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PubMedDate not supplied

Oral health status and treatment needs of Canadian adults aged 85 years and over.

In an oral health survey, 1375 adults aged 85 and older were examined in North York, Canada. Only 31% of dentate nursing home residents and 47% of dentate independently living subjects had received dental care in the year previous to examination. The overall prevalence of edentulism was 66%, and about 80% of subjects wore at least one denture. Of the dentate subjects, over 60% had untreated decay, and 47% of nursing home residents had untreated root decay. Regarding clinically defined treatment needs, high levels of unmet need were identified in subjects from both types of residences. Among nursing home residents, about 45% of dentate subjects required tooth extraction, and 56% required prosthodontic treatment. Although only 27% of dentate independently living residents required tooth extraction, over 60% needed restorative treatment. Higher prevalence of both untreated decay and unmet treatment needs was associated with lower utilization of dental care for dentate subjects. For edentulous subjects, prosthetic treatment was required by 70% of nursing home residents and by 51% of independently living subjects. These results indicate that, for both nursing home and independently living residents, dental diseases and treatment needs continue through out the lifespan.

Aged↗
PubMed2004

Dental alterations associated with X-linked hypophosphatemic rickets.

The X-linked hypophosphatemic rickets is a rare metabolic disorder characterized by low serum phosphate levels caused by a decreased renal tubular reabsorption of inorganic phosphates. The initial complaints are a delay in the development of walking caused by deformity of the legs. Oral findings include poorly mineralized dentin, enlarged pulp chambers and root canals, and periradicular abscesses in caries-free teeth. We present three patients from the same family with X-linked hypophosphatemic rickets showing bone and dental alterations.

Adult↗
PubMed1997

A review of root resective therapy as a treatment option for maxillary molars.

Restorative treatment planning is often confounded when periodontal attachment loss, caries or tooth fracture involves the furcation area of the tri-rooted maxillary molars. Although such involvement invariably diminishes the long-term prognosis of the affected teeth, extraction is not always an option. Root resective therapy, which removes the involved root plus its associated crown portion (trisection), is one of several treatment modalities that can be used in such cases. This article reviews the indications and contraindications for root resective therapy, describes the techniques of surgical trisection and presents a case in which combined resective, endodontic and prosthetic management resulted in a successful outcome.

Adult↗
PubMed1994

Effect of smear layer removal on the diffusion permeability of human roots.

Ten human maxillary incisors, extracted because of periodontal disease or nonrestorable caries, were obtained and instrumented to a size #70 K-Flex file at the working length using a standard stepback technique. Tritiated water (3H2O) was placed in the root canals and allowed to diffuse to the external surface of the roots until it reached a constant rate. The smear layer in each of the experimental roots was then removed using 0.5 M EDTA followed by 5.25% sodium hypochlorite (NaOCI). The constant rate diffusion of 3H2O was remeasured. The roots were then stored in deionized H2O for 2 months and the constant rate diffusion of 3H2O was remeasured. A statistically significant difference was noted between all three groups. A decrease in the diffusion permeability of the root to 3H2O was noted immediately after smear layer removal and the highest permeability was recorded after storage in the deionized water for 2 months.

Dentin↗
PubMed2001

Relationship between oral hygiene practices and oral status in dentate elderly people living in residential homes.

OBJECTIVES: To investigate the relationship between the oral hygiene practices of dentate elderly people living in residential homes, their requests for assistance and their oral health status. METHODS: 164 people (81.2+/-7.4 years) participated in an interview and oral examination, and provided a stimulated saliva sample. RESULTS: The mean number of coronal decayed surfaces (CDS) was 2.4+/-5.9, stimulated salivary levels (log(10)cfu/ml) of mutans streptococci, lactobacilli and yeasts were 1.6+/-2.1, 3.0+/-2.2, 2.1+/-1.7, respectively, and 53% had root decayed surfaces (RDS). Plaque (PI) and gingival (GI) Indices were 2.3+/-0.7 and 1.6+/-0.4 and denture debris scores (DDS) were high. 31% of the population cleaned their mouths twice daily without requesting help and they had significantly fewer yeasts, RDS, restorations on root surfaces, lower PI, GI (P<0.005) and DDS (P<0.0001) than the 69% who cleaned less often. 50% of those who cleaned less frequently requested assistance with oral hygiene but only 5% said that their carers supported them. Those residents who requested help had significantly higher levels of yeasts, lactobacilli (P<0.001), retained roots, DDS, RDS (P<0.005), PI and GI (P<0.0001). CONCLUSION: The elderly residents' perceived need for assistance with oral hygiene was related directly to oral hygiene status and to clinical indicators of mucosal and dental diseases.

