Caries experience and streptococci and lactobacilli salivary levels in 6-8-year-old Sardinians

Objectives. The aim of this investigation was to compare clinical data regarding oral status (DMFT/DMFS indices) and streptococci or lactobacilli counts in stimulated whole saliva in two groups of children, aged 6 and 8 years. Methods. Seventy‐nine boys and 93 girls aged 6 (84 subjects) and 8 (88 subjects) years old were selected. DMFT/dmft, DMFS/dmfs and OHI‐S indices were recorded. Mutans streptococci (Sm) and lactobacilli (Lb) salivary levels were assessed using commercially available strip tests and were rated from 0 to 3 and from 0 to 4 in the group as a whole. Results. Mean dmfs was 9·06 ± 10·80, made up of ds = 7·28 ± 9·54, fs = 1·19 ± 3·64 and ms = 0·59 ± 3·47. Mean DMFS was 0·73 ± 1·91, made of DS = 0·54 ± 1·29, FS = 0·08 ± 0·56 and MS = 0·11 ± 0·56. Statistically significant differences were found for both Sm and Lb scores between those with and without caries in the primary teeth (P < 0·05). The different Lb scores were also significant in relation to caries in permanent teeth in older children. Conclusion. A high proportion of children had some caries experience, and were in need of treatment.     

Oral health survey of 5-12-year-old children of National Guard employees in Riyadh, Saudi Arabia

Objectives. To assess the oral health status, preventive practices and mutans streptococci (MS) levels among the children of National Guard personnel living in Riyadh, Saudi Arabia. Design. Cross‐sectional study of schoolchildren. Setting. Dental Clinic of the National Guard Hospital in Riyadh, Saudi Arabia. Sample and methods. A sample of 272 5–12‐year‐old children, 154 males and 118 females (95% Bedouin), were selected from approximately 35 National Guard schools in the Riyadh area. An examination was performed in the dental clinic in the National Guard hospital. Oral hygiene was assessed using the Simplified Debris Index (DI‐S); Gingival Index (GI) was used to measure gingival health; dental fluorosis was recorded according to the criteria of Dean. Dental caries (dmft, dmfs, DMFT and DMFS) was recorded according to the recommendations of Haugejorden. Concentration of MS in saline rinse samples was assessed by routine laboratory methods and expressed as colony forming units (CFU) per ml (log₁₀). Results. There was a high level of dental caries (mean dmft = 3·8 ± 3·2; mean dmfs = 21·5 ± 15·7; mean DMFT = 2·0 ± 1·9; mean DMFS = 3·1 ± 3·7). Only 0·7% of the children had no caries experience (dmft + DMFT). MS levels ranged from 0 to 7·5×10⁵ CFU per ml (mean MS = 4·10 ± 0·90 log₁₀ CFU per ml). A significant relationship between MS and caries experience was observed (P = 0·003). Mild fluorosis was observed in 14% of the children. Oral hygiene scores indicated that most of the examined tooth surfaces had detectable plaque (mean DI‐S = 1·78). Gingivitis was present in 100% of the children and was considered moderate to severe in 14% (mean GI = 1·18). Conclusions. The study revealed a high level of oral diseases and poor oral hygiene in the study population and a need for therapeutic and preventive measures.     

Dental caries experience in children with congenital heart disease: a case-control study

