Gagging Problem Assessment: a re‐evaluation

The Gagging Problem Assessment (GPA) is an instrument to evaluate dental gagging. Although the GPA seemed to be reliable and valid in a pilot study, a replication study with more subjects was needed. Based on the pilot study, the number of items was reduced, resulting in the revised version of the GPA (GPA‐R). The aims of this study were to replicate the reliability of the GPA‐R and to investigate the correlation between dental gagging and general anxiety. Dental gagging patients (n = 59) were compared with a control group (n = 17) at t0 and 3 weeks later. The ‘gagging group’ also filled in the SCL‐90 anxiety scale. Gagging‐specific homogenous domains and internal consistency were determined. Stability and distinguishing capacity of the GPA‐R were assessed. SCL‐90‐Anxiety scores were compared with standard values in a non‐clinical population. The GPA‐R patient part was able to reliably discriminate between the absence or the presence of dental gagging. However, the reliability of the GPA‐R‐dentist part was insufficient. The GPA‐R seems to be sensitive to subtle differences in acts of the dentists. To overcome these problems, more detailed and explicit instructions on how to use the GPA‐R should be formulated and more specific gagging stimuli should be included. The ‘gagging group’ reported ‘fear of choking’ significantly more often than the control group (P = 0·008). This finding might be important for the treatment of dental gagging. Considering the outcome of our study, development of a new diagnostic gagging tool needs another approach that focuses on gagging severity.     

Oral health‐related quality of life of 12‐ and 15‐year‐old Thai children: findings from a national survey

Abstract – Objective: To assess the prevalence and characteristics of oral impacts on daily life, and the relationship between certain dental conditions and impacts attributed to them, in a nationally representative population of Thai school children aged 12 and 15 years. Methods: A cross‐sectional study on a representative sample of children in Sixth Thailand National Oral Health Survey. Sample included half the children aged 12‐ and 15‐year‐old selected in Bangkok and all participants in 8 of 16 provinces included in national survey. Children were individually interviewed using the Child‐OIDP (12‐year‐old) and OIDP indices (15‐year‐old), and two questions for overall subjective assessments. Results: A total of 1066 12‐year‐olds and 815 15‐year‐olds were interviewed. Some 85.2% of 12‐year‐olds reported experiencing oral impacts during the past 3 months. Child‐OIDP scores ranged from 0 to 68.0 (mean = 7.83, SD = 7.8). Eating was the most commonly affected performance (64.4%), followed by cleaning teeth (51.7%) and maintaining emotional state (49.1%). Among 15‐year‐old children, 83.3% had oral impacts during the past 6 months. OIDP scores ranged from 0 to 39.5 (mean = 5.47, SD = 6.0). The three most commonly affected performances were eating (64.0%), cleaning teeth (55.3%) and maintaining emotional state (53.1%). Toothache and oral ulcers were the two most important perceived causes in 12‐year‐olds. Impacts from toothache were the most prevalent (39.2%) and had a condition‐specific (CS) Child‐OIDP score of 7.0, while oral ulcers affected 24.7% of children; mean CS‐score of 8.0. Among 15‐year‐olds, oral ulcers ranked first in terms of both prevalence (36.2%) and CS‐score (6.0), followed by toothache (prevalence 33.9% and CS‐score 5.0). For both age groups, problems with gums were of less concern. Conclusions: Oral impacts were common but not severe in Thai children and adolescents. For both age groups, impacts were mostly on eating performance; toothache and oral ulcers were the two important perceived causes reflecting needs for oral health promotion and treatment of dental caries and oral ulcers.     

