Effect of a chronic nail‐biting habit on the oral carriage of Enterobacteriaceae

Background/aims: Nail biting is a common oral habit in children and young adults. However, its effect on the oral carriage of Enterobacteriaceae is unclear. The purpose of the study was to evaluate the differences in prevalence of Enterobacteriaceae in saliva samples from subjects with and without a nail‐biting habit. Methods: Saliva samples were taken from 25 subjects who were nail‐biters and 34 subjects with no oral habit. The mean chronological age for all subjects was 13.5 ± 1.9 years. The saliva samples were studied microbiologically. A Pearson chi‐squared test was performed to compare the prevalence of Enterobacteriaceae in the saliva samples of the subjects with and without nail‐biting habits. Results: Statistically significant differences were found in the prevalence of Escherichia coli and total Enterobacteriaceae between both groups (P < 0.001). E. coli, Enterobacter aerogenes, Enterobacter cloacae and Enterobacter gergoviae were found in the saliva samples of 19 of the 25 nail‐biting subjects (76%), whereas E. coli, E. aerogenes and E. cloacae were detected in the saliva samples of only nine of the 34 subjects who were not nail‐biters (26.5%). Conclusion: According to the results of the present study, the Enterobacteriaceae were more prevalent in the oral cavities of children with nail‐biting habits than in children with no oral habit.     

Finger-Sucking in Children A Study of Incidence and Occlusal Conditions

In this examination of predominantly 12-year old children the overall incidence of finger-suckers was 30.7 per cent. The habit had been given up by 17.4 per cent before school age, while 1.9 per cent still had this habit at the time of the study. Prolonged finger-sucking was more common in girls than in boys. The overall incidence of nail-biters was 26.6 per cent. Finger-sucking and nail-biting habits showed a tendency of coinciding. Orthodontic treatment had been received by 13.4 per cent of the children.

The investigation showed that the finger-sucking habit had led to a decreased overbite and an increased overjet, but no postnormal molar relation. No obvious improvement of finger-sucking anomalies could be shown after the habit had been given up, when this had persisted until the age of 12-14 years.     

Helicobacter pylori in the oral cavity is associated with gastroesophageal disease

Background:  In Mexico, more than 80% of the population is infected with Helicobacter pylori . The frequency of H. pylori detection in the oral cavity is unknown, as its relationship with gastroesophageal pathology.
Aim:  To detect the presence of H. pylori in the oral cavity in Mexican population by PCR and to determine its association with gastroesophageal disease.
Methods:  Patients were divided into two groups with different clinic conditions from whom gastric biopsy, dental plaque, and saliva samples were taken and analyzed. The first group comprised of hospitalized patients, the majority of whom were diagnosed with gastroesophageal disease, while the second group was selected from a dental clinic (ambulatory population) the majority of whom appeared to be healthy subjects.
Results:  H. pylori was detected in gastric biopsy, dental plaque and saliva samples by PCR using a set of specific primers for the signal sequence of the vacuolating cytotoxin gene; detection of H. pylori in general was higher in gastric biopsy and dental plaque samples than in saliva samples. Detection of H. pylori in the oral cavity is significantly ( P  = 0.0001) associated with patients presenting gastroesophageal disease, while healthy subjects and those with other non-gastric disease do not present with H. pylori in their oral cavity.
Conclusions:  H. pylori detection in the oral cavity is associated to gastroesophageal disease. In addition, it is suggested that all patients presenting gastric symptoms and H. pylori detection in the oral cavity would begin bacterial treatment immediately.     

