in pain. Nearly half of the participants (47.2%) had never received any oral health care instruction. Significant variations in oral health practices were found according to province and regular dental care habits were more frequent in urban than in rural areas. The risk of dental caries was high in the case of frequent consumption of sweets and dental caries risk was low for participants with use of fluoridated toothpaste. CONCLUSION: Systematic community-oriented oral health promotion programmes are needed to target lifestyles and the needs of children, particularly for those living in rural areas. A prevention-oriented oral health care policy would seem more advantageous than the present curative approach.

Adolescent↗
PubMed2004

The role of Triclosan in dentifrice formulations, with particular reference to a new 0.3% Triclosan calcium carbonate-based system.

AIM: To discuss the role of Triclosan in dentifrice systems and demonstrate the enhanced efficacy of Triclosan in calcium carbonate-based systems when the level of the antimicrobial agent is raised from 0.2% to 0.3%. Triclosan is the most commonly used antimicrobial agent in oral care products, being compatible with a wide range of ingredients found in toothpaste formulations, whilst having no negative sensory features (e.g. taste, staining) that are associated with some other antimicrobial/anti-plaque agents. Triclosan is a broad spectrum antimicrobial agent, with additional anti-metabolic and anti-inflammatory properties. When delivered to the mouth in oral care products, Triclosan can selectively inhibit Gram negative anaerobic bacteria implicated in gingivitis and periodontal diseases, while leaving species associated with oral health relatively unaffected. Worldwide, attempts have been made to boost delivery/activity of Triclosan, either by use of copolymers or by combination with other agents such as zinc citrate. However, Triclosan has also been shown to maintain clinical efficacy against plaque and gingivitis when present as the sole antimicrobial in toothpaste formulations.

Anti-Infective Agents, Local↗
PubMedDate not supplied

Some factors associated with the caries decline among Norwegian children and adolescents: age-specific and cohort analyses.

The purpose of this study was to evaluate factors related to the caries decline in children between 1966 and 1983. The decline started in the late sixties for the 8- to 11- and the 17-year-olds, and after 1971 for the remaining age groups. Regression analyses confirmed a significantly different start of the decline. Fluorides in school-based programmes, lozenges, and toothpaste, as well as education and sale of antibiotics were significantly (p< or =0.01) related to the caries decline in partial correlation analyses. Fluoride toothpaste was only significantly related to the decline in the last part of the period of observation. Supervised fluoride rinsing and brushing programmes at school may explain most of the decline before 1971. The later decline may be related to all fluoride agents and to education. Use of fluorides and other preventive efforts aimed at pre-school children may have contributed to the continual decline in the number of fillings in the permanent teeth of the youngest cohorts.

Adolescent↗
PubMed2001

Is the fluoride concentration limit of 1,500 ppm in cosmetics (EU guideline) still up-to-date?

The 1,500 ppm fluoride (F(-)) concentration limit set up for European cosmetic toothpaste needs to be considered in terms of effectiveness and toxicity. There is clear evidence for a dose-response relationship between F(-) concentration and caries-preventive effect (25-30% caries reduction achieved with a 1,000 ppm F(-) dentifrice). Clinical significance of higher F(-) concentration has not been totally proven. Low F(-) toothpastes (<500 ppm F(-)) have been marketed to reduce F(-) ingestion by young children in order to minimize the risk of dental fluorosis. Their effectiveness is, however, unclear. Fluoride intake and caries risk assessment should be performed by dental professionals and prescription of topical fluoride should be adjusted individually.

Cariostatic Agents↗
PubMedDate not supplied

How to improve the effectiveness of caries-preventive programs based on fluoride.

During recent years, an increasing number of reports have been published in which the observed caries-preventive effect of fluoride has been lower than could have been expected on the basis of the earlier literature. The current low levels of caries occurrence and the widespread use of fluoridated toothpastes as well as other fluoride products and methods have been suggested as reasons for the reduced relative effect of fluoride from any single source. Theoretically, one can improve the effectiveness of fluoride in caries-preventive programs by using measures that are more effective than the previous ones and still safe and feasible in everyday conditions. Another possibility is to direct fluoride-based prevention to high caries risk susceptible individuals who are most likely to benefit from it. Thirdly, one can enhance the intensity of existing fluoride prevention by increasing the frequency of applications, but this is of course worthwhile only if the recipients are lacking sufficient exposure to fluoride. In theory, people themselves could easily take care of their adequate fluoride supply by using fluoride toothpastes and/or other home use products frequently enough to maintain a sufficient salivary fluoride concentration at all times. Many people are unwilling to adopt healthy lifestyles, however, and therefore caries-preventive programs will remain necessary for the foreseeable future. Fluoride is the backbone of all such programs. Since conditions strongly determine the usefulness of caries prevention including different fluoride regimes, more research is still needed to monitor the effectiveness of caries-preventive programs and their components in variable conditions of today and tomorrow.

Cariostatic Agents↗
PubMed1993

A critical review of the relative anticaries efficacy of sodium fluoride and sodium monofluorophosphate dentifrices.

