Association of smoking in household and dental caries in Japan

OBJECTIVES: The study investigated the relationship between smoking in the household and dental caries in Japanese children using nationally representative cross-sectional data. METHODS: This study included 925 children aged 1-14 years. A child was considered to have decayed and/or filled teeth if a dentist diagnosed these conditions in deciduous or permanent teeth. Smoking in the household was defined as positive if someone in the household reported smoking cigarettes. RESULTS: No statistically significant relationship was observed between household smoking and caries experience. However, smoking in the household was independently associated with an increased prevalence of decayed teeth. The adjusted mean of filled teeth among children exposed to household smoking was higher than that among non-exposed children. CONCLUSIONS: The results of the study failed to substantiate a positive association between passive smoking and caries experience in Japanese children.     

有龋和无龋儿童四种唾液蛋白成分的比较

目的比较3～4岁有龋儿童和无龋儿童非刺激性和刺激性唾液中IgA、乳酸脱氢酶、溶菌酶和碱性磷酸酶含量的差异。方法分别采集98例有龋儿童和94名无龋儿童非刺激性和刺激性唾液，测定上述各成分含量。结果非刺激性和刺激性唾液中IgA、乳酸脱氢酶和溶菌酶含量有龋组均显著高于无龋组（P〈0．01），非刺激性唾液中碱性磷酸酶含量有龋组显著高于无龋组（P〈0．05）；但刺激性唾液中碱性磷酸酶含量两组间差异无统计学意义（P〉0．05）。结论非刺激性和刺激性唾液中IgA、乳酸脱氢酶和溶菌酶升高可能与婴幼儿龋的发生、发展有关。     

Association of passive smoking with caries and related salivary biomarkers in young children

OBJECTIVE: To investigate the association between passive smoking, as determined by salivary cotinine level, and caries, salivary pH, buffering capacity, flow rate and microbiological counts in young children. DESIGN: Ninety passive smokers (PS) with a mean age of 5.02 years and 90 healthy age-matched controls were included in this study. Family income, smoking habits of household members, parental education levels, child's tooth-brushing habit and child's daily dietary sugar exposure were recorded by questionnaire. Three categories were formed with respect to the number of cigarettes smoked. A dmft score was calculated according to the criteria recommended by the World Health Organization. The children were also investigated for stimulated salivary cotinine level, pH, flow rate, buffering capacity and salivary Streptococcus mutans and lactobacilli colonisation. RESULTS: There were no significant differences in tooth-brushing habit, sugar exposure, family income and parental education levels between the two groups (P>0.05). The mean cotinine level of the PS subjects was 1.58+/-4.3ng/ml. The dmft scores, and salivary S. mutans and lactobacilli colonisation in PS children were significantly higher than in the control subjects (P<0.05). Statistically significant decreases in salivary pH, flow rate and buffering capacity were found in the PS subjects (P<0.05). CONCLUSION: PS children are at increased risk of caries compared with control subjects.     

Comparison of immunological and microbiological characteristics in children and the elderly with or without dental caries

The purpose of this study was to determine the relationships among early childhood caries (ECC), root caries (RC), the quantity of Streptococcus mutans in saliva, and the concentrations of total and specific secretory IgA (sIgA). Saliva samples were collected from 70 children, 3–4 yr of age, with and without ECC, and from 43 adults, ≥60 yr of age, with and without RC. The decayed, missing, and filled teeth (dmft) and decayed, missing, and filled surfaces (dmfs) scores of each child, and the root decayed and filled teeth (RDFT) and root decayed and filled surfaces (RDFS) scores of each elderly subject, were determined. The S. mutans levels, total sIgA, and specific sIgA against two virulence antigens of S. mutans in saliva were analysed using quantitative real‐time PCR (qPCR) and ELISAs. The quantity of S. mutans was significantly higher in caries‐positive subjects within the two populations than in the caries‐free subjects; and a positive correlation was found between the quantity of S. mutans and the dmft, dmfs, RDFT, and RDFS scores. In addition, the salivary total sIgA was significantly higher in children with severe early childhood caries (SECC) and in the elderly subjects with RC. Moreover, although the S. mutans level was significantly higher, the concentrations of specific sIgA against S. mutans antigens were significantly lower in samples from elderly subjects than in samples from children. These results support the concept that S. mutans is positively associated with ECC and RC. Furthermore, the levels of S. mutans‐specific antibodies in saliva are too low to prevent infection with cariogenic bacteria and to inhibit development of ECC and RC.     