Sucking habits in childhood and the effects on the primary dentition: findings of the Avon Longitudinal Study of Pregnancy and Childhood

Introduction.  Most previous research on non-nutritive sucking habits has been cross-sectional in nature. This study determined the prevalence of non-nutritive sucking habits and the effects on the developing dentition within a longitudinal observational cohort.
Methods.  The Children in Focus group of the Avon Longitudinal Study of Pregnancy and Childhood study was studied. Questionnaire data on non-nutritive sucking habits were collected on the children at 15 months, 24 months, and 36 months of age. Dental examinations were performed on the same children at 31 months, 43 months, and 61 months of age.
Results.  At 15 months, 63.2% of children had a sucking habit, 37.6% used just a dummy, and 22.8% used a digit. By 36 months, sucking had reduced to 40%, with similar prevalence of dummy and digit sucking. Both habits had effects on the developing dentition, most notably in upper labial segment alignment and the development of anterior open bites and posterior crossbites.
Conclusions.  The majority of children had non-nutritive sucking habits up until 24 months of age. Both digit and dummy sucking were associated with observed anomalies in the developing dentition, but dummy-sucking habits had the most profound influence on the anterior and posterior occlusions of the children.     

Salivary microbiota of HIV-positive children and its correlation with HIV status, oral diseases, and total secretory IgA

Aim.  This study aimed to investigate the prevalence and levels of salivary microorganisms in HIV-positive children, and their correlation to HIV status, oral lesions, and salivary IgA levels.
Design.  Forty-two HIV-positive and 36 control children were clinically examined, had their saliva collected and processed for the microbiological analysis of 38 bacterial taxa by the checkerboard method, and salivary IgA quantification by ELISA.
Results.  The majority of the species tested were more prevalent in control children than in the HIV group. Mean concentration of total salivary IgA was similar in both groups. High levels of Veillonella parvula were found in children with cheilitis and herpes. Tannerella forsythia , Eikenella Corrodens , and Propionibacterium acnes were prevalent in children with gingivitis, while Fusobacterium periodonticum , Streptococcus gordonii , and Streptococcus oralis were significantly more frequent in children with no oral lesions. Significant negative correlations between salivary IgA levels and Eubacterium nodatum and oral streptococci were observed ( P  < 0.05).
Conclusion.  HIV-seropositive children presented significantly lower prevalence and levels of several bacterial species in saliva; HIV-positive children are able to mount a mucosal immune response; HIV-seropositive children under highly active antiretroviral therapy presented low prevalence of oral lesions.     

Distribution of selected cariogenic bacteria in five different intra-oral habitats in young children

Background.  Knowledge of the colonization patterns and composition of the oral microbiota can lead to a better understanding of disease initiation.
Aim.  The aim of this study was to examine the distribution of selected cariogenic bacteria in samples from five different oral habitats in young Greek children.
Design.  Ninety-three children 3–12 years old (mean + SD 7.9 ± 2.5) (60.2% male, 39.8% female) participated and split into three different age groups: primary (3–6 years), early mixed (6–9 years), and mixed dentition (9–12 years). Samples for bacterial enumeration were taken from saliva, supragingival and subgingival plaque, tongue dorsum, and soft tissues from each child, and were further analysed using checkerboard DNA–DNA hybridization.
Results.  Mean counts and proportions of all the test bacteria differed significantly among sample locations. Cariogenic bacteria were present in almost all healthy children. Mean proportions of Streptococcus mutans isolated from soft tissue and Streptococcus sanguinis from soft tissue, subgingival and saliva samples increased significantly with age, whereas the opposite was seen for Lactobacillus acidophilus .
Conclusions.  Cariogenic bacteria were present in almost all young children. Soft tissues, saliva, and tongue were more often colonized by cariogenic streptococcal species than teeth. These surfaces may serve as reservoirs for oral pathogens, requiring attention during preventive interventions.     

