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PubMed2001

Time trends in oral health behaviors among Norwegian adolescents: 1985-97.

The purpose of this study was to investigate 1) the temporal changes in oral health behaviors and 2) the development of the distribution of oral health behaviors on the basis of socioeconomic factors among Norwegian adolescents from 1985 to 1997. Large-scale national surveys to assess smoking, intake of sweets, soft drink consumption, and toothbrushing among Norwegian adolescents were conducted in November 1985, 1989, 1993, and 1997. The surveys were part of the World Health Organisation (WHO) international study, Health Behaviour in School-aged Children. A total of 3955 (1985), 5037 (1989), 4952 (1993), and 5026 (1997) 11-, 13-, and 15-year-old students completed anonymous questionnaires at school. The response rates varied from 79% to 90%. The results showed a strong increase in the percentages reporting ever smoking and daily intake of soft drinks and sweets with age from 11 to 15 years in each survey year. In 1997, at the age of 15 years, most students reported toothbrushing more than once a day (94% boys, 97% girls) and ever smoking (39% boys, 36% girls), whereas moderate proportions confirmed daily intake of soft drinks (28% boys, 19% girls). Comparison of the results across the survey years, from 1985 to 1997, showed an overall decrease in ever smoking (boys, 59% versus 39%; girls, 52%, versus 36%) and toothbrushing more than once a day (boys, 95% versus 94%; girls, 99% versus 97%). Contemporary increases occurred with regard to daily soft drink consumption. Inequalities in ever smoking and daily soft drink consumption between socioeconomic status groups decreased and increased, respectively, from 1983 to 1997. The sex disparities observed in 1985, with boys being more likely than girls to report ever smoking and daily soft drink consumption, leveled off in 1997.

Adolescent↗
PubMed1998

Recurrence rate of streptococcal pharyngitis related to hygienic measures.

OBJECTIVE: To test the hypothesis that treatment failures of streptococcal pharyngotonsillitis may be caused by reinfection by the patients' own streptococci remaining on a toothbrush or in the bedclothes. DESIGN: To elucidate the role of streptococcal contamination of the environment, hygienic measures regarding change of toothbrush and bed linen and washing of toys were given to half of the patients/families. Throat specimens were taken from all the patients before treatment with phenoxymethylpenicillin for 5 days, and the patients were followed-up for 1 month. At a home visit after 6-10 days, throat specimens were taken from the patients and all permanent residents of the home. Environmental samples were taken from pillowcases, floors, toothbrushes, dummies, and toys. SETTING: Six health care centres. SUBJECTS: 114 patients of all ages suffering from group A streptococcal pharyngotonsillitis, and 289 family members. MEASUREMENTS AND MAIN RESULTS: 54 patients/families received hygiene instructions. The total number of recurrences was 40 (35%). There was no difference in treatment failure rate between patients/families that had taken or not taken hygienic measures. CONCLUSIONS: Hygienic measures have no decisive influence on the risk of recurrence of streptococcal pharyngotonsillitis.

Adolescent↗
PubMed1995

A comparison of partial and full mouth scoring of plaque and gingivitis in oral hygiene studies.

The clinical testing necessary to demonstrate the safety and efficacy of new toothbrushes is complex and expensive. Any modification of methodology that could reduce complexity and cost without compromising quality would benefit both investigators and the public. Results from an 8-week toothbrush study were assessed for the use of partial as compared to full-mouth evaluations. The potential utility of an objective, minimally-invasive bleeding index for the evaluation of gingivitis was also tested. 2 partial evaluations, half-mouth and molar/anteriors, revealed decrements in modified gingival index (MGI), bleeding index and plaque index that were statistically significant and similar in magnitude to those derived from full-mouth examinations. % decrements in MGI and bleeding index based on the Ramfjord teeth were not significant statistically. Results for the new sulcular bleeding index were essentially similar to those for the MGI. However, the bleeding index offered the advantage of improved objectivity for use in both white and non-white subjects. These results suggest that partial evaluations and the new bleeding index may be useful elements in the design of toothbrush efficacy studies.

Adult↗
PubMed2005

Bacteraemia following periodontal procedures.

