Assessment and management of oral health in liver transplant candidates

Liver transplantation has become a standard treatment for end-stage liver disease and the number of recipients has grown rapidly in the last few years. Dental care during pre-transplant workup is important to reduce potential sources of infection in the drug-induced immunosuppression phase of liver transplantation.

Objectives

The objectives of this study were to document the prevalence of oral abnormalities in patients on a liver transplant waiting list presenting to an urban dental school clinic, discuss the appropriate dental treatment according their systemic conditions and compare their oral manifestations with those of healthy individuals.

Material and Methods

A pilot study was conducted involving 16 end-stage liver disease individuals (study group- SG) attending the Special Care Dentistry Center of the University of São Paulo and 16 control individuals (control group- CG) with no liver diseases, receiving dental care at the Dental School of the University of São Paulo. These individuals were assessed for their dental status (presence of oral disease or abnormalities), coagulation status, and dental treatment indications.

Results

The patients from SG exhibited a greater incidence of oral manifestations compared with CG (p=0.0327) and were diagnosed with at least one oral disease or condition that required treatment. Coagulation abnormalities reflecting an increased risk of bleeding were found in 93.75% of the patients. However, no bleeding complications occurred after dental treatment.

Conclusions

The patients with chronic liver diseases evaluated in this study exhibited a higher incidence of oral manifestations compared with the control group and had at least one oral disease or abnormality which required dental treatment prior to liver transplantation. Careful oral examination and evaluation of the patient, including laboratory tests, will ensure correct oral preparation and control of oral disease prior to liver transplantation.     

PERCEIVED DENTAL ANXIETY AMONG SCHOOLCHILDREN TREATED THROUGH THREE CARIES REMOVAL APPROACHES

Objectives:

The aim of the investigation was to test the differences in the perceived level of dental anxiety among children treated restoratively using the Atraumatic Restorative Treatment (ART) approach, the traditional restorative (TRA) approach and ART aided with a chemomechanical caries removal gel (ART plus).

Methods:

The study subjects were 6-7-year-old children. TRA was compared to ART in a clinical setting after children had seen a dentist twice (Group A), ART was compared to ''ART plus'' in a clinical setting after children had seen a dentist once (Group B) and ART was applied outside the clinic on school premises (Group C). The treatments were carried out in Class II cavitated dentine lesion in primary molars. Dental anxiety was measured using the Venham Picture Test (VPT). Three-way analysis of variances and interaction was applied to test for treatment approach, gender and operator effects on the mean VPT scores.

Results:

There was no statistically significant difference (p=0.80) observed between the mean VPT scores for the traditional approach and those for the ART approach and between ART with and without a chemomechanical caries removal gel (p=0.07). Children in Group A had lower mean VPT scores than children in Group B (p=0.02) and Group C (p<0.00001) when treated using the ART approach by the same two operators.

Conclusions:

The level of dental anxiety was low. There was no difference in level of dental anxiety observed in children treated with ART in comparison to the traditional restorative approach, and between children treated with ART with and without a chemomechanical caries removal gel. The treatment environment and prepatory visits may be factors determining the level of dental anxiety in children treated through the ART approach only.     

The association between dental and periodontal diseases and sickle cell disease. A pilot case-control study

Objective

This is a pilot case-control study conducted to investigate the prevalence of dental caries and periodontal disease and examine the possible association between oral health deterioration and SCD severity in a sample of Saudi SCD patients residing in the city of Al-Qatif, Eastern Province, Saudi Arabia.

Materials and methods

Dental examination to determine the Decayed, Missing and Filled Teeth index (DMFT), Community Periodontal Index (CPI), and plaque index system were recorded for 33 SCD patients and 33 age and sex-matched controls in the Al-Qatif Central Hospital, Qatif, Saudi Arabia. Self-administered surveys used to assess socio-economic status; oral health behaviors for both SCD patients and controls were recorded. In addition, the disease severity index was established for all patients with SCD. SPSS data analysis software package version 18.0 was used for statistical analysis. Numerical variables were described as mean with a standard deviation.

Results

Decayed teeth were significantly more in individuals with ages ranging from 18 to 38 years with SCD compared to the control group (p = 0.036) due to oral hygiene negligence. The mean number of filled teeth was significantly lower in individuals with SCD when compared to the control group (p = 0.015) due to the lack of appropriate and timely treatment reflected in the survey responses of SCD patients as 15.2% only taking oral care during hospitalization. There were differences between the cases and controls in the known caries risk factors such as income level, flossing, and brushing habit. The DMFT, CPI, and plaque index systems did not differ significantly between the SCD patients and the control group.