A cross-sectional survey to ascertain the prevalence of oral habits among eleven to twelve year old children in Trinidad and Tobago

ObjectiveThe aim of this study was to determine the prevalence of oral habits in eleven to twelve year old children in Trinidad and Tobago and to determine if there is any association with ethnicity and gender.DesignCross-sectional survey.MethodsAn epidemiological survey of 975 high school students (566 females (58.1%) and 409 males (41.9%)) was conducted. A questionnaire was developed to record information on the presence of oral habits. A clinical examination was also conducted at the school site. Statistical analysis was undertaken using Chi-square test and binary logistic regression.ResultsThere was a high prevalence of oral habits. The overall prevalence of habits was 93%. 81.3% of children had a tongue thrust, 46.3% nail biting habit, and 34.9% digit sucking habit. Afro-Trinidadian subjects and female subjects were more likely to have habits with tongue sucking in particular exhibiting a female (OR 0.419 95%CI 0.285, 0.616) and Afro-Trinidadian ethnic (OR 0.559 95%Ci 0.433, 0.721) predilection.ConclusionThe prevalence of oral habits in eleven and twelve year old children in Trinidad and Tobago is high, with higher prevalence in females and Afro-Trinidadians with tongue thrusting being most prevalent oral habit overall.     

Sjögren's syndrome sufferers have increased oral yeast levels despite regular dental care

Aim:  To investigate the prevalence and quantity of oral yeasts and their association with oral candidiasis in Sjögren's syndrome (SS) patients receiving regular dental care.
Materials and methods:  Yeasts in oral rinse and full-mouth supra-gingival plaque samples from 25 primary SS, 27 secondary SS and 29 control subjects were selectively cultured. All yeasts except single-species isolates were genotyped using pulsed field gel electrophoresis (PFGE).
Results:  Ten (19%) SS sufferers had symptomless candidiasis. SS subjects had a higher prevalence (73% vs 7%) and quantity of yeasts than controls in both oral rinse and plaque samples ( P  < 0.05). The prevalence of yeasts in plaque was associated with candidiasis regardless of denture wearing ( P  ≤ 0.04). Candida albicans was the predominant yeast isolated. PFGE showed 20 (66% of total) C. albicans isolate pairs, i.e. C. albicans species isolated from plaque and oral rinse samples of the same individual, were of closely related genetic clonal types ( P  < 0.01).
Conclusions:  Despite effective oral hygiene, more SS subjects than controls had detectable levels of oral yeasts and their presence in supra-gingival plaque was associated with candidiasis. Candida albicans colonized supra-gingival biofilm even in well-maintained SS individuals, posing a challenge to the control of oral candidiasis.     

The prevalence of oral mucosal lesions in adults from the Turin area

Aim:  To assess the prevalence of oral mucosal lesions (OML) and evaluate its association with tobacco and alcohol consumption and the wearing of removable dentures in an adult population from the Turin area, Italy.
Materials and methods:  A retrospective study, based on an invitational self-selected screening, was performed on 4098 subjects. It included clinical examination plus biopsies when necessary. Patient history included age, sex, denture wearing and risk habits. Internationally accepted criteria were adopted to classify the OMLs.
Results:  Males were observed to have more OMLs (557/2040; 27.3% vs 471/2058; 22.89%). Overall OML prevalence was linked to risk habits and age. Tobacco was linked to leukoplakia, melanin pigmentation, smoker's palate, frictional lesions and papilloma. It was negatively related to recurrent aphthous stomatitis and oral lichen planus. Alcohol was linked to leukoplakia, frictional lesions and median rhomboid glossitis. The tobacco–alcohol association was linked to frictional lesions, leukoplakia, melanin pigmentation and smoker's palate. Denture wearers had an overall higher prevalence of OMLs, in particular candidiasis, traumatic and frictional lesions.
Conclusions:  The prevalence of OMLs in Turin seems to be comparable to those in other European studies and emphasize that risk habits and denture wearing have some relationship with the presence of OMLs.     