Aged↗
PubMed2001

Reasons for placement and replacement of amalgam restorations in Jordan.

AIMS: To record the reasons for placement and replacement of amalgam restorations in Jordan, to determine the use of amalgam restorations in common cavity types and to collect data on the age of the replaced amalgam restorations. SUBJECTS AND SETTING: Dentists in Jordan (n=241). METHOD: Cross-sectional study using postal survey backed up with personal contact. Data was recorded for all restorations placed or replaced over a period of one month. RESULTS: Information was collected on 3,166 restorations from patients aged 9 to 66 years. Of all restorations, 54.8% were first time placements while 45.2% were replacements of old restorations. The major reason for the first time restorations was primary caries, while that for replacement was secondary caries (28.5%) followed by broken and lost restorations (20.4%), root canal therapy (17%), tooth fracture (12%), pain or sensitivity (8.8%), poor margins (8.5%). CONCLUSIONS: In Jordan, the main reason for first placement of amalgam restoration is primary caries, the main reason for replacement is secondary caries.

Adolescent↗
PubMed2006

Do the levels of selected metals differ significantly between the roots of carious and non-carious teeth?

Since the metals deposited in teeth during formation and mineralization processes are to a large extent retained, human teeth receive a considerable attention as the indicators of the heavy metal exposure. The use of permanent teeth is limited because the extraction of healthy permanent teeth just for this purpose is hardly acceptable. As the issue of the loss of elements from a carious lesion in the coronal part of a tooth remains controversial, the valuable material could only be the root of carious and fractured permanent teeth. However, to ensure the validity of the results, it should be ascertained that the levels of certain toxic and essential elements do not differ significantly between the roots of non-carious and carious teeth, and therefore this is the aim of this project. The levels of cadmium, chromium, copper, iron, manganese, lead, zinc, potassium, sodium, calcium and magnesium were determined in the roots of 344 permanent teeth (189 carious and 155 caries-free teeth) from the residents of Ruda Slaska, Poland, aged 18 to 34. No statistically significant difference between the concentration of these metals in the roots of non-carious and carious teeth was found. This finding applies to both the general population and after the grouping by donor's gender and tooth type. The concentration of lead, iron, calcium and manganese in the roots of non-carious and carious teeth exhibited dependence upon tooth type, as well as the concentration of potassium in the roots of carious teeth. Since the mineral composition of the roots of permanent teeth is similar for the non-carious, as well as the carious teeth, they can be indiscriminately selected for the tests required by a research project, as they will produce the comparable results. However, in the case of lead, iron, calcium, potassium and manganese, the comparison should be made after grouping by tooth type.

Adult↗
PubMed1997

Follow up after root canal treatment of young permanent molars.

The purpose of the present study was to assess the success of root canal treatment in permanent molars of children and adolescents. Twenty-eight endodontically treated first permanent molars of 18 patients aged 8 to 16 years at the time of treatment were examined. The age of the patient at the time of treatment ranged from 8 to 16 years (mean age 12.4 +/- 2.3). The majority of the treatments were done on the mandibular teeth (67%). Nine patients had one treated molar, eight patients had two treated molars and one patient had three treated teeth. None of the patients had all four molars treated. The time elapsed from the root canal treatment until our examination ranged from 24 months to 77 months (mean time 45.1 +/- 19.1). The examination included clinical and radiological parameters as follows: sensitivity to percussion, mobility, quality of restoration (contact point reproduced, overhang, secondary caries), periapical lesions before and after treatment, external root resorption, furcation involvement and interproximal bone resorption. Treatment was considered completely successful if no pathology was found. Only 10 teeth (36%) demonstrated complete treatment success, less than previously reported. No significant differences between mandibular and maxillary teeth were found with respect to any of the variables. The results suggest that considering a number of multidisciplinary criteria for assessing success of root canal treatments in first permanent molars of children and young adolescents is essential, and provides a realistic success rate.

Adolescent↗
PubMed1986

Effect of proteolytic enzymes on caries lesion formation in vitro.