INTRODUCTION: Transient bacteraemias are frequently detected following dental manipulation. Infective endocarditis (IE) can arise in susceptible individuals and antibiotic prophylaxis is routinely performed for certain procedures considered to be "at risk" of IE. Evidence is emerging that periodontal disease may be a significant risk factor for the development of certain systemic diseases such as cardiovascular disease. These systemic conditions could be initiated or detrimentally influenced by the repeated entry of bacteria into the bloodstream. MATERIALS AND METHODS: The present study comprised a single blind parallel study of 2 weeks duration. A baseline blood sample was obtained from 30 volunteers with untreated periodontal disease following which a periodontal probing depth chart was collected. A further blood sample was taken following this procedure, and each subject was recalled 2 weeks later. A blood sample was collected, the subject carried out toothbrushing and a further blood sample taken. Full-mouth ultrasonic scaling was then performed and a final blood sample taken. Blood samples were analysed for bacteraemia using conventional microbiological culture and polymerase chain reaction (PCR) using universal bacterial primers that target the 16S ribosomal RNA gene of the vast majority of bacteria. RESULTS: Using culture methods, the incidence of bacteraemias was as follows: following ultrasonic scaling (13%), periodontal probing (20%) and toothbrushing (3%). PCR analysis revealed bacteraemia incidences following ultrasonic scaling, periodontal probing and toothbrushing of 23%, 16% and 13%, respectively. CONCLUSION: These findings suggest that detectable dental bacteraemias induced by periodontal procedures are at a lower level than previously reported.

Adult↗
PubMed1976

Effectiveness of a dental education program on oral cleanliness of schoolchildren in Israel.

The purpose of this study was to examine the effectiveness of a dental health education program providing dental health information and toothbrushing instruction on oral cleanliness. Two methods of instruction, individual and group instruction, are presented in this study. The plaque situation was assessed in a group of 175 children, 11-14 years of age, by the Patient Hygiene Performance (PHP) method at the beginning of the study and at 1, 2, and 12 months. It was found that immediately after instruction the dental health education program resulted in improved oral hygiene home care for the two experimental groups. However, the improvement noted was achieved regardless of the method of toothbrushing instruction (individual versus group). Moreover, it was demonstrated that maintenance of a satisfactory level of oral hygiene home care was dependent upon review of educational programs and toothbrushing instruction and not related to the method of instruction.

Adolescent↗
PubMed1983

Effect of oral hygiene instruction on brushing skills in preschool children.

This study provides new information on the assessment of toothbrushing skills in preschool children. 420 children aged 2-4 years were given a single lesson on toothbrushing. Their levels of toothbrushing skills, in terms of the locations of the tooth surfaces brushed, were recorded before and after the lesson. The number of skills per child possessed before the lesson (innate skills) and the number acquired from the lesson, both increased with age. A high correlation was found between the proportion of children innately possessing a particular skill and the proportion who subsequently learned it from the lesson. An effectiveness index was devised to help compare the relative difficulty and utility of teaching different skills at different ages.

Age Factors↗
PubMed1985

Use of gingival bleeding for reinforcement of oral home care behavior.

The present study examined the use of gingival bleeding as a reinforcement mechanism for interproximal home care with the toothpick. After initial assessments of plaque and gingival bleeding, 36 subjects were given a professional toothcleaning and instructed to maintain oral hygiene by toothbrushing alone for 3 months. After 3 months of brushing only, subjects were re-examined and given another professional toothcleaning. Having been matched for age and percentage of sites bleeding on probing, as determined at the initial examination, they were than randomly attached to one of three groups. One group, the control, continued to clean their teeth with only a toothbrush, while the other two groups used the toothbrush supplemented with the toothpick for interproximal subgingival cleaning. Both toothpick groups received identical instruction in toothpick technique, but one group was taught to use bleeding as an interpretive device for health. Three months later, clinical assessments indicated significantly less gingival bleeding for both toothpick groups as compared with the control (whose gingival health worsened). Although there was no significant difference between the final scores of the toothpick groups, only the group that used gingival bleeding as a sign of disease showed a significant improvement in gingival health (P less than 0.003), and also had a fivefold higher rate of return of self-report compliance cards. These results suggest that the use of gingival bleeding as a reinforcement mechanism should be considered as a strategy in oral home care instruction to promote compliance with recommended behavior.

