Sugar-sweetened beverages and dental caries in adults: A 4-year prospective study

Objectives

To explore the association between frequency of consumption of sugar-sweetened beverages (SSB) and caries increment over 4 years in adults. A second objective was to explore whether the association between frequency of SSB consumption and caries increment varied by socio-demographic characteristics and use of fluoride toothpaste.

Methods

Data from 939 dentate adults who participated in both the Health 2000 Survey and the Follow-Up Study of Finnish Adults’ Oral Health were analysed. At baseline, participants provided information on demographic characteristics, education and dental behaviours, including two questions on frequency of SSB consumption. The 4-year net DMFT increment was calculated using data from baseline and follow-up clinical oral examinations. The association was tested in negative binomial regression models and the moderating role of sex, age, education and use of fluoride toothpaste was examined by adding their two-way interaction with SSB consumption to the main effects model.

Results

A positive association was found between frequency of SBS consumption and 4-year net DMFT increment, regardless of participants’ socio-demographic and behavioural characteristics. Adults drinking 1–2 and 3+ SSB daily had, respectively, 31% (Incidence Rate Ratio: 1.31; 95%CI: 1.02–1.67) and 33% (IRR: 1.33; 95%CI; 1.03–1.72) greater net DMFT increments than those not drinking any SSB. None of the four two-way interaction terms was significant (all p > 0.05).

Conclusion

There seems to be a dose–response relationship between frequency of SSB consumption and caries increment in adults. That association was consistent across socio-demographic characteristics, and more importantly, use of fluoride toothpaste.

Clinical significance

Drinking sugar-sweetened beverages on a daily basis is related to greater caries risk in adults.     

健康宣教降低牙槽外科焦虑症的初步研究

目的针对牙槽外科牙科焦虑症（DA）高发的现象,采用简单、经济、有效的健康教育方法降低DA的发生率。方法对2013年5-6月就诊患者,有明显牙科恐惧的40例患者由护理人员一对一进行拔牙健康教育,应用多种形式对拔牙前准备、拔牙过程及拔牙后各种并发症的处理进行讲解,有针对性的回答患者疑问,评估宣教前后焦虑程度。结果患者焦虑程度明显降低,术中配合默契,无1例无效复诊。结论相关健康知识的掌握有助于降低牙槽外科焦虑,提高患者术中及术后的配合,同时也改善了医患关系。     

口腔健康宣教对拔牙患者牙科焦虑心理的作用

目的 评价口腔健康宣教能否作为预防拔牙患者牙科焦虑心理有效方法.方法 实验组和对照组各40例拔牙患者在术前30分钟、术前2分钟应用牙科焦虑量表(MDAS)测评焦虑程度,两次测评之间实验组患者接受口腔健康宣教.结果 实验组术前2分钟的焦虑程度显著性低于术前30分钟(P＜0.05),同时也显著低于对照组术前2分钟(P＜0.01),两组术前30分钟焦虑程度无显著性差异.结论 口腔健康宣教能显著减轻拔牙患者术前焦虑.     

牙科焦虑病人在局麻治疗时的心理干预

目的探索缓解病人的不良情绪,增加局麻治疗时的舒适度的方法。方法通过柯式牙科焦虑量表,选择有明显牙科焦虑症（DA）特质的病人150例（牙科焦虑程度评分〉12分）。随机分为两组：75例为实验组,75例为对照组。实验组在改良牙科局麻治疗同时,根据病人主要担心的问题及焦虑程度给予心理辅导,消除顾虑;对照组接受传统局麻治疗。观察并记录两组病人分别在局麻前10min、局麻后即刻、局麻后10min时的牙科焦虑量表（DAS）评分,同时测量并记录血压、脉搏。结果比较对照组,实验组各项指标波动范围不大。结论通过合理使用心理干预,可有效改善病人的牙科焦虑,使更多病人坚持完成治疗。     

Assessment of dental anxiety using modified dental anxiety scale among adults with cleft lip and/or palate