Conclusion

Data suggest that patients with SCD have increased susceptibility to dental caries, with a higher prevalence of tooth decay and lower prevalence of filled teeth. Known caries risk factors influenced oral health more markedly than did factors related to SCD.     

Social aspects of dental caries in the context of mother-child pairs

The relationship between mother and child in the context of oral health has traditionally been exposed by the scientific literature in microbiology, which lacks a broad and necessary discussion of health and illness seen as processes, both biological and social.

Objective

Investigate the family social determinants associated with the caries history of children and the need for dental treatment (NDT) among their mothers was the objective of this study.

Material and methods

This research employed a cross-sectional study of mother-child pairs living in southern Brazil. Data collection occurred in public institutions of early childhood education. The instruments included a structured questionnaire administered to mothers and clinical oral examinations of the mothers and children. The social variables considered were marital status, maternal education, number of children, income, employment status, and frequency of visits to a dental professional. The measured outcomes were the maternal NDT and child caries history. Data were analyzed by the chi-square test (χ2) and by discriminant analysis.

Results

The final sample consisted of 272 mother-child pairs and it was found that the greatest need for treatment was among mothers with low educational level and low family income who rarely or never visited a dentist. Tooth decay was less frequent in only child, and most frequent in children of mothers with low educational attainment, and in children in lower income households who rarely or never visited the dentist. The social determinants of caries in children and of the maternal NDT were similar. It follows that the maternal NDT and caries history among children were strongly associated with maternal education (p<0.0001), household income (p<0.0001), and frequency of visits to a dental professional (0.0018). Caries history among children was also associated with number of children in the household (p<0.0001).

Conclusions

The results suggest that the caries experience in children depended less on the family social variables than on the maternal NDT.     

Dental care protocol based on visual supports for children with autism spectrum disorders

Background

Subjects with Autism Spectrum Disorders (ASDs) have often difficulties to accept dental treatments. The aim of this study is to propose a dental care protocol based on visual supports to facilitate children with ASDs to undergo to oral examination and treatments.

Material and Methods

83 children (age range 6-12 years) with a signed consent form were enrolled; intellectual level, verbal fluency and cooperation grade were evaluated. Children were introduced into a four stages path in order to undergo: an oral examination (stage 1), a professional oral hygiene session (stage 2), sealants (stage 3), and, if necessary, a restorative treatment (stage 4). Each stage came after a visual training, performed by a psychologist (stage 1) and by parents at home (stages 2, 3 and 4). Association between acceptance rates at each stage and gender, intellectual level, verbal fluency and cooperation grade was tested with chi-square test if appropriate.

Results

Seventy-seven (92.8%) subjects overcame both stage 1 and 2. Six (7.2%) refused stage 3 and among the 44 subjects who need restorative treatments, only three refused it. The acceptance rate at each stage was statistically significant associated to the verbal fluency (p=0.02; p=0.04; p=0.01, respectively for stage 1, 3 and 4). In stage 2 all subjects accepted to move to the next stage. The verbal/intellectual/cooperation dummy variable was statistically associated to the acceptance rate (p<0.01).

Conclusions

The use of visual supports has shown to be able to facilitate children with ASDs to undergo dental treatments even in non-verbal children with a low intellectual level, underlining that behavioural approach should be used as the first strategy to treat patients with ASDs in dental setting. Key words:Autism spectrum disorders, behaviour management, paediatric dentistry, visual learning methods.     

Epidemiological assessment of predictors of caries increment in 7-10-year-olds: a 2-year cohort study

Objective

The aim of this 2-year cohort study (2003 to 2005) was to investigate how caries experience, at initial lesions (early or non-cavited lesions) and cavited stages, predicts caries increment in permanent teeth in 7-10- year-olds.

Material and Methods

The random sample of 765 children attending public schools in the city of Piracicaba, SP, Brazil, was divided into two groups: 423 children aged 7-8 years and 342 children aged 9-10 years. All subjects were examined by a calibrated examiner, using dental mirror and ball-ended probes, after tooth brushing and air-drying in an outdoor setting, based on the World Health Organization criteria. Active caries with intact surfaces were also recorded as initial lesion (IL). Univariate analysis was used for statistical analysis (Odds Ratios and Chisquare).