Areca chewing in Xiangtan, Hunan province, China: interviews with chewers

Background:  To report on Areca chewing (AC) in Xiangtan, Hunan province, China, and to test the knowledge of chewers related to side effects of the habit.
Methods:  Interviews with 276 individuals were performed. A questionnaire including general data, chewing habits, educational level and knowledge about side effects were used. Data were analysed using spss . Chi-square test was used at a significance level of P  < 0.05.
Results:  Around 257 individuals were chewers (male: 54.1%; female: 45.9%) and 19 were former chewers (male: 31.6%; female: 68.4%). Mean age of chewers was 36.1 years. Around 42.4% of chewers smoked; 58.0% had a drinking habit. Average period of chewing was 11.2 years. Around 88.3% of chewers did not include the nut (seed). Around 79.0% considered AC habits negative for general health and 85.2% for oral health.
Conclusions:  Most respondents did not know that AC may induce oral submucous fibrosis and oral cancer. The 'betel quid' chewed in Xiangtan usually does not contain Areca 'nut' (seed, endosperm), but consists of the husk. As no studies on the chemical composition of the Areca husk have been published such investigations are urgently needed.     

Oral Candida infection and colonization in solid organ transplant recipients

Introduction:  Oral Candida carriage and infection have been reported to be associated with a greater risk for systemic infection in transplant recipients; however, a systematic analysis of the oral Candida titers and species has not been previously conducted. The objectives of this study were to determine the prevalence of oropharyngeal candidiasis, the oral carrier status, Candida titers and species in this population.
Methods:  Ninety kidney and heart transplant subjects and 72 age-matched healthy controls were included. Swabs from the oral mucosa and a standardized amount of unstimulated saliva were plated on Chromagar™ Candida , and colony-forming units per millilitre were calculated. Initial speciation was based on colony color and was confirmed by standard germ tube, biotyping, or polymerase chain reaction assays.
Results:  Infection with C. albicans was detected in seven transplant subjects and none of the controls. The transplant group had significantly higher oral Candida titers than the control group. There were no statistically significant relationships between the dose or type of immunosuppressants and oral Candida titers or infection. A significantly higher percentage of transplant subjects were colonized by more than one species, compared with control subjects. The most frequent species combination in transplant subjects was C. albicans and C. glabrata . C. glabrata was isolated from 13.5% of transplant carriers and none of the controls.
Conclusions:  Increased oral Candida infection and carriage titers were found in the transplant population. Although the majority of transplant patients were colonized by C. albicans , C. glabrata appears to emerge as the second most prevalent species.     

Body adiposity status in teenagers and snacking habits in early childhood in relation to approximal caries at 15 years of age

Background.  The prevalence of overweight and obesity in children is steadily increasing in many countries. Dental caries and obesity are both multifactorial diseases and are associated with dietary habits.
Objective.  The purpose of this study was to investigate the relationship between body weight status in adolescents and snacking habits in early childhood to approximal caries prevalence at 15 years of age.
Methods.  This study is part of a series of surveys of oral health in children followed from the ages of 1 year to 15 years. Body adiposity status was estimated at 13.5–16.4 years using the International Obesity Task Force cut-off values [age-specific body mass index (isoBMI)]. Information about snacking habits in early childhood was collected from interviews conducted at 1 year and 3 years. Approximal caries information was obtained from bitewing radiographs at 15 years. Data related to isoBMI and approximal caries were available in 402 teenagers.
Result.  Adolescents with isoBMI ≥ 25 ( n  = 64) had an approximal caries prevalence that was a mean of 1.6 times higher than those with isoBMI < 25 ( n  = 338) (4.64 vs. 2.94; P  = 0.014). Furthermore, children's snacking habits at an early age were associated with approximal caries at 15 years.
Conclusion.  Overweight and obese adolescents had more approximal caries than normal-weight individuals. Moreover, the frequent consumption of snacking products during early childhood appears to be a risk indicator for caries at 15 years. Future preventive programmes should therefore include, on a multidisciplinary level, strategies to prevent and reduce both obesity and dental caries at an early age.     