致龋菌、唾液缓冲能力与婴幼儿龋的相关性研究

目的探讨唾液中变形链球菌、乳酸杆菌和唾液pH值、缓冲能力与婴幼儿龋的关系。方法将178名42～54个月的儿童分为患龋组（患龋牙数≥5）87例和无龋组91人。吐唾法采集非刺激性唾液和嚼蜡法采集刺激性唾液各2ml，用选择性培养的方法检测刺激性唾液中变形链球菌、乳酸杆菌的检出率和计数水平；测定非刺激性及刺激性唾液的pH值和缓冲能力。结果患龋组唾液变形链球菌和乳酸杆菌的检出率分别为96．6％和79．3％，显著高于无龋组的63．7％和27．5％（P〈0．05）；患龋组两种细菌的计数水平比无龋组高近10倍。患龋组和无龋组刺激性唾液的初始pH值和对酸的缓冲能力均显著高于非刺激性唾液（P〈0．001）；患龋组刺激性和非刺激性唾液的初始pH值和缓冲能力均显著低于无龋组（P〈0．05）；无龋组中变形链球菌、乳酸杆菌和唾液pH值、缓冲能力之间无明显的相关性；患龋组刺激性唾液的缓冲能力与变形链球菌的计数水平显著相关（r=0．249，P〈0．05）。结论变形链球菌和乳酸杆菌是婴幼儿龋的重要致病菌；唾液的初始pH值和缓冲能力偏低可能是影响婴幼儿龋的重要因素。     

儿童唾液分泌型免疫球蛋白A、过氧化物酶和龋病关系的研究

目的 对儿童唾液分泌型免疫球蛋白A(secretory immunoglobulin A，SIgA)、过氧化物酶(Salivary peraxidase，Spx)浓度及二者相关关系和龋病关系进行研究。方法 随机选取4～5岁多龋儿童(dmft≥5)20名及无龋儿童20名，取非刺激性全唾液2ml，用NABA法测定SIgA浓度，Nb-SCN^-法测定Spx浓度，比较多龋组、无龋组儿童唾液SIgA、Spx浓度及二者的相关关系有无差别。结果 多龋组儿童唾液SIgA浓度显著低于无龋组；两组儿童唾液Spx浓度无显著性差异；无龋组儿童唾液SIgA、Spx浓度呈显著正相关，相关系数r值为0.72。多龋组儿童唾液SIgA、Spx无显著相关。结论 NABA法是测定唾液SIgA浓度的快速准确的先进方法；SIgA对儿童龋病发生有预防作用；无龋组儿童唾液内存在抗菌蛋白的协同关系。     

唾液及菌斑液中蛋白成分与龋易感性的关系

目的：探讨纯腮腺液，全唾液及菌斑液中蛋白成分与龋易感性的关系。方法：选39名无龋者（caries free,CF)和27例高龋者（caries susceptible,CS)，用Folin酚法测定纯腮腺液，全唾液及菌斑液的总蛋白含量，SDS－PAGE和图像分析系统定量分析各蛋白成分。结果：总蛋白含量菌斑液高于唾液近10倍，其中仅CF组全唾液与菌斑液有较大相关性（r=0.804).3种液体共有的蛋白为14000，66000及76000蛋白，菌斑液中14000，15000及38000蛋白和全唾液中14000蛋白的含量CS组显著低于CF组，结论：无龋组菌斑液蛋白受全唾液影响较大。3种液体中总蛋白含量均与患龋无关，但菌斑液和全唾液中某些蛋白可能有重要的抗龋作用。     

Association of free amino acids with caries experience and mutans streptococci levels in whole saliva of children with early childhood caries

Objective

The aim of the present study was to identify the free amino acid content in whole saliva of children with (CE) and without early childhood caries (CF) (ECC), correlating these findings with caries experience and mutans streptococci (MS) levels in saliva.