Results

The association between the DMFT (decayed, missing and filled teeth) increment and the presence of IL was significant only for 9-10-year-old children. The children with DMFT>0 at baseline were more prone to have DMFT increment, with the highest risk for caries increment occurring in children aged 7-8 years.

Conclusion

The predictors of caries increment were the presence (at baseline) of caries experience in permanent teeth for both age groups (7-8; 9-10-year-olds) and the presence of the IL (at baseline) for 9-10-year-olds.     

Analysis of the association between lactotransferrin (LTF) gene polymorphism and dental caries

Objective

The present study evaluated the association between lactotransferrin (LTF) gene polymorphism (exon 2, A/G, Lys/Arg) and dental caries.

Material and Methods

A convenience sample of 110 individuals, 12 years old, was divided into: group 1, 48 individuals without caries experience (DMFT=0), and group 2, 62 subjects with caries experience (DMFT≥1). DNA was obtained from a mouthwash with 3% glucose solution, followed by a scrapping of the oral mucosa. After DNA purification, polymerase chain reaction (PCR), single strand conformation polymorphism (SSCP) was performed to access the study polymorphism. The LTF A/G (Lys/Arg) polymorphism had been previously reported as located in exon 1.

Results

Allele 1 of the study polymorphism was associated with low DMFT index and showed a protective effect against caries experience (OR=0.16, IC=0.030.76, p=0.01).

Conclusion

Lactotransferrin A/G (exon 2, Lys/Arg) polymorphism was associated with susceptibility to dental caries in 12-year-old students.     

IMPACT OF THE BITEWING RADIOGRAPHY EXAM INCLUSION ON THE PREVALENCE OF DENTAL CARIES IN 12-YEAR-OLD STUDENTS IN THE CITY OF FRANCA,S?O PAULO,BRAZIL

Introduction:

The pattern of development of carious lesions has changed. The carious lesion has been progressive and reaches the dentin without showing alterations in the clinical aspects.

Objectives:

To determine the prevalence of caries in 12-year-old students in the city of Franca – São Paulo, Brazil, during the year of 2003, and to evaluate the additional value of bitewing radiograph to detect hidden carious lesions in permanent molar dentin.

Materials and Methods:

A probabilistic sample composed of two hundred and fifty six (256) students, from public and private schools, was submitted to a cross-sectional study through examination by a calibrated examiner, in order to detect the caries prevalence, using the methodology recommended by the World Health Organization (WHO). For 66% of the sample, bitewing radiographs of the permanent molar region were obtained. The images were analyzed by a calibrated examiner, who established the presence of hidden caries in teeth with radiolucency in dentin, yet considered healthy in the epidemiological survey.

Results:

The prevalence of dental caries in epidemiological exam without (WHO) and with (WHO/R) the inclusion of hidden caries lesion was 54% and 64%, and the DMFT index was 1.73 and 1.92 respectively.

Conclusion:

Utilization of the method of bitewing radiographic diagnosis significantly increased (p<0.001) the prevalence of caries in the studied population.     

Dental caries profile in Monte Negro, Amazonian state of Rondônia, Brazil, in 2008

Objective

This epidemiological survey assessed the dental caries profile in Monte Negro, a small town in the Amazonian state of Rondônia, Brazil, and its relationship with the northern region, national and global goals for oral health in the years 2000 and 2020.

Material and Methods

The groups randomly examined were composed of individuals aged 5, 12, 15 to 19, 35 to 44, 65 to 74 years, living in both rural and urban areas.

Results

The means dft (standard deviation) and DMFT (standard deviation) for the groups were, respectively, 3.15 (3.12), 3.41 (2.69), 5.96 (4.19), 16.00 (7.30) and 25.96 (9.82). Caries-free individuals were 34.42%, 14.81% and 8.16% in the preschoolchildren, schoolchildren and adolescent groups, respectively. The Significant Caries Index percentages applied to the two younger groups were 6.65 and 6.70, and they increased to 32.00 in the individuals aged 65 to 74 years. Care Index percentages for adolescents, adults and elderly groups were, respectively, 29.40, 25.00 and 1.41. The dental caries profile in Monte Negro in 2008 shows that, 8 years after the year 2000, no FDI/WHO goal for any age settled in 1982 has been achieved. Dental caries increased with age and the main dental problem of adult and elderly groups was tooth loss.