Objectives. To compare the dental health of a group of children with complex congenital heart disease with that of age and gender matched healthy controls. Design. Case‐control study. Setting. Faculty of Medicine and Odontology/Pediatric cardiology and Pedodontics, Umeå University, Sweden. Sample and Methods. All the cases and their controls lived in the county of Västerbotten in northern Sweden. Each group comprised 41 children with a mean age of 6·5 years. Data were collected from medical and dental records while all bitewing radiographs were read separately by one of the authors. Results. Children with congenital heart disease had significantly more caries in their primary teeth than the control group. The mean dmfs‐value was 5·2 ± 7·0 in the cardiac group compared to 2·2 ± 3·5 in the control group (P < 0·05). Twenty‐six of the children had all four 6‐year‐molars, and their mean DMFS‐values were 0·9 ± 1·9 in the cardiac group compared to 0·3 ± 0·6 in the control group (P > 0·05). The children with congenital heart disease had received more caries prevention based on the use of fluorides than the control group. There was a significant correlation between the number of fluoride varnish treatments and the dmfs value of the child (r = 0·411, P < 0·01). Fifty‐two per cent of the children in the cardiac group had been prescribed fluoride tablets on one or more occasions compared to 17% in the control group (P < 0·01). Number of months on digoxin medication and the dmfs‐value had a significant correlation (r = 0·368, P < 0·05). Ten of the children had been on digoxin medication between 6 and 87 months; this subgroup had a mean dmfs‐value of 10·1 ± 8·5. Conclusion. Swedish children with complex congenital heart disease have poorer dental health than healthy age and gender matched controls in spite of intensive preventive efforts. In many cases, intervention had been given when caries were present. A closer cooperation between paediatric cardiology and paediatric dentistry is needed.     

Dental health of dentists' children in Mongolia

Summary. Objectives. To describe the dental health of dentists’ children, to evaluate its association with their dentist‐parents’ background and work‐related characteristics and to compare it with that of children in the general population in Mongolia. Design. Cross‐sectional survey, questionnaire‐based data. Subjects. Dentists’ children, aged 3–13 years. Sample. All dentists (n = 250) actively practising in the capital city of Mongolia. Results. The dentists’ children's dmft ranged from 0 to 12, and DMFT from 0 to 8; 50% were caries‐free. The younger the children, the higher was their total caries experience expressed as the sum of DMFT + dmft scores (r = ?0·22; P = 0·001). Dentist‐parents’ background and work‐related factors were not associated with their children's caries status (P > 0·05). When dentists’ children were compared with their counterparts at the population level, mean dmft for 6‐year‐olds was 2·6 for (urban) dentists’ children, 6·5 for children in the urban population and 0·9 for those in rural population of equivalent age. Mean DMFT for 12‐year‐olds were 1·0, 1·8 and 1·2, respectively, in the same three groups. In general, (urban) dentists’ children in all age groups had better dental health than did their urban counterparts at the population level. Among 5–7‐year‐olds, dentists’ children had worse dental health than did their counterparts in the rural population. Conclusions. Despite the dentists’ knowledge and awareness, their children demonstrated higher rates of dental caries than expected. This suggests that Mongolian dentists may have insufficient preventive orientation. In particular, the primary dentition of younger children seems to be poorly valued. In Mongolia, dentists should have better training and education in modern methods of caries prevention and their advantages. Appreciation and care of the primary dentition need to be improved at all levels of oral health promotion in Mongolia.     

Self-assessed bleeding as an indicator of gingival health among 12-14-year-old children

summary The aim of this study was to evaluate the relationship between self‐assessed gingival bleeding (GB) and clinically diagnosed gingival health among 12–14‐year‐old school children. A study group (982) comprising of school children aged 12–14 years was chosen by a simple random method from the five geographical areas in Irbid Governate, Jordan. All children completed a questionnaire related to self‐assessment of GB after brushing before they had a clinical examination for oral hygiene and gingival condition using the criteria of Silness & Löe plaque index (1964) and Löe and Silness gingival index (1963). The results showed that the proportions of children who had self‐assessed or clinically assessed GB increased gradually from 12 to 14 years of age with no significant difference (P > 0·05). There were significantly higher proportions of boys than girls who had self‐assessed or were clinically assessed GB (P=0·02, 0·001). The mean plaque (1·83 ± 0·54) and gingival scores (1·90 ± 0·59) of children who reported GB were significantly higher than parallel scores of children without GB (1·27 ± 0·62, 1·23 ± 0·59), respectively (P < 0·001). There was a moderate correlation (r=0·501) between self‐assessed GB and gingival health. In conclusion, there was a positive correlation between self‐assessed GB and gingival health of 12–14‐year‐old children. Therefore, this may be beneficial for monitoring gingival health in children of, at least, developing countries.     