Design

Seventy-eight healthy children, both genders, 6-71 months age, were selected to participate in the study. Following examination for dmft scores calculation, unstimulated whole saliva was collected from all 78 participants, stored at −80 °C, and used for amino acid analysis, on a Biochem 20 plus amino acid analyzer. Stimulated whole saliva was collected from 52 children, transported, diluted and plated on MSB agar medium for detection of MS in cfu/mL.

Results

Forty different free amino acids were identified in whole saliva, with great variation in their concentration. A statistically significant relation was found between caries experience and the presence of free proline and glycine. While proline (p = 0.0182) was more frequently absent in the CF group, the absence of glycine (p = 0.0397) was more often observed in the CE group. In the presence of higher levels of MS, free glycine reduced the risk of experiencing dental caries (p = 0.0419). Conversely, the presence of proline was found to increase the risk of experiencing the disease (p = 0.0492).

Conclusions

The presence of free proline and absence of free glycine in children with ECC, highly contaminated with MS, increased the chances of experiencing dental caries in the present population. Further studies are needed to better understand this phenomenon.     

Relationship of microbial and salivary parameters with dental caries in Brazilian pre-school children

Caries examination and collection of paraffin wax-stimulated saliva samples were performed in 37 children, 3-6 years old, in a child-care facility at the Vidigal slum, Rio de Janeiro, Brazil. The levels of mutans streptococci and lactobacilli in saliva were estimated by the Cariescreen and by the Dentocult tests and the saliva secretion rate was determined. Statistical analysis was performed on surface-based and patient-based caries prevalence rates (SBCPR and PBCPR), and related to bacterial and salivary parameters. The results show that 31 of the 37 children were caries active. The SBCPR for the primary dentition was 6.7% +/- 1.0%. Occlusal surfaces were the most affected by decay. Regression analysis revealed that mutans streptococci salivary levels were significantly associated with the SBCPR (P = 0.0001). Similarly, lactobacilli salivary levels were significantly associated with the SBCPR (P = 0.0001). No significant association could be found between the saliva secretion rate and the SBCPR. When regression analysis was used to model dependence of the SBCPR on both organisms, the mutans streptococci and lactobacilli salivary levels were significantly associated with the SBCPRs (P = 0.0021 and 0.0118, respectively), and salivary levels of these organisms accounted for 57% of the SBCPR variability. These findings indicate that the levels of mutans streptococci and lactobacilli in saliva are significantly related to the SBCPRs on the primary dentition of these children.     

The association between environmental tobacco smoke and primary tooth caries

OBJECTIVE: Environmental tobacco smoke (ETS) has been associated with a number of negative health outcomes for exposed children. The goal of this study was to assess the association between ETS and dental caries in a pediatric population. METHODS: This study included 637 Iowa Fluoride Study children whose parents provided socioeconomic information, completed at least three questionnaires during the first year of life, and had a primary dentition exam at age 4-7 years. Households reporting in all questionnaires that someone smoked in the home were categorized as regularly smoking homes. Socioeconomic status (SES) was divided into three groups (low, middle, and high) based on family income and mother's education. Children were classified as having caries if any of the primary teeth had fillings or cavitated lesions at the primary dentition exam. RESULTS: Overall, children residing in regularly smoking homes had a higher prevalence of caries. For the middle SES group and overall, the children from smoking homes had a significantly higher prevalence of caries compared to nonregular/nonsmoking homes (52% vs 24%, P=.05 and 44% vs 25%, P=.002, respectively). After adjusting for age, SES, toothbrushing frequency, total ingested fluoride, and combined intake of soda pop and powdered drink beverages, the relationship of smoking and caries still remained significant (odds ratio [OR]=3.38; P=.001). CONCLUSIONS: Environmental tobacco smoke was associated with an increased risk of caries among children.     