ObjectivesThis study aimed to investigate dental anxiety levels among adults with cleft lip and/or palate (CL/P) and compare to adults with no orofacial cleft. The study also intended to find out the impact of cleft severity, gender and age on the perceived dental anxiety.MethodsThe study was composed of a sample of 70 adult participants who received and completed dental treatments. After sending self-addressed envelopes with consent forms and Modified Dental Anxiety Scale (MDAS) to 192 potential participants, 35 participants with CL/P (CL/P group) and 35 participants with no CL/P (control group), agreed to participate. Data were analysed using Mann–Whitney U test. A two-tailed P-value < 0.05 was considered as statistically significant.Results54.3% of adults with CL/P (23 females and 12 males, age range from 16 to 72 years) reported normal dental anxiety, while the remaining 45.7% reported moderate dental anxiety. No extreme dental anxiety were recorded in the CL/P group. These results were similar to the control group and there were no significant differences between groups (p > 0.05). Female participants recorded higher median anxiety scores than male participants in the CL/P group, and participants with cleft lip had higher median scores than participants with cleft lip and palate. However, these were not statistically significant.ConclusionThe results suggest that CL/P did not affect dental anxiety levels for participants with the CL/P as there were no extreme cases and their results were comparable to a general non-cleft sample.     

Treatment of dental anxiety disorders. Outcome related to DSM-IV diagnoses

In this study we evaluated treatment effects in 70 consecutively admitted patients in a specialized university clinic for treatment of dental fear. Thirty-three (47%) of the patients fulfilled the diagnostic criteria for Specific Phobia alone (Dental Phobia, DP), 24 (33%) had severe dental anxiety without fulfilling the criteria for phobia (ND), and 13 (19%) fulfilled the criteria for multiple DSM-IV diagnoses (MD). Dental anxiety was measured prior to, immediately after and at follow-up (mean = 19 months) using Corah's Dental Anxiety Scale and Dental Fear Survey. Dental attitudes were measured by Getz' Dental Beliefs Survey. Dental attendance and everyday functioning were measured by self-report. DP patients received significantly more treatment-sessions as compared to the ND group. Despite significant overall reductions in scores on all psychometric instruments from pretreatment to follow up, patients in the MD group reported significantly more severe anxiety at pre- and post-treatment and at follow-up as compared to patients in the ND group. There was no interaction between diagnostic group and assessment occasion (pre treatment, post treatment and follow up) on the self-reported anxiety. Patients reported significant improvements in self-esteem, social relations and everyday functioning, regardless of diagnostic group. Sixty-three percentage of the respondents had been to the dentist within 1 year after completed treatment. Patients treated by dentists who had received supervised training in exposure treatment had significantly more often seen the dentist at follow-up.     

Management of fear and anxiety in the dental clinic: a review

People who are highly anxious about undergoing dental treatment comprise approximately one in seven of the population and require careful and considerate management by dental practitioners. This paper presents a review of a number of non‐pharmacological (behavioural and cognitive) techniques that can be used in the dental clinic or surgery in order to assist anxious individuals obtain needed dental care. Practical advice for managing anxious patients is provided and the evidence base for the various approaches is examined and summarized. The importance of firstly identifying dental fear and then understanding its aetiology, nature and associated components is stressed. Anxiety management techniques range from good communication and establishing rapport to the use of systematic desensitization and hypnosis. Some techniques require specialist training but many others could usefully be adopted for all dental patients, regardless of their known level of dental anxiety. It is concluded that successfully managing dentally fearful individuals is achievable for clinicians but requires a greater level of understanding, good communication and a phased treatment approach. There is an acceptable evidence base for several non‐pharmacological anxiety management practices to help augment dental practitioners providing care to anxious or fearful children and adults.     

Dental anxiety and symptoms of general anxiety and depression in 15‐year‐olds

Abstract: Objectives: The objective of the study was to analyse the relationship between dental anxiety and symptoms of general anxiety and depression among 15‐year‐old individuals. Methods: The sample analysed included 221 randomly selected 15‐year‐old individuals living in the city of Jönköping, Sweden. One questionnaire captured sociodemography and dental history, while dental anxiety was assessed by the Dental Fear Survey (DFS) and symptoms of general anxiety and depression by the Hospital Anxiety and Depression Scale (HADS). Results: About 6% of the adolescents were classified as dentally anxious. Symptoms of general anxiety and depression were significantly correlated with dental anxiety in both the bivariate and multivariate analyses. The latter analyses were adjusted for gender and previous painful experiences of dental care. Individuals with high dental anxiety showed general anxiety scores on a clinical level (mean = 9.8, SD = 4.3). Conclusions: Symptoms of general anxiety and depression were shown to be significantly correlated with dental anxiety among 15‐year‐old individuals.     