Oral health in children undergoing liver transplantation

Aims. To determine the prevalence of dental caries in children undergoing liver transplantation and to compare the plaque, gingivitis, and gingival overgrowth indices and oral mucosal lesions in children before and after liver transplantation. Patients and methods. Patients undergoing liver transplantation at King’s College Hospital were examined before transplantation, at 3 and 106 days post‐transplantation. Healthy children from the Greenwich Health District, south‐east London, were matched to the liver transplant patients by age, gender, socio‐economic factors and the presence or absence of active dental caries. Results. Twenty‐seven liver transplant patients (mean age: 7 years and 10 months; SD 3 years and 5 months) and 27 controls (mean age: 8 years and 6 months; SD 3 years and 7 months) were examined. The mean dmft and DMFT scores were 2·3 (SD 4·1) and 0·8 (SD 1·4), respectively, in the liver transplant patients, and 1·2 (SD 2·2) and 0·9 (SD 1·5), respectively, in the controls. There were no significant differences between either the mean plaque or gingivitis indices for the primary and permanent teeth in patients before and after transplantation. There were no significant differences between the liver transplant patients and the controls for either mean plaque or gingivitis indices at each examination time. Gingival overgrowth was present in 41% of liver recipients receiving cyclosporin with or without nifedipine, but not in the majority receiving tacrolimus at the final examination. Oral mucosal lesions were absent in both the patients and controls at each examination time. Conclusions. The oral health of the children undergoing liver transplantation was inadequate. Funding and implementation of an oral health care programme must become a priority for all children before and after liver transplantation.     

Turned versus anodised dental implants: a meta‐analysis

The aim of this meta‐analysis was to test the null hypothesis of no difference in the implant failure rates, marginal bone loss (MBL)and post‐operative infection for patients being rehabilitated by turned versus anodised‐surface implants, against the alternative hypothesis of a difference. An electronic search without time or language restrictions was undertaken in November 2015. Eligibility criteria included clinical human studies, either randomised or not. Thirty‐eight publications were included. The results suggest a risk ratio of 2·82 (95% CI 1·95–4·06, P < 0·00001) for failure of turned implants, when compared to anodised‐surface implants. Sensitivity analyses showed similar results when only the studies inserting implants in maxillae or mandibles were pooled. There were no statistically significant effects of turned implants on the MBL (mean difference‐MD 0·02, 95%CI ?0·16–0·20; P = 0·82) in comparison to anodised implants. The results of a meta‐regression considering the follow‐up period as a covariate suggested an increase of the MD with the increase in the follow‐up time (MD increase 0·012 mm year^?1), however, without a statistical significance (P = 0·813). Due to lack of satisfactory information, meta‐analysis for the outcome ‘post‐operative infection’ was not performed. The results have to be interpreted with caution due to the presence of several confounding factors in the included studies.     

Occlusal tooth wear in Chinese adults with shortened dental arches

To assess associations between occlusal tooth wear and shortened dental arches (SDA) in Chinese 40 years and older subjects. From a sample of 1462 urban and rural adults, those presenting with SDA (n = 150) were compared with a control group of 65 randomly selected subjects with complete dentitions (CDA). Occlusal wear was assessed using a modified Smith and Knight index – the occlusal tooth wear index (OWTI) – and analysed using multivariate (logistic) regression. There was no significant effect from SDA on severe occlusal wear (OTWI score 3 or 4: OR = 2·016; 95% CI = 0·960–4·231; P = 0·064). Higher age was associated with severe occlusal wear (P values ≤0·007) and with higher mean OTWI scores; urban had less often severe occlusal wear than rural residents (OR = 0·519; P = 0·008). Higher mean OTWI scores were associated with rural residents, except for anterior teeth. Females had lower mean OTWI score for anterior teeth (effect = ?0·153; P = 0·030). Premolars in SDA had higher mean OTWI scores compared with those in CDA (effect = +0·213; P = 0·006). In SDA, more posterior occluding pairs (POPs) were associated with lower mean OTWI sores for anterior teeth (effect: ?0·158; P = 0·008) and higher scores for molars (effect: +0·249, P = 0·003). Subjects with SDA or CDA presented comparable occlusal wear, but premolars in SDA tend to have higher probability for having occlusal wear. Fewer numbers of POPs were associated with more wear in anterior teeth.     