Periodontal disease in mothers indicates risk in their children

Introduction.  It is well established that severe periodontitis clusters in families, but there are no data about the relationship between mothers with chronic periodontitis and their children's periodontal status.
Objective.  To evaluate a risk for periodontal diseases in children of periodontally diseased and healthy mothers.
Methods.  Four study groups were included: (I) 20 female patients with untreated generalized severe chronic periodontitis, (II) their children (34), (III) 13 periodontally healthy mothers and (IV) their children (13). Material was collected from years 2004–2006. The clinical examination included registration of visible plaque index, modified gingival index and, bleeding sites on probing. Periodontal microbiological samples were obtained from all study subjects and the isolates were identified according to morphology and biochemical profiles; similar interfamilial pathogens were compared by PCR-technique.
Results.  The children of diseased mothers more frequently had periodontal diseases, especially gingivitis. In addition, clinical parameters of gingival inflammation were more expressed and oral hygiene was worse in this group of children. VPI and VPI% of the diseased and healthy mothers differed significantly. The most common oral pathogens were P. intermedia/nigrescens and A. actinomycetemcomitans . The children of healthy mothers harboured pathogens less frequently than the children of diseased mothers. The sharing of P. intermedia/nigrescens was more frequent (5 families) than A. actinomycetemcomitans (2 families).
Conclusion.  Maternal indicators, such as periodontitis, hygiene habits, and periodontal microflora are risk factors for childhood periodontal diseases, and might be predictive of future childhood and adolescent periodontitis.     

The anti-endotoxic effects of the KSL-W decapeptide on Escherichia coli O55:B5 and various oral lipopolysaccharides

Background and Objective:  Host responses following the recognition of bacterial lipopolysaccharide can range from acute inflammation to septic shock. The aim of this study was to evaluate the ability of the KSL-W decapeptide to bind to and block the endotoxic effects of lipopolysaccharide.
Material and Methods:  An enzyme-linked immunosorbent assay-based binding assay using fluorescently labeled KSL-W to detect adsorbed Escherichia coli O55:B5 lipopolysaccharide was employed. A commercially available recombinant Factor C lipopolysaccharide detection assay, hemagglutination of rabbit erythrocytes as well as E-selectin expression in human umbilical vein endothelial cells were used to assess the anti-endotoxic effects after KSL-W exposure to E. coli lipopolysaccharide as well as to oral lipopolysaccharide samples.
Results:  Lipopolysaccharide-binding assays using E. coli O55:B5 lipopolysaccharide revealed both a higher maximal binding range (532–713 μ m) and a half-maximum binding concentration (70–185 μ m) for the KSL-W peptide when compared with its analog control. Significant inhibition of E-selectin expression in human umbilical vein endothelial cells ( p  < 0.0001) as well as hemagglutination of rabbit erythrocytes occurred after the interaction of KSL-W with E. coli lipopolysaccharide. Recombinant Factor C enzyme detection inhibition revealed dose-dependent inhibition values ranging from 1.0–51.8 μ m, which were dependent upon the type of lipopolysaccharide sample tested.
Conclusion:  These results demonstrate that for the concentrations tested, the KSL-W decapeptide was nontoxic to mammalian cells and could bind to and block the host recognition and response towards enteric, as well as oral, lipopolysaccharide samples.     

The microbiota on different oral surfaces in healthy children

Introduction:  Knowledge of the early oral colonization patterns could provide a better understanding of oral biofilm development and disease initiation that in turn could be the basis for early preventive programmes.
Methods:  Microbial samples were collected from five different oral habitats from a total of 93 children (age 3–12 years), attending the Dental School of the University of Athens, who were split into three age groups. A total of 38 microbial species were sought out by the checkerboard DNA–DNA hybridization technique.
Results:  All of the test species, except Parvimonas micra and Porphyromonas gingivalis , differed significantly among sample locations providing quite distinct microbial profiles for the different oral surfaces. Supragingival and subgingival plaque had similar profiles and exhibited higher proportions of Actinomyces species and Green complex while soft tissue samples were dominated by streptococci of the Yellow complex. The profiles of the tongue dorsum and saliva were also similar. Many of the species were in similar proportions in all three age groups for a given location. Periodontal pathogens showed increases in proportions with increasing age. Specifically, the Red complex species ( Tannerella forsythia , P. gingivalis , Treponema denticola ) showed a significant increase in proportion with age ( P  < 0.05) in all sample locations.
Conclusions:  The results showed a pattern of colonization in children similar to that previously found in adults. Differences in the profile between age groups suggest a gradual maturation of the oral microbiota, with it being made up of an increasing number of Orange and Red complex species.     