While there is broad consensus in the research community that fluoride dentifrices provide important anticaries benefits, debate still remains as to the most efficient form of fluoride used in toothpastes. Recently, the authors of this paper collaborated as part of a scientific advisory group whose objective was to comprehensively review all clinical information available comparing the anticaries efficacy of the two agents most widely used in fluoridated toothpastes, sodium fluoride (NaF) and sodium monofluorophosphate (SMFP). This review included a detailed analysis of each published study pertinent to the question, a comprehensive meta-analysis of all available clinical findings, and an epidemiological assessment of how anticaries benefits of dentifrices may be anticipated to propagate with time. Overall, the use of meta-analysis of head-to-head clinical comparisons between the two fluoride-active systems was found to be the most valid means for comparing the relative efficacy of NaF and SMFP dentifrices. Results of this analysis demonstrated that NaF was significantly more effective than SMFP in preventing caries (p < 0.01). While the numerical difference in efficacy between NaF and SMFP measured between 5 and 10% (total DMFS) over a 2- to 3-year clinical period, this could be expected, on theoretical grounds, to propagate to substantially larger differences (e.g. 10-20%) over 10-20 years. Hence, the difference in efficacy between these two actives was judged to be clinically important as well as statistically significant. Based upon these findings the authors recommend that NaF be used as the active system in fluoridated dentifrices whenever practically feasible. However, the authors caution that this recommendation pertains to the formulation of NaF in highly compatible abrasive systems, which must be demonstrated by critical evaluation of ionic fluoride within formulations for stability, availability and bioavailability. One additional recommendation emanating from this review is that important improvements must be made in the design, execution and reporting of future caries clinical trials in order to bring these important methods up to scientifically acceptable standards.

Adolescent↗
PubMed1994

Effect of various post-brushing activities on salivary fluoride concentration after toothbrushing with a sodium fluoride dentifrice.

The study consisted of eight experiments, divided into three series, aimed at investigating the effect on the salivary fluoride (F) concentration of three post-brushing regimes: (1) rinsing once or twice with water, (2) rinsing either with a slurry of the toothpaste foam and water or with an 0.05% NaF solution, or a single NaF mouthrinse with no prior brushing, and (3) chewing and drinking ('eating') for 2 min. Brushing was done with 1.5 g of an 0.32% NaF dentifrice. The concentration of F in whole saliva was determined in 15 subjects at various time points up to 45 min after completing each experimental procedure. Results showed that the initial (0 min post-brushing) F concentration in saliva decreased about 1-2 times after a single, and 4-5 times after a double post-brushing water-rinse, as compared with no rinsing at all (p < 0.001). Brushing followed by a mouthrinse with an 0.05% NaF solution elevated the F concentration more than brushing alone (p < 0.001). Rinsing with the slurry of toothpaste foam and water gave only a somewhat (but not significantly) lower concentration of F in saliva than just rinsing with the 0.05% NaF solution. Eating immediately after brushing reduced the salivary F level about 12-15 times (p < 0.001) compared with brushing alone.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1996

Oral hygiene as a variable in dental caries experience in 14-year-olds exposed to fluoride.

The aim of the study was to examine the relationship between oral hygiene level and caries experience in 14-year-olds using fluoride dentifrices on a regular basis. Oral hygiene expressed as Gingival Bleeding Points (GBP) was recorded in 267 individuals in the county of Lillehammer in Norway. Total caries experience as DMFS and approximal carious lesions in the outer half of the enamel (D1), in the inner half of the enamel (D2), in dentin (D3), and filled approximal surfaces were registered clinically and on standardized bite-wing radiographs. Using multiple regression analysis, oral hygiene level expressed as GBI was the only factor that could account for variation in caries experience (DMFS). Any significant effect of consumption of sweets on caries experience could not be demonstrated with the multivariate analysis. The average percentage of GBP (+/- SD) was 35.7 +/- 10.0%. The individuals were divided into one group with good oral hygiene (GBP < 35.7%) and one group with poor oral hygiene (GBP > or = 35.7%). Significantly fewer carious lesions and filled approximal surfaces were demonstrated in the group with good oral hygiene compared with the group with poor oral hygiene. About 16% of the study population used fluoride tablets or fluoride mouthrinses in addition to a fluoride toothpaste. Only in the good oral hygiene group, additional fluoride resulted in a lower caries experience compared with those using only a fluoride toothpaste. In the group with poor oral hygiene, additional fluoride did not result in lower caries experience. The study thus supported the view that during regular fluoride exposure oral hygiene level is an important variable to explain caries risk.

Adolescent↗
PubMed1996

Fluoride in the interdental area after two different post-brushing water rinsing procedures.

The aim of the present investigation was to study two post-brushing water rinsing procedures: (1) on fluoride (F) accumulation in approximal dental plaque, and (2) on F clearance in the interdental area. Twenty subjects participated first in the accumulation study, including three experimental periods (A, B and C), each lasting for 7 days. During period A, they brushed with a 0.32% NaF dentifrice for 2 min, followed by a 1-min active mouth rinse with the toothpaste foam combined with 5 ml of water. During period B, the 2-min brushing was followed by three quick water rinses with 15 ml each. During period C, toothbrushing, which was carried out without any toothpaste, was followed by a 2-min active mouthrinse with 10 ml of a 0.05% NaF solution. All three procedures were performed in the morning (after breakfast) and in the evening (just before bedtime). The results showed that the accumulation of F in pooled approximal plaque after 7 days reached on average 2.7 times higher values after procedure A than B (p<0.001). Procedure C also resulted in more F in plaque than B (p<0.001). The same 20 subjects participated in the clearance study on a separate occasion. When measuring the F concentration in the interdental area at 3 h after the application, procedure A resulted in a significantly higher F concentration than both toothbrushing B and mouth rinse C; the AUC was 2.2 times larger for A than for B (p <0.001). Thus, both the accumulation of F in approximal plaque and the clearance of F in the interdental area are related to the mode of water rinsing after toothbrushing.

Adult↗