Adult↗
PubMed1988

Oral hygiene behavior and periodontal status in European adolescents: an overview.

The object of this review is to examine toothbrushing as a health behavior in European adolescents. The aims are to investigate the role of environmental and social factors on toothbrushing as a health behavior, to illustrate the importance of such factors in the prevention of periodontal diseases and to demonstrate how a knowledge of these factors can aid the development of specific health education programs. In order to do this the results of many studies concerned with oral hygiene behavior from different European countries have been examined. It is from the detailed study of these various European investigations that the results section is composed. The findings from this review demonstrate that toothbrushing as a health behavior is influenced by both environmental and social factors, that both of these factors affect the incidence of gingivitis and periodontal disease in the countries examined, and that when they are incorporated into health education programs based on the community development approach they can aid behavior change.

Adolescent↗
PubMed1992

Oral self-care behaviours in older dentate adults.

Defining oral self-care as activities undertaken by individuals to maintain or promote dental health, this paper examines the distribution of oral self-care behaviours in a sample of dentate adults, age 50 and over, living in Ontario, Canada (n = 713). Results are presented separately for two older cohorts, respondents ages 50-64 and those 65 and older, and for females and males. Six oral self-care behaviours were examined: toothbrushing, flossing, use of an interdental device, extra fluoride use, frequency of between meal snacks and ingestion of cariogenic foods. High rates of self-care occurred only for toothbrushing. Age groups differed significantly for use of interdental devices, consumption of cariogenic foods and snacking between meals while gender differences were found for toothbrushing, flossing and consuming sweet foods. The need to target older adults and especially older males for oral hygiene information and instruction in order to counteract possible misleading beliefs learned before the advent of current dental hygiene practices is apparent from these data.

Age Factors↗
PubMed1992

Improvement of oral hygiene in patients with rheumatoid arthritis.

Programs in power toothbrushing, manual toothbrushing with conventional fluoride toothpaste and with a chlorhexidine/fluoride gel has been evaluated for plaque removal in an observer blind cross-over clinical trial on 14 rheumatoid arthritis patients. All three regimens lead to considerable improvement in oral hygiene. The use of an electric toothbrush was slightly more effective than a manual brush. Brushing with a chlorhexidine/fluoride gel gave the best results, but its clinical use is limited by unacceptable taste, discoloration and possibly adverse soft tissue effects.

Arthritis, Rheumatoid↗
PubMed2006

Symptoms of depression and anxiety in relation to dental health behavior and self-perceived dental treatment need.

The purpose of this study was to investigate the dental health behavior and self-perceived dental treatment need, in relation to depressive symptoms and symptoms of anxiety, among a general population drawn from a sample of 31-yr-old-men and women born in Northern Finland in 1966 (n = 8463). The dental health behavior included toothbrushing frequency and the frequency of dental check-ups. Depressive symptoms, as well as symptoms of anxiety, were determined on the basis of the Symptom Checklist-25 (SCL-25). The participants were also asked about their education and family income. Subjects with a high number of depressive symptoms had lower toothbrushing frequency as well as a lower frequency of dental visits than subjects with no or only a few depressive symptoms. Morover, the self-perceived dental treatment need was more common among those with a high number of depressive symptoms. Symptoms of anxiety were significantly associated with lower toothbrushing frequency. The results support the view that there is an increased risk for impaired dental health among subjects with depressive symptoms or symptoms of anxiety.

Adult↗
PubMed1989

Effects of flossing on plaque and gingivitis in third grade schoolchildren.