Comparison of utility weighted DMFT with patient‐reported oral well‐being

This study investigated a method of measuring oral health, as opposed to measuring disease. The objective was to compare DMF score and whole mouth utility scores to a patient‐reported outcome measure (PROM). Disutility values for lost and restored teeth were used to weight the decayed, missing and filled teeths(DMFTs) of 10 adult patients. This gave two whole mouth utility scores (WMU). These scores were then compared with a patient‐reported oral health outcome measure recorded by the use of a visual analogue scale (VAS). The anchors for the VAS were ‘my mouth could not be worse’ and ‘my mouth could not be better’. There was a positive correlation (r = 0·6457) between WMU1 and the patient‐reported outcome measure (P < 0·05) and a negative correlation (r = ?0·8383) between WMU1 and DMFT which was significant at the P < 0·01 level. There was a statistically significant positive correlation of r = 0·7926 between WMU2 and the patient‐reported outcome measure (P < 0·01) and a negative correlation (r = ?0·9393) between WMU2 and DMFT (P < 0·01). The Pearson's correlation between DMFT and the patient‐reported outcome measure was ?0·8757, which was significant at the 0·01 level. Patient reports of their perceived level of health correlate well with DMFT scores. Weighting DMFT scores according to the differential values assigned to missing, or missing and filled, teeth does not increase the degree of correlation between the measure and the patients’ personal quantification of their oral health. Decayed, missing and filled teeth therefore seems to adequately capture the patient's sense of well‐being.     

Increased phosphatidylcholine concentration in saliva reduces surface tension and improves airway patency in obstructive sleep apnoea

Surface tension may have important role for maintaining upper airway patency in patients with obstructive sleep apnoea. It has been demonstrated that elevated surface tension increases the pharyngeal pressures required to reopen the upper airway following collapse. The aim of the study was to evaluate the associations between the concentrations of endogenous surfactants in saliva with indices of upper airway patency in obstructive sleep apnoea. We studied 20 male patients with obstructive sleep apnoea (age: 60·3 ± 10·3 years; BMI: 25·9 ± 4·6 kg m^?2; AHI: 41·5 ± 18·6 events h^?1). We obtained 100‐μL samples of saliva prior to overnight polysomnographic sleep study. The surface tension was determined using the pull‐off force technique. The concentration of phosphatidylcholine (PC) was evaluated by liquid chromatography‐mass spectrometry (LC‐MS/MS). Regression analysis between apnoea, hypopnoea and apnoea/hypopnoea indices and the ratio of hypopnoea time/total disordered breathing time (HT/DBT) with surface tension and PC were performed. P < 0·05 was considered significant. The mean saliva surface tension was 48·8 ± 8·0 mN m^?1 and PC concentration was 15·7 ± 11·1 nM. The surface tension was negatively correlated with the PC concentration (r = ?0·48, P = 0·03). There was a significant positive correlation between surface tension with hypopnoea index (r = 0·50, P = 0·03) and HT/DBT (r = 0·6, P = 0·006), but not apnoea or apnoea/hypopnoea index (P > 0·11). Similarly, PC concentration negatively correlated with hypopnoea index (r = ?0·45, P = 0·04) and HT/DBT (r = ?0·6, P = 0·004), but not with apnoea index or AHI (P > 0·08). An increase in salivary PC concentration may increase upper airway patency in obstructive sleep apnoea through a reduction in surface tension.     