This study investigates enzyme degradation of collagen at various pH levels and is designed to obtain information pertaining to the effect of proteolytic enzymes on caries-like lesion formation and progression. One hundred and eight sections of human teeth with exposed areas on enamel and root face, were placed into an enzyme/buffer system maintained at pH levels of 4.0, 5.5 and 7.0. Periodically, throughout the experimental period, sections were removed and examined histologically for caries-like lesion formation. Results showed consistent surface erosion occurring on the root face only at a pH level of 5.5 in buffer containing enzymes. Sections placed in pH 5.5 buffer only, which served as controls, showed obvious lesion formation on the root face, but with histologically intact surfaces. This interaction occurring between enzymatic activity and acid demineralization suggests that enzymes may have a contributory effect on caries lesion formation in root surfaces.

Dental Caries↗
PubMed1998

Surgical management of impacted third molars.

Teeth may become impacted when they fail to erupt or develop into the proper functional location. As such, impacted teeth are considered nonfunctional, abnormal, and pathological. The mandibular third molar is the most common tooth to become impacted. The cause of impacted third molars is thought to be inadequate space. Several studies indicate that a change from a coarse, attritive diet to a modern, refined diet has lead to an increased incidence of impacted teeth. Interproximal attrition allows for greater mesial migration of teeth and space for third molar teeth. Teeth that fail to attain a functional position may be pathological and should be considered for removal. The indications for removing impacted teeth can be divided into those of acute or chronic pathology. Impacted third molars are often associated with pain, infection, cyst formation, benign tumors, root resorption, bone loss, periodontal disease, and caries. The decision to surgically remove impacted third molars is often unclear. There are no absolute treatment protocols established. The dentist must consider a variety of factors and make an informed decision with the patient. Most experienced clinicians combine objective data and common sense to arrive at a logical treatment plan. The purpose of this article is to discuss factors related to impacted teeth and help the orthodontist understand the general management of impacted third molars. The decision for surgery will be assisted by an understanding of all of the risk factors associated with impacted teeth and presenting the options to the patient.

Decision Trees↗
PubMed2003

Oral health condition in southern Chinese after radiotherapy for nasopharyngeal carcinoma: extent and nature of the problem.

OBJECTIVE: To measure the oral health status of southern Chinese nasopharyngeal carcinoma (NPC) survivors 1-4 years after radiotherapy. SUBJECTS AND METHODS: A total of 109 subjects participated in this cross-sectional study. Thirty-eight subjects were NPC survivors, 40 subjects were patients newly diagnosed with NPC and 31 were healthy subjects. Verified clinical examination techniques were used to assess limitation of jaw opening, the presence of mucositis, candidiasis, dental caries, periodontal disease [community periodontal index (CPI)] including attachment loss (ALoss) and prosthetic status/need. Differences among three groups were tested by chi-squared and Kruskal-Wallis tests. Relationships between selected clinical variables and radiation parameters were analysed using Spearman's rank correlation coefficients. RESULTS: The NPC survivors attended for dental treatment more frequently than the other groups (P < 0.01). NPC survivors had significant xerostomia (92%, P < 0.01), trismus (29%, P < 0.01), a higher prevalence of clinical candidiasis (24%, P < 0.01), a greater DMFT (16.4 +/- 7.0, P < 0.01), more decay/filled roots (2.1 +/- 2.9, P = 0.01) compared with new NPC patients and controls. No difference was found in CPI, ALoss, prosthetic status and need between groups. Dry mouth and tooth hypersensitivity were the most common oral problems perceived by the NPC survivors. CONCLUSION: Despite having regular dental follow-ups, oral health was compromised in NPC survivors 1-4 years postradiotherapy.

Candidiasis, Oral↗
PubMed1991

Tooth loss and caries prevalence in older Floridians attending senior activity centers.

Older adults attending 14 senior activity centers in six countries of Florida cooperated for a questionnaire and an oral examination. The mean age was 76.5 yr, and about one-third were 80 yr or older. One-third of the dentate persons had dental caries. Most of the carious lesions were on the crown, not the root, and most of the decay was primary, not recurrent. Most of the persons with a need for caries treatment were likely to seek dental care; however, the majority of carious surfaces were in persons who reported being infrequent users of care. These results from ambulatory older adults suggest that older adults have significant caries treatment needs, and provide support for the view that the treatment of older U.S. adults may grow in the coming decades.