Risk factors for impaired oral health among 18‐ to 34‐year‐old Australians

Objectives: The objective of this study was to determine risk factors for a summary measure of oral health impairment among 18‐ to 34‐year‐olds in Australia. Methods: Data were from Australia's National Survey of Adult Oral Health, a representative survey that utilized a three‐stage, stratified, clustered sampling design. Oral health impairment was defined as reported experience of toothache, poor dental appearance, or food avoidance in the last 12 months. Multivariate Poisson regression models were used to evaluate effects of sociodemographic characteristics, self‐perceived oral health, dental service utilization, and clinical oral disease indicators on oral health impairments. Effects were quantified as prevalence ratios (PR). Results: The estimated percent of 18‐ to 34‐year‐olds with oral health impairment was 42.4 [95 percent confidence interval (CI) 37.7‐47.2]. In the multivariate model, oral health impairment was associated with untreated dental decay (PR 1.38, 95 percent CI 1.13‐1.68) and presence of periodontal pockets 4 mm+ (PR 1.29, 95 percent CI 1.03‐1.61). In addition to those clinical indicators, greater prevalence of oral health impairment was associated with trouble paying a $100 dental bill (PR 1.37, 95 percent CI 1.12‐1.68), usually visiting a dentist because of a dental problem (PR 1.46, 95 percent CI 1.15‐1.86), reported cost barriers to dental care (PR 1.46, 95 percent CI 1.16‐1.85), and dental fear (PR 1.43, 95 percent CI 1.18‐1.73). Conclusions: Oral health impairment was highly prevalent in this population. The findings suggest that treatment of dental disease, reduction of financial barriers to dental care, and control of dental fear are needed to reduce oral health impairment among Australian young adults.     

Oral health behaviors of preschool children with cerebral palsy: a case‐control community‐based study

To describe and compare the oral health behaviors of preschool children with and without cerebral palsy (CP), and to assess the oral health knowledge and attitudes of their primary caregivers (PCGs). Seventy‐two preschool children with CP were recruited from 23 Special Child Care Centers in Hong Kong. An age‐ (±3 months) and gender‐matched sample of children from mainstream preschools was recruited as a “control group.” Assessment of children's oral health behaviors and the PCGs' oral health knowledge and attitudes was conducted using questionnaires. Preschool children with CP were less likely to have ever attended a dentist (p < 0.05). Tooth brushing frequency was similar between the two groups (p > 0.05), but PCGs of children with CP more frequently reported provision of tooth brushing assistance to their children (p < 0.001). PCGs in both groups had similar oral health knowledge and attitudes (p > 0.05). Difference in oral health behaviors existed between preschool children with and without CP. PCGs of children with and without CP had similar oral health knowledge and attitudes.     

Novel Mouth‐Exercising Device for Oral Submucous Fibrosis

Oral submucous fibrosis (OSMF) is a chronic inflammatory disease resulting in progressive juxtaepithelial fibrosis of the oral soft tissues and can cause increasing difficulty in mastication, swallowing, speaking, and mouth opening. The treatment of severe trismus requires a combination of surgical release and physiotherapy. Often physiotherapy alone can modify tissue remodeling in OSMF to increase oral opening. This article describes the fabrication and use of a new mouth‐exercising device that helps the patient to squeeze/stretch the cheek mucosa to increase elasticity. The device can be used as a sole treatment modality or can be used in association with pharmacological and surgical treatment modalities for OSMF. Improvement in mouth opening was observed in four OSMF patients treated with a mouth‐exercising device for 6 months as a sole treatment modality.     

Colonization of Candida: prevalence among tongue‐pierced and non‐pierced immunocompetent adults

Oral Diseases (2010) 16 , 176–175 Objective: To evaluate the colonization of Candida at the tongue‐piercing site of immunocompetent individuals. Subjects and methods: Swabs samples were obtained from the anterior lingual mucosa of healthy young adults with tongue piercing (N = 115); 86 subjects with (non‐intra‐oral) facial piercing served as a comparison group. Candida colonization was examined by light microscopy after 5‐day incubation. Positive specimens were re‐cultured on Chromagar?Candida plates for species identifying. Results: Candida colonization was more prevalent among tongue‐pierced (20.0%) than facial‐pierced subjects (9.4%; P = 0.048). All colonies were of Candida albicans. No difference was found between current tongue ornament wearers (21.2%) and non‐wearers (19.5%; P = 0.803). In multivariate analysis, the only significantly positive influencing factors on colonization were tongue piercing (P = 0.034) and daily smoking of more than 10 cigarettes (P = 0.024). Conclusions: Piercing of the tongue was found to be a risk factor for colonization of Candida albicans, without an influence of whether or not an ornament is in place.     