P31 The relationship between the relative amount of Porphyromonas gingivalis in saliva and halitosis

Objectives  Porphyromonas gingivalis is one of the microorganisms that most actively produce CH₃SH and we have reported that subjects with P . gingivalis have higher CH₃SH levels than subjects without P .  gingivalis . However, little is known about the relationship between P . gingivalis levels in saliva and the condition of oral malodor. In this study, we evaluated the association between the relative amount of P . gingivalis in saliva and halitosis in mouth air.
Methods  All of the subjects were patients at the Preventive Dentistry and Breath Odor Clinic of Kyushu Dental College, where they received a periodontal examination. Volatile sulfur compounds (VSC: hydrogen sulfide and methyl mercaptan) were measured using gas chromatography. Saliva samples were collected in a sterile plastic tube over a period of 5 min while the subject chewed on paraffin wax, and were then immediately stored at –80°C until use. Template DNA was obtained from the stored saliva using an Easy-DNA Kit (Invitrogen, CA, USA) according to the manufacturer's instructions. Conventional PCR assays were used to confirm the presence of P . gingivalis . A 5' nuclease TaqMan PCR was used to quantify P . gingivalis in saliva. The relative numbers of bacteria were measured using the comparative threshold cycle method.
Results  We found a quantitative relationship between the P . gingivalis levels in saliva and the condition of halitosis in mouth air.
Conclusion  We analyzed the relationship between the relative amount of P . gingivalis in saliva and oral malodor.     

Analysis of Streptococcus mutans biofilm proteins recognized by salivary immunoglobulin A

Introduction:  The purpose of this study was to examine the Streptococcus mutans biofilm cellular proteins recognized by immunoglobulin A (IgA) in saliva from various caries-defined populations.
Methods:  Biofilm and planktonic S. mutans UA159 cells were prepared. The proteins were extracted, separated by two-dimensional gel electrophoresis, transferred to blotting membranes, and probed for IgA using individual saliva samples from three groups of subjects; those who developed 0 caries (no active caries), 5–9 caries (medium), or more than 10 caries (severe) over a 12-month interval.
Results:  Several proteins were recognized by salivary IgA in all groups of saliva but spot distribution and intensity varied greatly between the groups, and some proteins were recognized more strongly in biofilm cells than in planktonic culture, and vice versa. Furthermore, 15 proteins were only recognized by saliva from the 'no active caries' group, and four proteins were recognized by saliva samples from subjects in all three groups. Specifically, antigen I/II was recognized less in biofilm cells by caries-free saliva compared with planktonic cells. However, salivary IgA antibody to antigen I/II was absent in blots using saliva from the 'medium caries' and 'severe caries' groups.
Conclusion:  The bacterial molecules recognized by caries-free saliva are significant factors for S. mutans caries formation, and their inhibition could be a therapeutic target. In addition, saliva of caries-free subjects includes significant IgA antibody against antigen I/II of S. mutans , indicating a protective mechanism. However, microorganisms may protect themselves from host immune attack by forming biofilms and decreasing expression of antigen I/II.     