The purpose of this investigation was to determine whether flossing, as an adjunct to toothbrushing, performed in a school-based program can contribute significantly to a reduction in gingivitis. Four volunteer third grade classrooms (n = 112) were randomly assigned to finger-floss, looped-floss, flossholder, and brushing-only control group. Measures taken at baseline and in four weeks included gingival (GI), plaque (PI), and flossing dexterity indices (FDI). Results using ANOVA showed no differences in PI among groups. However, both brushing-only and finger-floss groups showed GI scores significantly lower than the looped-floss group. A repeated measures ANOVA revealed that the finger-floss group improved gingivitis scores most over time, while the flossholder group improved scores the least. The ANCOVA results with FDI showed that at the final measurement, looped-floss manual dexterity was rated significantly better than finger-floss and that both groups were rated better than flossholder. Final indications are that toothbrushing alone can produce clinical results similar to use of a combination of toothbrushing and flossing.

Child↗
PubMedDate not supplied

Prospective study of the effect of post-brushing rinsing behaviour on dental caries.

Previous studies have indicated that rinsing the mouth with a beaker of water after toothbrushing may compromise the caries reducing effect of fluoride toothpaste. A 3-year clinical trial of daily supervised brushing with fluoride toothpaste at school was used to test the effect of post-brushing rinsing with water on caries increment. A total of 407 children, mean age 11.8 years, attending three schools in Kaunas, Lithuania were enrolled following informed consent of the children and their parents. Caries was recorded at baseline and annually for 3 years. During the study, children in two schools (A and B) performed daily supervised brushing with a 1,500-ppm fluoride toothpaste. Children in school A rinsed their mouths thoroughly with a beaker of water after toothbrushing whereas children in school B were only permitted to spit out once after brushing. Furthermore, the children in these schools were supplied with toothpaste and toothbrushes for use at home and in school. A third school (C), without daily brushing and without supply of toothpaste, served as control. Compliance with the protocol was consistently better in school B. After 3 years 276 children were available for examination. Three-year DMFS increments, including non-cavitated lesions (mean, 95% CI), were: school A, 6.8 (5.3; 8.3); school B, 6.2 (4.6; 7.8), and school C, 12.4 (10.6; 14.1). Mean increments for schools A and B did not differ significantly but were both significantly lower than those of school C (p< 0.001). It is concluded that post-brushing rinsing with water, under the conditions of this study, does not significantly affect the caries reducing effect of a fluoride toothpaste.

Analysis of Variance↗
PubMedDate not supplied

Risk/prevention indicators for the prevalence of dental caries in schoolchildren: results from the Italian OHSAR Survey.

The Italian Oral Health of Schoolchildren of the Abruzzo Region (OHSAR) Survey was designed to assess indicators associated with the prevalence of caries in both the primary and permanent dentitions in the same schoolchildren, and it comprised a representative sample of 5,938 7-, 9- and 11-year-old schoolchildren from three provinces within the region of Abruzzo, Italy, a low fluoride concentration area. Gender, age, geographic location, socioeconomic level, dietary and oral hygiene habits, and the use of F supplements were all considered as indicators. The subsequent multivariate analyses showed that the socioeconomic level, snack consumption frequency, consumption of sweets and the use of F supplements were mostly associated with caries prevalence in both dentitions. Other indicators, such as gender, age, geographic location, between-meal snack consumption frequency, consumption of sweet drinks, toothbrushing frequency and onset of regular toothbrushing habits also showed some significant associations with dental caries across the age groups and/or dentitions. Of interest, the consumption of commercial bottled mineral water was also seen to be a preventive indicator for dental caries of the primary dentition, particularly in the 7-year-old group. The consumption of sweet snacks, use of interdental floss and kind of toothbrush mainly used (manual or electric) did not show any relevant association with the outcomes. The strong effect of the geographic location, socioeconomical level and the preventive effects of commercial bottled mineral water are worth further investigation.

Analysis of Variance↗
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↗
PubMed1985

Effect of filler content and size on properties of composites.