Association between passive and active smoking evaluated by salivary cotinine and periodontitis

AIM: This study attempted to determine the relationship between passive and active smoking on the basis of salivary cotinine levels and periodontitis severity. METHODS: Japanese workers (n=273) were surveyed via an oral examination, a self-administered questionnaire and collection of whole saliva. Probing pocket depth (PPD) and clinical attachment level (CAL) served as periodontal parameters. Periodontitis was defined as the presence of two or more teeth with PPD > or =3.5 mm and CAL > or =3.5 mm. Salivary cotinine was determined using ELISA. Statistical methods included Wilcoxon's rank-sum test and multiple logistic regression analysis. RESULTS: Based on the results of receiver-operating characteristic plots for cotinine-level classification derived from self-reported smoking status, non-, passive and active smokers were defined as those subjects exhibiting cotinine levels of 0, 1-7 and > or =8 ng/ml, respectively. Numbers of teeth displaying CAL > or =3.5 mm in passive and active smokers were significantly higher than those in non-smokers. Multiple logistic regression analysis revealed significantly higher periodontitis odds ratios in passive and active smokers relative to non-smokers following adjustment for other lifestyle factors; odds ratios were 2.87 [95% confidence interval (CI); 1.05-7.82] and 4.91 (95% CI; 1.80-13.35), respectively. CONCLUSION: These findings suggest that passive smoking classified in terms of salivary cotinine level may be an independent periodontitis risk indicator.     

Association of salivary proteins with dental caries in a Colombian population

Saliva has an important role in maintaining normal conditions of the oral tissues. Variability in salivary composition determines its protective characteristics against dental caries. Knowledge of the molecular content of saliva in humans is important to better understand its protective properties. The aim of the present work was to recognize protein composition in whole saliva of subjects with active caries (AC), History of caries (HC), and free of caries (H) in a Colombian population, by electrophoretic pattern, and to correlate these results with clinical diagnoses. Patients over 18 years old were selected after clinical examinations, and classified into three study groups. After patients signed the informed consent form, whole saliva samples were collected. Total protein determinations were made using the Bradford method. Individual saliva samples were analyzed by SDS-PAGE and related to DMFT indexes. The gels were analyzed by Quantity One 1-D software (BIO-RAD). No statistically significant difference was found between the total protein concentration and absence of prior experience of dental decay. Total protein content was higher in female subjects (p = 0.0028) than male, and regarding the disease, it was higher in women with HC and AC. Salivary proteins present in the majority of individuals were 101, 77, 62, 55, 44, 22 and 13 kDa in size. Association was found between 17 kDa salivary protein and AC in men. Conclusions: whole salivary proteins are very similar in the three groups, except for the 17 kDa salivary protein, which might be risk marker for dental caries.     

Mouthrinses and dental caries

Mouthrinsing for the prevention of dental caries in children and adolescents was established as a mass prophylactic method in the 1960s and has shown average efficacy of caries reduction between 20-50%. Commonly, weekly or twice monthly rinsing procedures using neutral 0.2% NaF solutions have been used in schools or institutions in areas with low fluoride concentrations in the drinking water. Today, when dental caries has declined substantially in the western countries, and relatively few individuals are suffering from caries, the efficiency of large scale mouthrinsing is questioned and more individual approaches of caries prevention strategies are needed. For this reason individual caries risk assessments are necessary, utilising diagnostic tools with the aim of explaining the main causes of the caries disease. Therefore in high risk patients, daily mouthrinses using 0.05% NaF can be recommended combined with other selective preventive measures such as sugar restriction, improved oral hygiene, antibacterial treatments, and so forth. Mouthrinsing solutions have therefore been combined with antiplaque agents like chlorhexidine and other agents which can improve the caries preventive effect not only in high caries risk patients, including those with dry mouth problems and root caries. Other agents than sodium fluoride have been used, such as stannous and amine fluoride with proven clinical effects. However, although a series of new formulas of mouthrinses containing fluoride combined with different antiplaque agents have shown promising antibacterial and antiplaque efficacy, their long-term clinical effects are sparsely documented. Acute and chronic side effects from established and recommended mouthrinsing routines are extremely rare but ethanol containing products should not be recommended to children for long-term use or to individuals with alcohol problems. Patients with dry mouth problems should avoid mouthrinses containing high concentration of detergent components which reduce the substantivity of the agent and worsen the dry mouth effect. For the future, patients, dentists and public health officials will welcome new and safe, controlled and self-administrated mouthrinsing procedures with not only high efficacy, but also high effectivity and efficiency.