Effects of oral care with tongue cleaning on coughing ability in geriatric care facilities: a randomised controlled trial

Methods for preventing aspiration pneumonia are needed soon in order to reduce mortality from aspiration pneumonia and promote the health of the elderly. The aim of this randomised controlled trial was to examine whether oral care with tongue cleaning improves coughing ability in elderly individuals living in geriatric care facilities. Participants comprised of 114 residents of 11 group homes and private nursing homes in Aso City in Kumamoto Prefecture. Participants were randomly assigned to either (i) a group that underwent routine oral care with tongue cleaning (intervention group; n = 58) or (ii) a group that underwent routine oral care alone (control group; n = 56). Coughing ability was evaluated by measuring peak expiratory flow (PEF) before and after 4 weeks of intervention. Before the intervention, PEF did not differ significantly between the intervention group (1·65 ± 1·11 L s^?1) and control group (1·59 ± 1·05 L s^?1; P = 0·658). However, on termination of the intervention, PEF was significantly higher in the intervention group (2·54 ± 1·42 L s^?1) than in the control group (1·90 ± 1·20 L s^?1; P = 0·014). After the intervention, PEF had increased significantly in both groups; however, this increase was significantly greater in the intervention group (0·90 ± 0·95 L s^?1) than in the control group (0·31 ± 0·99 L s^?1; P < 0·001). Oral care with tongue cleaning led to increased PEF, suggesting improved coughing ability. Oral care incorporating tongue cleaning appears to be important for preventing aspiration pneumonia.     

Piroxicam and laser phototherapy in the treatment of TMJ arthralgia: a double‐blind randomised controlled trial

This study aimed to evaluate the efficacy of piroxicam associated with low‐level laser therapy compared with single therapies in 32 patients presenting temporomandibular joint arthralgia in a random and double‐blind research design. The sample, divided into laser + piroxicam, laser + placebo piroxicam and placebo laser + piroxicam groups, was submitted to the treatment with infrared laser (830 nm, 100 mW, 28 s, 100 J cm^?2) at 10 temporomandibular joint and muscle points on each side during four sessions concomitant to take one capsule a day of piroxicam 20 mg during 10 days. The treatment was evaluated throughout four sessions and 30 days follow‐up through visual analogue scale (VAS), maximum mouth opening and joint and muscle (temporal and masseter) pain on palpation. The results showed that all the study groups had a significant improvement in the VAS scores (P < 0·05), and there were no significant group differences. Piroxicam was effective in the reduction of joint and muscle pain on palpation (P < 0·05) and showed the lowest temporal pain (P = 0·02) at the 30‐day follow‐up. The combination of low‐level laser therapy and piroxicam was not more effective than single therapies in the treatment of temporomandibular joint arthralgia. The use of piroxicam was more effective in the following 30 days.     

Oral health status and treatment needs among school children in Sana’a City,Yemen

To cite this article:
Int J Dent Hygiene
DOI: 10.1111/j.1601‐5037.2009.00398.x
Al‐Haddad KA, Al‐Hebshi NN, Al‐Ak’hali MS. Oral health status and treatment needs among school children in Sana’a City, Yemen. Abstract: Data on the oral health status and treatment needs among Yemeni children are lacking. Objectives: To assess caries prevalence, treatment needs and gingival health status among school children in Sana’a City and to examine how these are affected by age, gender and khat chewing. Methods: 1489 children (6‐ to 14‐year old) were randomly selected from 27 schools representing all nine districts of Sana’a City. Dental caries and treatment needs were evaluated using standard WHO oral survey methods. The plaque index (PI), calculus index (CI) and the gingival index (GI), recorded at the six Ramfjord’s teeth, were used to assess gingival health status. Results: 4.1% of the study subjects were caries‐free. Prevalence of these was significantly higher among the males. Overall, mean dmfs, dmft, DMFS and DMFT scores were 8.45, 4.16, 3.59 and 2.25 respectively. The decayed component accounted for >85% of the scores. The highest dmfs/dmft means were found among the 6–8 years age group, while the highest DMFS/DMFT means were scored by the 12–14 years age group. The need for restorative treatment and extractions was high; the former was significantly higher among the females. All subjects had gingivitis; the mean PI, CI and GI were 1.25, 0.3 and 1.36 respectively. Khat chewing did not affect caries experience; however, it was significantly associated with higher PI, CI and GI scores. Conclusions: The prevalence of caries, gingivitis and treatment needs among children in Sana’a city is high. More surveys in other Yemeni cities to generate comprehensive data are required.     