Aged↗
PubMed2001

Relationships between medication intake, complaints of dry mouth, salivary flow rate and composition, and the rate of tooth demineralization in situ.

The aim of this study was to describe the relationships between the rate of tooth demineralisation and medication intake, subjective feeling of dry mouth, saliva flow, saliva composition and the salivary level of lactobacilli. The study group consisted of 28 subjects that were divided into three groups according to their unstimulated whole saliva flow rate. Group 1 had an unstimulated saliva low rate < or =0.16 ml/min (n=10), group 2 had one from 0.17--0.30 ml/min (n=9), and group 3 had one >0.30 ml/min (n=9). The rate of tooth demineralization was determined as mineral loss assessed by quantitative microradiography of human root surfaces, exposed to the oral environment for 62 days in situ. The unstimulated and stimulated saliva flow rates, pH, bicarbonate, calcium, phosphate, and protein concentrations, as well as the degree of saturation of saliva with hydroxyapatite and the saliva buffer capacity were determined. The results showed that almost all subjects developed demineralization, albeit at highly varying rates. Eighty-five percent of the subjects in group 1, 33% of the subjects in group 2, and 0% of the subjects in group 3 developed mineral loss above the mean mineral loss for all the root surfaces in this experiment. Futhermore, group 1 differed significantly from groups 2 and 3 in having a higher medication intake, a more pronounced feeling of dry mouth, lower stimulated saliva flow rate, lower stimulated bicarbonate concentration, lower unstimulated and stimulated compositional outputs (bicarbonate, calcium, phosphate, and protein), and a higher Lactobacillus level. The best explanatory variable for high mineral loss in this study was a low unstimulated saliva flow rate. In conclusion, our results suggest that an unstimulated salivary flow rate < or =0.16 ml/min as described by Navazesh et al. (1992), is a better indicator of increased caries risk due to impaired salivation, than the currently accepted definition of hyposalivation (unstimulated saliva flow rate < or =0.10 ml/min), which relates to the function of the salivary glands (Sreebny, 1992).

Adult↗
PubMed1988

Factors influencing lead concentrations in shed deciduous teeth.

Data collected for the Edinburgh Lead Study have been used to investigate lead concentrations in children's naturally shed deciduous teeth. A within-child multiple-regression analysis has shown that the upper jaw has a higher concentration of lead than the lower, and that there is a gradient of decreasing concentration from the front to the back of the mouth. Even after the effects of jaw and tooth type have been allowed for, the concentration is still found to be negatively correlated with the weight of the tooth and with the age at which the tooth was shed. No statistically significant effects could be attributed to caries, fillings, or the incomplete resorption of roots. A single-valued index of tooth lead has been derived for each child, taking into account the fact that children gave different types of teeth.

Age Factors↗
PubMed1993

Partial pulpotomy in crown-fractured permanent incisor with hyperplastic pulpitis: a case report.

Hyperplastic pulpitis, which is regarded as one type of asymptomatic irreversible pulpitis, occurs usually in young teeth where pulps are exposed by caries or trauma. If apices are mature, root canal therapy is recommended. In this case, the success of partial pulpotomy in a crown-fractured permanent incisor with hyperplastic pulpitis, which had been contaminated with oral microflora for six months is reported.

Adolescent↗
PubMedDate not supplied

Necrosis of gingiva and alveolar bone caused by acid etching and its treatment with subepithelial connective tissue graft.

The misuse of various chemicals in dentistry may cause damage to gingiva and alveolar bone. In this case report, we describe necrosis of the gingiva and alveolar bone caused by acid etching. A patient whose caries on the cervical third of the root of his mandibular right first molar were treated 2 days earlier presented to our clinic with severe pain and discomfort in the treated area. Intraoral examination revealed a spreading gingival ulceration and exposed alveolar bone. The patient was followed and a week later, when the gingival inflammation had decreased, periodontal surgery was performed. A full-thickness flap was raised and necrotic gingiva and bone were removed. As a result, only a narrow band of keratinized gingiva remained. To treat the gingival recession and protect the underlying bone, a subepithelial connective tissue graft was placed during the same session. After the operation, the patient"s complaints resolved. Subepithelial connective tissue graft can be an important treatment approach in cases of necrosis and gingival recession caused by the misuse of various chemicals.

Acid Etching, Dental↗