Conclusion

Oral health promotion and prevention of oral disease policies are urgent needs. Setting of oral health goals and targets to people living in Monte Negro or Amazonia to be pursuit and achieved in a near future is an important action to do because of the culture, sanitary conditions and socioeconomic aspects of this particular population.     

Caries risk assessment in schoolchildren - a form based on Cariogram? software

Identifying caries risk factors is an important measure which contributes to best understanding of the cariogenic profile of the patient. The Cariogram^® software provides this analysis, and protocols simplifying the method were suggested.

Objectives

The aim of this study was to determine whether a newly developed Caries Risk Assessment (CRA) form based on the Cariogram^® software could classify schoolchildren according to their caries risk and to evaluate relationships between caries risk and the variables in the form.

Material and Methods

150 schoolchildren aged 5 to 7 years old were included in this survey. Caries prevalence was obtained according to International Caries Detection and Assessment System (ICDAS) II. Information for filling in the form based on Cariogram^® was collected clinically and from questionnaires sent to parents. Linear regression and a forward stepwise multiple regression model were applied to correlate the variables included in the form with the caries risk.

Results

Caries prevalence, in primary dentition, including enamel and dentine carious lesions was 98.6%, and 77.3% when only dentine lesions were considered. Eighty-six percent of the children were classified as at moderate caries risk. The forward stepwise multiple regression model result was significant (R2=0.904; p<0.00001), showing that the most significant factors influencing caries risk were caries experience, oral hygiene, frequency of food consumption, sugar consumption and fluoride sources.

Conclusion

The use of the form based on the Cariogram^® software enabled classification of the schoolchildren at low, moderate and high caries risk. Caries experience, oral hygiene, frequency of food consumption, sugar consumption and fluoride sources are the variables that were shown to be highly correlated with caries risk.     

A comparative study of oral health amongst trisomy 21 children living in Riyadh,Saudi Arabia: Part 1 caries,malocclusion, trauma

Background

Trisomy 21 (T21) is a genetic disorder stemming from a chromosomal abnormality and characterized by general and mental retardation. Depending on the population, T21 is known to affect 1 in every 600–2000 live births. The current literature provides a mixed view on the oral health status of T21 individuals.

Aim

To establish the prevalence of dental caries, malocclusion, and trauma amongst children with T21 compared with non-T21 children in Riyadh, Saudi Arabia.

Methods

This cross-sectional study recruited non-T21 and T21 children between the ages of 7–15 years who were studying at the Saut Society. After informed consent was obtained from parents and both groups were matched by age and gender, trained examiners screened children at the dental clinic of King Saud University to record the presence of dental caries, malocclusion, and trauma in both groups.

Results

While there was no statistical difference between the two groups with regard to the mean decayed, missing, and filled teeth (DMFT) index (2.66 for T21 versus 3.11 for controls), T21 children had a higher prevalence of incisal fractures compared to the control group (24.73% versus 4.95%, respectively) and that was statistically significant (P < 0.05). There were also highly significant group differences concerning the prevalence of malocclusion. Therein, 45% of T21 children had a Class III incisor relationship compared with 8% of control children, and 50% of T21 children had a Class III molar relationship compared with 8% of control children.

Conclusions

While there was no significant difference in the incidence of caries between children with and without T21, practitioners should be aware of the disparities in malocclusion and trauma in this vulnerable population.     

Comparative study of oral health among trisomy 21 children living in Riyadh,Saudi Arabia: Part 2, gingival condition

Background

Trisomy 21 (T21) is a congenital disorder characterized by triplication of Chromosome 21 components. Patients with T21 have an increased risk of acquiring periodontal disease due to their inability to maintain good oral hygiene. Consequently, it is important to determine an approach for disease prevention in this population.

Aim

The purpose of the study was to assess the periodontal health, through the prevalence of gingivitis and plaque, among children with T21 living in Riyadh, Saudi Arabia.

Subjects and method

This study included 93 children with T21 and 99 age- and gender-matched children without T21 between the ages of 7 and 15 years. Parents were informed about the study and provided informed consent. Trained examiners using standardized tools assessed the prevalence rates of gingivitis and plaque in all children.