Transcranial direct current stimulation and exercises for treatment of chronic temporomandibular disorders: a blind randomised‐controlled trial

To evaluate the effect of adding transcranial direct current stimulation (tDCS) to exercises for chronic pain, dysfunction and quality of life in subjects with temporomandibular disorders (TMD). Participants were selected based on the RDC/TMD criteria and assessed for pain intensity, pressure pain threshold over temporomandibular joint and cervical muscles and quality of life. After initial assessment, all individuals underwent a 4‐week protocol of exercises and manual therapy, together with active or sham primary motor cortex tDCS. Stimulation was delivered through sponge electrodes, with 2 mA amplitude, for 20 min daily, over the first 5 days of the trial. A total of 32 subjects (mean age 24·7 ± 6·8 years) participated in the evaluations and treatment protocol. Mean pain intensity pre‐treatment was 5·5 ± 1·4 for active tDCS group, and 6·3 ± 1·2 for sham tDCS. Both groups showed a decrease in pain intensity scores during the trial period (time factor – F_4·5,137·5 = 28·7, P < 0·001; group factor – F_1·0,30·0 = 7·7, P < 0·05). However, there were no differences between the groups regarding change in pain intensity (time*group interaction – F_4·5,137·5 = 1·5, P = 0·137). This result remained the same after 5 months (t‐test t = 0·29, P > 0·05). Pressure pain thresholds decrease and improvement in quality of life were also noticeable in both groups, but again without significant differences between them. Absolute benefit increase was 37·5% (CI 95%: ?15·9% to 90·9%), and number needed to treat was 2·66. This study suggests that there is no additional benefit in adding tDCS to exercises for the treatment of chronic TMD in young adults.     

The efficacy of non‐narcotic analgesics on post‐operative endodontic pain: A systematic review and meta‐analysis

The objective of this review was to evaluate the efficacy of non‐narcotic analgesics including non‐steroidal anti‐inflammatory drugs (NSAIDs) and/or paracetamol in the treatment of post‐operative endodontic pain. Additionally, we aimed to examine the possible association of study covariates on the pain scores using meta‐regression analysis. An electronic search was performed in 2016. After data extraction and quality assessment of the included studies (n = 27, representing 2188 patients), meta‐analysis was performed using a random‐effect inverse variance method. Meta‐regression analysis was conducted to examine the associations between effect sizes and study‐level covariates (P < 0·05). The results showed that administration of non‐narcotic analgesic was more effective than placebo in the management of post‐operative pain, resulting in a lower pain scores with a standardised mean difference of ?0·50 (95% CI= ?0·70, ?0·30), ?0·76 (95%CI= ?0·95, ?0·56), ?1·15 (95% CI= ?1·52, ?0·78), ?0·65 (95% CI= ?1·05, ?0·26) for immediately after the procedure, 6?, 12? and 24 h post?operative follow‐ups (test for statistical heterogeneity: P = 0·000, P = 0·000, P = 0·000 and P = 0·001), respectively. Our meta‐regression analysis provided the evidence for association between some study covariates with treatment effect, each at different follow‐ups. We concluded that the clinicians can manage post‐operative endodontic pain by administration of NSAIDs and/or paracetamol. However, analgesic regimens should be considered as important determinants when prescribing a pharmacological adjuvant.     