Immediate functional loading of TiOblast dental implants in full‐arch edentulous maxillae: a 3‐year prospective study

Introduction: Immediate functional loading of dental implants for full‐arch restoration is a patient‐friendly approach, shown to be feasible with a good long‐term prognosis in a completely edentulous mandible. For the complete restoration of the maxilla, acceptable long‐term clinical follow‐up is lacking or based on case reports rather than on prospective studies. Objectives: This prospective mono‐centre study reports the 3‐year outcome of immediately functionally loaded Astra Tech Dental implants in completely edentulous maxillae based on clinical survival and success based on radiographical assessment of bone level. Material and methods: One hundred and ninety‐five Astra Tech TiOblast surface fixtures were installed in 25 consecutively treated patients (age range: 42–76 years), of whom eight were smokers, 12 had a confirmed history of periodontitis and six had poor bone quality normally deemed for delayed loading. Fixtures and abutments were inserted in a one‐stage procedure and functionally loaded within 24 h with a 10‐unit provisional glass‐fibre or metal‐reinforced screw‐retained restoration. After 6 months, each implant was checked for stability using a manual torque of 20 N cm and the provisional restoration was replaced by a 10–12‐unit screw‐retained metal–ceramic or metal–resin cantilever bridge. Bone level was assessed radiographically from the day of surgery up to 3 years and used to calculate mean bone loss at the patient level and individual implant success. Results: No failures occurred in implants or prostheses, the total survival rate being 100%. Mean marginal bone loss was 0.58 mm (SD 0.58); 0.6 mm (SD 0.53); 0.63 (SD 0.61); and 0.72 (SD 0.63) after 6 and 12 months, and 2 and 3 years, respectively, yielding a 100% success at the patient level. Wilcoxon's signed ranks test showed only statistically significant bone loss between baseline and 6 months and a steady‐state condition during all other intervals. At the individual fixture level, 82% lost <1 mm marginal bone between baseline and 1 year. After 3 years, 86% have <1.5 mm total bone loss and can be considered a success. The fixtures expressing more bone loss were all inserted in smokers. Conclusion: Immediate loading of a full‐arch maxillary bridgework on 7–9 Astra Tech TiOblast implants is a predictable treatment option with 100% fixture survival and stable bone‐to‐implant contact up to 3 years. The steady state in bone remodelling is indicative of a good long‐term prognosis in non‐smokers but smokers seem to be more prone to bone loss.     

氟片防龋3年效果观察

〕目的：比较氟化物对儿童龋病的预防作用。方法：对饮水氟含量１．５７８×１０－５ｍｏｌ／Ｌ低氟区７岁～８岁学生５５７名，以学生班为单位分为氟片组与对照组，进行群体防龋试验。结果：试验３年后，氟片组与对照组比较，龋均、龋面均的降低率分别为４５．００％、５６．１４％，对第一恒磨牙，龋均、龋面均降低率分别为４０．５４％、５０．００％，龋齿都发生在第一恒磨牙的点隙窝沟处。对照组前牙及双尖牙龋患较低，氟化物对前牙光滑面龋的预防效果仍有待继续观察。结论：氟化物对窝沟龋有一定的防龋作用，但较窝沟封闭剂的防龋效果差。对于儿童龋齿的预防，如果将氟化物与窝沟封闭同时应用，将会取得最佳的效果。     

Dental pain and oral health-related quality of life in individuals with severe dental anxiety

Objectives: To analyze the prevalence and level of dental pain among adult individuals with severe dental anxiety (DA), and the association between dental pain and oral health-related quality of life (OHRQoL).

Methods: The study was based on 170 adult individuals with DA referred to a specialized DA clinic. All patients answered a questionnaire including questions on DA (DAS, DFS), OHRQoL (OIDP) and dental pain. An adapted clinical examination and a panoramic radiograph revealed the present oral status.

Results: The prevalence of dental pain was high (77.6%) and among those reporting pain the intensity was high (49.0–61.0 on a VAS). One or more problems during the last 6 months with the mouth or teeth affecting the individual’s daily activities were reported in 85.3% of the participants. Individuals who reported dental pain had lower OHRQoL compared with those who did not report dental pain (p?p?p?=?.008).

Conclusion: This study revealed a high prevalence and a high level of dental pain among adult individuals with severe DA. Having dental pain was associated with poor OHRQoL.