Results

Gingivitis prevalence was elevated among T21 children (46.9%) compared to controls (34%) in all arch sextants except the mandibular middle (P < 0.01). Comparing the two groups, the prevalence of plaque was higher in the maxillary right sextant of the T21 group and the mandibular middle sextant of the control group (P < 0.05).

Conclusion

T21 children have significantly elevated plaque levels, resulting in greater prevalence of gingivitis, compared to healthy children. Preventive measure, such as oral health awareness programs, should be delivered early to parents and continued at school to encourage and motivate children.     

Randomized controlled clinical trial of long-term chemo-mechanical caries removal using PapacarieTM gel

Objectives

Compare the effectiveness of Papacarie^TM gel for the chemo-mechanical removal of carious lesions on primary teeth to conventional caries removal with a low-speed bur with regard to execution time, clinical aspects and radiographic findings.

Material and Methods

A randomized controlled clinical trial with a split-mouth design was carried out. The sample was composed of 20 children aged four to seven years, in whom 40 deciduous teeth were randomly divided into two groups: chemo-mechanical caries removal with Papacarie^TM and removal of carious dentin with a low-speed bur. Each child underwent both procedures and served as his/her own control. Restorations were performed with glass ionomer cement. The time required to perform the procedure was also analyzed. The patients underwent longitudinal clinical and radiographic follow-up of the restorations.

Results

No statistically significant difference between groups was found regarding the time required to perform the procedures and the radiographic follow up. Statistically significant differences between groups were found in the clinical evaluation at 6 and 18 months after treatment.

Conclusion

Papacarie^TM is as effective as the traditional method for the removal of carious dentin on deciduous teeth, but offers the advantages of the preservation of sound dental tissue as well as the avoidance of sharp rotary instruments and local anesthesia.     

Prevalence of enamel defects and associated risk factors in both dentitions in preterm and full term born children

Objectives

The aim of this study was to evaluate the prevalence of enamel defects and their risk factors on primary and permanent dentitions of prematurely born children and full-term born children born at Regional Hospital of Asa Sul, Brasília, DF, Brazil.

Material and Methods

Eighty 5-10-year-old children of both genders were examined, being 40 born prematurely (G1) and 40 born full term (G2). The demographic variables, medical history and oral health behaviors were retrieved using a questionnaire and data obtained from clinical examination were recorded. The teeth were examined and the presence of enamel defects was diagnosed according to the DDE Index and registered in odontograms. Subsequently, the defects were categorized in four groups according to one of the criteria proposed in 1992 by the FDI Commission on Oral Health, Research and Epidemiology. Kruskal-Wallis, Chi-square, Kappa, Mann-Whitney tests and logistic regression were used for statistical analysis.

Results

75% of total sample had enamel defects. There was a major prevalence of hypoplasia of the enamel in G1 (p<0.001). There was a significant relationship between low weight and presence of the imperfections on the enamel in G1 on the primary dentition. The logistic regression model showed that the other risk factors such as monthly per capita family income, educational level, dietary and hygiene habits, fluoride exposure, trauma, and diseases were not associated with enamel defects and caries.

Conclusions

Pre-term labor can be a predisposing factor for the presence of the enamel hypoplasia in the primary dentition.     

Alkali production in the mouth and its relationship with certain patient’s characteristics

Objectives

To assess the relationships among alkali production, diet, oral health behaviors, and oral hygiene.

Methods

Data from 52 subjects including demographics, diet, and oral hygiene scores were analyzed against the level of arginine and urea enzymes in plaque and saliva samples. An oral habit survey was completed that included: use of tobacco (TB), alcohol (AH), sugary drinks (SD), and diet. Alkali production through arginine deiminase (ADS) and urease activities were measured in smooth-surface supragingival dental plaque and un stimulated saliva samples from all subjects. ADS and urease activities were measured by quantification of the ammonia generated from the incubation of plaque or saliva samples. Spearman correlations were used to compute all associations.

Results

Participants in the lowest SES (Socio-economic status) group had the habit of consuming sugary drinks the most and had the highest rate of tobacco use. Males consumed significantly more alcohol than females. No significant relationship was found between age or gender and alkali production. Higher rates of sugary drink consumption and tobacco use were significantly related to lower alkali production.

Conclusion

The study showed a relationship between alkali production and oral hygiene, diet, and certain oral health behaviors. Poor oral hygiene was significantly associated with age, lower SES, tobacco use, and alcohol, and sugary drinks consumption.