Dental fluorosis and caries experience in relation to three different drinking water fluoride levels in South Africa

Objectives. The purpose of this study was to determine the relationship between caries experience, degree of fluorosis and different concentrations of fluoride in the drinking water of children. Sample and methods. The study included 282 children aged 10–15 years, who lived continuously since birth in three different naturally fluoridated areas (Leeu Gamka, 3·0; Kuboes 0·48 and Sanddrif 0·19 p.p.m. F), with virtually no dental care or any fluoride therapy. The teeth of the children were examined for caries using the DMFT index according to the WHO criteria and for fluorosis, using Dean’s criteria according to the WHO guidelines. Results. The prevalence of fluorosis (scores 2, 3, 4 and 5) among the school children was 47% in Sanddrif, 50% in Kuboes and 95% in Leeu Gamka. Almost half the children in the two low fluoride areas had no fluorosis (scores 0 and 1), whereas only 5% in Leeu Gamka had no fluorosis. Of the children in Sanddrif, 42·5% had very mild/mild (scores 2 and 3) fluorosis, 44·3% in Kuboes and 34·1% in Leeu Gamka. Except for one individual in Kuboes, severe fluorosis (score 5) was only observed in the high fluoride area in 30% of the children. According to the Bonferroni adaptation for multiple comparisons, the degree of fluorosis in Leeu Gamka differed significantly from both those of Sanddrif and Kuboes. The mean DMFT for the children in Sanddrif and Kuboes was similar (1·64 ± 0·30 and 1·54 ± 0·24, respectively) but the caries experience of Leeu Gamka (1·98 ± 0·22) was significantly higher (P < 0·05) than that of both the other two areas. A strong positive correlation (P < 0·05) was found between the caries experience and the fluorosis scores of children in the high fluoride area (Leeu Gamka) but no correlation could be found in the other two areas. Significantly (P < 0·01) more children had decayed teeth in the high F area (Leeu Gamka) than in the other two areas. Conclusion. The results suggest a positive association between high F levels in the drinking water and dental caries. Furthermore, a low caries experience and no difference in DMFT and fluorosis between the two low fluoride areas were found.     

Prevalence of salivary Streptococcus mutans in mothers and in their preschool children

Summary. Objectives. To establish the prevalence and possible relationship of oral Streptococcusmutans colonization in mother–child pairs. Design and setting. An analytical cross‐sectional study was carried out at a well‐baby evaluation clinic held at the Public Dental Clinic, Varberg, Sweden. Sample and methods. Two hundred preschool children, 100 of which were 18 months old and the remaining 100 were 3 years old, and their mothers attended the clinic. All mothers were interviewed and their children’s medical history, oral hygiene routines and dietary habits established. All children were clinically examined. The presence and level of S. mutans was estimated in the mother–child pairs with the aid of the Strip mutans chair‐side test. Results. Nearly 50% of mothers exhibited high levels of salivary S. mutans, prevalence among the 18‐month‐ and 3‐year‐olds was 30% and 42%, respectively. A statistically significant (P < 0·01) mother–child relationship was found; a greater presence in mothers led to a higher number of children found harbouring the bacteria. Logistic regression analysis found that high maternal S. mutans levels (P < 0·001), daily sweet intake (P < 0·01) and sugary drinks in feeding bottles (P < 0·05) were significant factors for S. mutans colonization in children. Absence of daily toothbrushing and use of feeding bottles at night failed to fit into the model. Caries prevalence (initial and manifest decayed surfaces) was significantly related to S. mutans colonization (P < 0·01). Conclusion. The results support the concept of vertical transmission (mother–child), emphasizing the importance of the dietary component, and justifying a primary preventive approach with targeted action directed at mothers with high levels of S. mutans colonization.     