Programmable bio‐nanochip‐based cytologic testing of oral potentially malignant disorders in Fanconi anemia

Fanconi anemia (FA) is caused by mutations of DNA repair genes. The risk of oral squamous cell carcinoma (OSCC) among FA patients is 800‐folds higher than in the general population. Early detection of OSCC, preferably at it precursor stage, is critical in FA patients to improve their survival. In an ongoing clinical trial, we are evaluating the effectiveness of the programmable bio‐nanochip (p‐BNC)‐based oral cytology test in diagnosing oral potentially malignant disorders (OPMD) in non‐FA patients. We used this test to compare cytomorphometric and molecular biomarkers in OSCC cell lines derived from FA and non‐FA patients to brush biopsy samples of a FA patient with OPMD and normal mucosa of healthy volunteers. Our data showed that expression patterns of molecular biomarkers were not notably different between sporadic and FA‐OSCC cell lines. The p‐BNC assay revealed significant differences in cytometric parameters and biomarker MCM2 expression between cytobrush samples of the FA patient and cytobrush samples of normal oral mucosa obtained from healthy volunteers. Microscopic examination of the FA patient's OPMD confirmed the presence of dysplasia. Our pilot data suggests that the p‐BNC brush biopsy test recognized dysplastic oral epithelial cells in a brush biopsy sample of a FA patient.     

No evidence of triclosan‐resistant bacteria following long‐term use of triclosan‐containing toothpaste

Background and Objective

There is a paucity of data in relation to the possible emergence of triclosan (TCS)‐resistant bacteria following long‐term exposure to TCS toothpaste. Therefore, this study investigated whether long‐term continuous exposure to TCS in toothpaste selects for TCS‐resistant bacteria within the oral biofilm.

Material and Methods

Dental plaque samples were collected from 40 individuals during year 5 of a randomised controlled trial. Participants had been randomly assigned to use TCS (3000 μg/mL TCS) (n = 18) or placebo toothpaste (n = 22). Diluted plaque samples were plated on to Wilkins–Chalgren agar plates containing 5% (v/v) laked sheep red blood cells and TCS (concentrations ranging from 25 to 150 μg/mL) and incubated at 37°C under microaerophilic and anaerobic conditions for 2–10 d. Selected bacterial isolates were identified by partial 16S rDNA sequencing and TCS minimum inhibitory concentration (MIC) determined for each isolate.

Results

At 3000 μg/mL TCS no growth was observed under microaerophilic or anaerobic conditions in either group. The MICs of TCS for all isolates ranged from 125 to 1000 μg/mL in both groups. Species common to both groups had similar MICs. Veillonella parvula and Campylobacter gracilis were the most frequent isolates from both groups, with similar MICs in both groups.

Conclusion

The use of TCS‐containing toothpaste did not appear to lead to an increase in MIC of TCS of oral bacterial isolates.     

One‐piece zirconia oral implants for single‐tooth replacement: Three‐year results from a long‐term prospective cohort study

Aim

This 3‐year report of a prospective long‐term cohort investigation aimed to evaluate the clinical and radiographic outcomes of a one‐piece zirconia oral implant for single‐tooth replacement.

Materials and Methods

Sixty‐five patients received a 1‐stage implant surgery with immediate temporization. Standardized radiographs were taken at implant insertion, after 1 year, and after 3 years to monitor peri‐implant bone levels. A univariate analysis of the association of different baseline parameters on marginal bone loss from implant insertion to 36 months was performed. Soft‐tissue parameters were evaluated at prosthesis insertion, after 6 months, after 1 year, and at the 3‐year follow‐up.

Results

After 3 years, six posterior site implants were lost, giving a cumulative survival rate of 90.8%. The mean marginal bone loss was 1.45 mm; 35% of the implants lost at least 2 mm bone, and 22% more than 3 mm. The univariate analysis did not identify any parameter associated with marginal bone loss. Probing depth, clinical attachment level, and bleeding index increased over 3 years, and plaque index decreased.

Conclusions

The low survival rate of the presented ceramic implant and especially the high frequency of advanced bone loss are noticeable but remain unexplained.