Periodontitis lesions are the main source of salivary cytomegalovirus

Background:  Herpesviruses play causal or cooperative roles in childhood infections, tumorigenesis, ulcerogenesis, and periodontitis. Saliva is a common vehicle of herpesvirus horizontal transmission, but the source of salivary herpesviruses remains obscure. To evaluate the significance of periodontal disease in shedding of oral herpesviruses, this study determined the genome-copy counts of human cytomegalovirus (HCMV) and Epstein–Barr virus (EBV) in whole saliva of subjects with periodontitis, gingivitis, or no natural teeth.
Methods:  Whole saliva was collected from 14 periodontitis patients, 15 gingivitis patients and 13 complete denture wearers. The study subjects were systemically healthy and had not received periodontal treatment in the past 3 months. Real-time TaqMan polymerase chain reaction was used to determine the salivary load of HCMV and EBV.
Results:  Salivary HCMV was detected in seven (50%) periodontitis patients, but not in any gingivitis or edentulous subjects ( P  < 0.001). Salivary EBV was detected in 11 (79%) periodontitis patients, in five (33%) gingivitis patients, and in seven (54%) edentulous subjects ( P  = 0.076). Salivary samples showed copy counts of HCMV in the range of 3.3 × 10³–4.2 × 10⁴/ml and of EBV in the range of 3.6 × 10²–1.6 × 10⁹/ml.
Conclusions:  HCMV and EBV are commonly present in the saliva of periodontitis patients. Periodontitis lesions of systemically healthy subjects seem to constitute the main origin of salivary HCMV, but do not comprise the sole source of salivary EBV.     

Hyposalivation, xerostomia and oral health status of HIV-infected subjects in Thailand before HAART era

J Oral Pathol Med (2010) 39 : 28–34
Background:  The aims of this study were to determine hyposalivation, xerostomia, and oral health status of HIV-subjects in Thailand before highly active antiretroviral therapy era.
Methods:  Oral examination and measurement of saliva flow rate of both unstimulated and wax-stimulated whole saliva were performed in 135 subjects (56 HIV-subjects, mean age: 34.5 years, and 79 non-HIV controls, mean age: 29.5 years). Presence of oral candidiasis, cervical root caries, and number of existing teeth were recorded. Microbiological investigation of oral Candida was conducted using oral rinse technique. Risk factors associated with hyposalivation and xerostomia were analysed.
Results:  The unstimulated flow rates in HIV-subjects and non-HIV controls were 0.19 and 0.33 ml/min ( P  = 0.0024). For stimulated flow rates, the corresponding figures were 1.45 and 1.62 ml/min ( P  = 0.31). The unstimulated flow rate was significantly higher in the asymptomatic HIV-subjects: 0.17 ml/min, when compared with the symptomatic/AIDS group 0.11 ml/min ( P  = 0.003). No significant difference between the groups could be found with respect to stimulated flow rate. Hyposalivation was significantly associated with the colony forming unit of Candida . Smoking and alcohol consumption were significantly associated with hyposalivation, but not xerostomia. The following factors were significantly associated with both hyposalivation and xerostomia; sex, stage of HIV infection, risk group of HIV infection, systemic disease, and medication use.
Conclusions:  Salivary flow rate of HIV-subjects in Thailand was affected by HIV infection. The rate was significantly decreased with advanced stage of the disease. Various factors including medication use were associated with hyposalivation and xerostomia among the subjects.     

Strategies for caries risk assessment in children and adolescents at public dental clinics in a Swedish county

Background.  Since caries prevalence has decreased and become polarized, high-risk preventive strategies have been widely adopted. The underlying factors leading to assessment and management of caries risk are poorly understood.
Aim.  The aim of this study was to identify the factors forming the basis for dentist's caries risk assessment in dental care for children and adolescents.
Design.  From all 3372 children in a Swedish county identified as at high risk for developing caries, a sample of dental records from 432 children, aged 3–19 years, were randomly selected to be analysed in the study. Information about medical and social history, dental status, dietary habits, oral hygiene, and salivary data was obtained from the records.
Results.  The results show that the only data registered in the majority of the dental records were dental status from the clinical examination and bitewing radiographs. In approximately half of the dental records, medical history and data concerning oral hygiene were registered. Dental history and dietary habits were noted in approximately 25% of the dental records, whereas other risk factors/indicators were occasionally registered.
Conclusions.  Dentists mainly base their caries risk assessments on past caries experience, a reliable risk indicator for assessing the risk of being affected by caries again. In children with no experience of caries, knowledge of other risk factors/indicators needs to be available to perform a caries risk assessment. In this study, documentation of such knowledge was strongly limited.