Clinical relevance

Certain oral health behaviors have an impact on oral hygiene and on alkali production; it is important to address these factors with patients as a strategy for caries control.     

Cariostatic effect of fluoride-containing restorative materials associated with fluoride gels on root dentin

Secondary caries is still the main cause of restoration replacement, especially on the root surface

Objective

This in vitro study evaluated the cariostatic effects of fluoride-containing restorative materials associated with fluoride gels, on root dentin.

Materials and Methods

A randomized complete block design was used to test the effects of the restorative systems, fluoride regimes and the interactions among them at different distances from restoration margins. Standardized cavities were prepared on 240 bovine root specimens and randomly assigned to 15 groups of treatments (n=16). Cavities were filled with the following restorative materials: Ketac-Fil (3M-ESPE); Vitremer (3M-ESPE); Dyract/Prime & Bond NT (Dentsply); Charisma/Gluma One Bond (Heraeus Kulzer) and the control, Z250/Single Bond (3M-ESPE). The specimens were subjected to a pH-cycling model designed to simulate highcaries activity. During the cycles, 1.23% acidulated phosphate fluoride, 2.0% neutral sodium fluoride or deionized/distilled water (control) was applied to the specimens for 4 min. The surface Knoop microhardness test was performed before (KHN_i) and after (KHN_f) the pH cycles at 100, 200 and 300 mm from the margins. Dentin microhardness loss was represented by the difference in initial and final values (KHN_i - KHN_f). Data were analyzed by Friedman''s and Wilcoxon''s tests, ANOVA and Tukey''s test (α=5%).

Results

The interaction of restorative systems and topical treatments was not significant (p=0.102). Dentin microhardness loss was lowest closer to the restoration. Ketac-fil presented the highest cariostatic effect. Vitremer presented a moderate effect, while Dyract and Charisma did not differ from the control, Z250. The effects of neutral and acidulated fluoride gels were similar to each other and higher than the control.

Conclusion

Conventional and resin-modified glass ionomer cements as well as neutral and acidulated fluoride gels inhibit the progression of artificial caries adjacent to restorations. The associated effect of fluoride-containing restorative materials and gels could not be demonstrated.     

Knowledge,perceptions, and attitudes of dental students towards obesity

Aims

Obesity is a chronic medical condition associated with various oral health problems. The aim of this study was to assess the knowledge, perceptions, and attitudes of dental students towards obesity.

Material and methods

Second-, third-, and fourth-year dental students completed a self-administered questionnaire. An ethics committee approved the study. Participants were asked questions focused on three areas: (i) knowledge, (ii) perceptions, and (iii) attitudes about obesity. Data analyses were carried out using SPSS version 20.

Results

Among the dental students, 78.9% received 0–1 h of formal education about obesity. The mean score of the total time allocated for obesity-related education was 1.31 ± 0.23 h. Eighty-nine percent of the dental students agreed that obesity is a chronic medical condition, 30% agreed that they would modify their equipment and office furniture to accommodate obese patients, and 46.8% were interested in learning more about obesity in dental school.

Conclusion

Obesity-related education should be implemented as a formal component of dental student training. Oral health practitioners should also provide their patients with information about how weight loss is beneficial to both general and oral health.     

Caries-free subjects have high levels of urease and arginine deiminase activity

Objectives

This study investigated the relationship between urease and arginine deiminase system (ADS) activities and dental caries through a cross-sectional study.

Material and Methods

Urease and ADS activities were measured in saliva and plaque samples from 10 caries-free subjects and 13 caries-active. Urease activity was obtained from the ammonia produced by incubation of plaque and saliva samples in urea. ADS activity was obtained from the ammonia generated by the arginine-HCl and Tris-maleate buffer. Specific activity was defined as micromoles of ammonia per minute per milligram of protein. Shapiro-Wilk statistical test was used to analyze the distribution of the data, and Mann-Whitney test was used to determine the significance of the data.

Results

The specific urease activity in saliva and plaque was significantly higher in individuals with low DMFT scores. ADS activity in saliva (6.050 vs 1.350, p=0.0154) and plaque (8.830 vs 1.210, p=0.025) was also higher in individuals with low DMFT scores.

Conclusions

Caries-free subjects had a higher ammonia generation activity by urease and arginine deiminase system for both saliva and plaque samples than low caries-active subjects. High levels of alkali production in oral environment were related to caries-free subjects.