Two series of dental composites, along with the unfilled resin matrix, were examined to determine the effects of filler level and size on selected properties. Both series were prepared by incorporating a silanated barium borosilicate filler into a visible-light-activated polyphenylene polymethacrylate resin matrix. One series had a filler particle size of 2 microns, with filler levels of 20, 40, 45, 50, and 53% (vol). The second series contained a 15-microns filler in amounts of 20, 40, 50, 60, and 65% (vol). Tests conducted included: depth of cure as evaluated by hardness, water sorption, compressive strength, stress-strain behavior under slow compression, toothbrush abrasion, and wear by hydroxyapatite. Analysis of the data indicated that increased filler levels resulted in increased hardness, compressive strength and stiffness, and decreased water sorption. Also, there was a slight trend toward improved depth of cure. Incorporation of the 2-microns filler decreased the abrasion resistance of the resins to toothbrushing as compared with the unfilled resin, while addition of the 15-microns filler improved resistance. All filled resins exhibited a significant improvement in resistance to wear by hydroxyapatite as compared with the unfilled resin. There was a trend for increased wear with increased filler level. The particle size of the filler appeared to have a moderate influence on the properties. When compared with 15-microns filled resins of the same filler levels, the 2-micron filled series appeared to have inferior properties in terms of depth of cure, compressive strength, water sorption, and resistance to toothbrush abrasion. Properties which were less affected by particle size were hardness, stiffness, and wear resistance to hydroxyapatite.

Chemical Phenomena↗
PubMed1988

Effects on gingivitis of two different 0.4% SnF2 gels.

For nine months we monitored the periodontal health of 81 adolescents undergoing orthodontic treatment with fixed appliances, to determine whether daily use of a brush-on 0.4% SnF2 gel would be better than toothbrushing alone in maintaining periodontal health in these patients, and whether a gel supplying a high percentage of available Sn2+ ion would be more beneficial than a gel supplying a low percentage of available Sn2+ ion. The subjects were matched for age and sex and placed into a control group, which used toothbrushing alone, and two treatment groups, which used toothbrushing supplemented with daily use of a SnF2 gel. One treatment group used a gel with 98% available Sn2+ ion twice daily for the entire nine months. The other treatment group used a gel with less than 2% available Sn2+ once a day for six months, then twice a day for the remaining three months of the study. Clinical assessments (Plaque Index, Gingival Index, Bleeding Tendency, pocket depth, and coronal staining) were made before appliances were placed and at one, three, six, and nine months after appliances were placed. Results indicated that the group using the high-availability Sn2+ gel twice daily had significantly lower Gingival Index and Bleeding Tendency scores at the one-, three-, six-, and nine-month examinations than did the control group. The group using the low-availability Sn2+ gel showed no significant differences in these assessments from the control group. Neither treatment group showed significant differences from the control group in Plaque Index or pocket depth. In the group using the high-availability Sn2+ gel, one subject developed mild coronal staining, and two developed moderate staining.

Adolescent↗
PubMed1980

Ill effects of improper oral hygeine procedure.

Improper use of the tools that prevent tooth decay and gingival disease can also produce harmful effects. For example, dental floss can cause inflammation; toothbrushes could cause abscesses; and water-irrigation devices might drive foreign material into soft tissue. This report discusses the effects of incorrect oral hygiene, the signs the practioner should notice, and the proper corrective steps. Although effective oral hygiene is essential for the maintenance of healthy teeth and supporting tissues, analysis of the literature and clinical observation suggested that six problem areas may be associated with common oral hygiene measures. --Overly vigorous toothbrushing or using the wrong type of brush for the technique often leads to cervical tooth abrasion, gingival irritation, and gingival recession, or all of these problems. --Uncontrolled or overly vigorous dental flossing may lead to irritation, ulceration, or defects of the gingiva. Proximal root surfaces are rarely abraded. --Dentifrices, mouthwashes, and chewing gum may elicit allergic or toxic reactions in susceptible persons. These reactions take a variety of traumatic injuries, especially if used at high pressure. Perhaps, detailed individual instruction should be given by dental personnel before use. --Abscess of gingival tissues may occur from implantation of fragments of such oral hygiene aids as toothbrush bristles and toothpicks. --Bacteria may enter the bloodstream during certain oral hygiene measures, especially in patients with advanced chronic gingival disease. The rate of occurrence is unknown because of conflicting results in different studies. These bacteremias are of concern to patients who have rheumatic heart disease, prosthetic heart valves, prosthetic joints, and renal dialysis shunts, or fistulas used in renal dialysis. A classification of oral hygiene-caused disorders is proposed, based on the injury and the causative agent.

Dental Devices, Home Care↗