The relationship between dental aesthetic index (DAI) and perceptions of aesthetics,function and speech amongst secondary school children in Ibadan,Nigeria

Objective. The purpose of the study was to investigate the relationship between a professionally derived index, the Dental Aesthetic Index, and some indications for orthodontic treatment as perceived by potential patients. Methods. An epidemiological survey of 614 secondary school students, 327 males (53·3%) and 287 females (46·7%) was carried out in Ibadan, Nigeria. Children aged 12–18 years (mean age, 14·9 ± 2·9 SD) were randomly selected, none of them had received previous orthodontic treatment. One examiner assessed the students using the Dental Aesthetic Index (DAI). Subjects were also asked to complete a questionnaire consisting of three questions concerning appearance, function, and speech, using a 5‐point Likert scale. Results. Weak but statistically significant correlations were found for subjective assessments of appearance of teeth and the DAI (r = 0·174; P < 0·01) and between biting/chewing and appearance of teeth (r = 0·095; P < 0·05). Statistically significant correlations were found between appearance of teeth and speech (r = 0·148; P < 0·01) and biting/chewing and speech. The last showed the strongest correlation (r = 0·268; P < 0·01). Conclusion. The study has shown weak but significant correlation between DAI and children's perceptions of the appearance of their teeth. We recommend further study involving both DAI and Index of Orthodontic Treatment Need (IOTN) for comparison in the Nigerian population.     

The cause of drooling in children with cerebral palsy – hypersalivation or swallowing defect?

Summary. Objective. To determine whether or not drooling in children with cerebral palsy is due to hypersalivation. Population and methods. The study population consisted of 10 children with cerebral palsy who were identified as having severe drooling, and a matched control group composed of 10 unaffected children who had no known physical or mental disabilities. Salivary flow rate was compared between the cerebral palsied children and the control group using the chin‐cup collection drool quantification method described by Sochanjwskyj. Components of the system included a cup‐like collection device, a vacuum pump, plastic tubing, an airtight collection chamber, and calibrated test tubes held against the subject's chin with elastic straps attached to an orthodontic head bonnet. Statistical analysis was completed using the Student's t‐test and Fisher's Exact Probability test. Results. The ages of the population ranged from 5·2 to 15·6 years, mean age (± SE) of 10·56 ± 1·13 years. There was no statistically significant difference in the rate of salivary flow rate between the two groups’ mean ± SE: cerebral palsy group 0·220 ± 0·018; control group 0·334 ± 0·052 (P = 0·053). The results were further confirmed by comparing the buffering capacity (P = 1·00) and concentrations of the sodium (P = 0·065) and potassium ions (P = 0·058) in the saliva of the study groups. Conclusions. Children with cerebral palsy who drool do not appear to produce excess saliva. Their salivation is similar to the control children.     

Evidence for reversal of the caries decline among Norwegian children

Summary. Objective. The purpose of the present study was to report on caries status and to explore possible reasons for changes in caries experience among 5‐ and 12‐year‐old Norwegian children. Design. National cross‐sectional and time trend study. Methods. Aggregated data from the Public Dental Services and from official statistics were used. Information was available on the total number of children, the proportion receiving treatment, sale of fluoride tablets, socio‐economic background, caries prevalence and dmft/DMFT scores. Results. The prevalence of caries among 5‐year‐olds reached a low of 30·4% in 1997 and increased to 38·9% in 2000. The mean dmft scores increased from 1·1 to 1·5. Conversely, the prevalence of caries among 12‐year‐olds decreased from 55·4% in 1997 to 52·2% in 2000 and the mean DMFT score from 1·7 to 1·5. Bivariate analyses at county level revealed significant associations, which for the most part disappeared in multivariate analyses. The sale of fluoride tablets had a significant effect on caries prevalence among 5‐year‐olds in 1998, in 1999 and in 2000. Infant mortality was associated with the dmft score in 1999. The only consistently significant predictor of caries experience at 12 years of age was caries prevalence at age 5. Conclusions. There has been a highly significant increase in caries experience among 5‐year‐olds (P < 0·001) and a levelling off among 12‐year‐olds over the past 3 years. Considering the association between caries prevalence at age 5 and caries experience at 12 years of age, there is a need for reassessment of the caries preventive programmes for children in Norway.