Dental caries, gingivitis, and oral hygiene among schoolchildren in Kampala, Uganda

ABSTRACT – An epidemiologic survey of dental caries, gingivitis and oral hygiene was conducted on 875 schoolchildren aged 6–15 in Kampala, the capital of Uganda. Findings arc reported in detail for the African children, and in brief for the Asian children. Among the African children, DMF teeth averaged from 0.6–2.7, and def teeth from 0.0–1.9. A significantly higher proportion of the first permanent molars was carious among the 6 to 9-year-old than among the 10 to 14-year-old Africans, which is interpreted as a sign of the rapid increase in caries prevalence occurring during these years. Among the Asian children, dental caries was more prevalent and advanced. Generalized, mild gingivitis and moderate amounts of soft debris were found uniformly throughout all groups. The need for dental health education is stressed, and the case for longitudinal socio-epidemiologic studies is discussed.     

Effect of proper oral hygiene on gingivitis and dental caries in Swedish schoolchildren

ABSTRACT The present paper reports the effect of a 3-year study of regularly repeated professional toothcleaning on oral hygiene status, gingivitis, and dental caries. At the initiation of the study in 1971, the children were 7–8 years old (Group 1), 10–11 (Group 2) or 13–14 (Group 3). The children were divided into test and control groups. Before the study all the children were examined regarding oral hygiene, state of the gingiva and dental caries. Throughout the 3-year period the controls brushed their teeth with a 0.2 % sodium fluoride solution once a month under supervision. During the first 2 years of the trial all the children of the test groups were given professional oral prophylaxis once every second week during the school terms. During the third year the interval between consecutive prophylactic sessions was prolonged to 4 weeks in Groups 1 and 2 and to 8 weeks in Group 3. The results demonstrated that regularly repeated professional cleaning of the teeth combined with fluoride applications and toothbrushing instructions, over a 3-year period in schoolchildren resulted in the establishment and maintenance of excellent oral hygiene standards. Inflammation of the marginal gingiva almost entirely disappeared, and practically no new carious lesions developed.     

Prevalence of dental caries, gingivitis, and oral hygiene in hospitalized AIDS cases in Kinshasa, Zaire

The prevalence of dental caries and periodontal disease in African HIV-infected patients has not previously been assessed, in spite of the high prevalence of HIV-infection in some countries and the fact that atypical gingivitis may represent an early sign of HIV infection. In the present study 83 AIDS patients hospitalized in Kinshasa, Zaire, were assessed for dental caries, gingivitis and oral hygiene status. The prevalence of dental caries was lower among AIDS patients than among healthy controls previously examined in the same area. The prevalence of gingivitis was higher in AIDS than in controls in spite of good oral hygiene observed among AIDS patients.     

Effect of oral hygiene instruction and professional toothcleaning on caries and gingivitis in schoolchildren

Abstract The present study was performed lo assess the effect on caries and gingivitis of plaque control measures such as oral hygiene instruction, toothcleaning practice and professional toothcleaning. 104 children, 13-14 years old, participated in the trial. Prior to the start of the preventive treatment all children were examined regarding oral hygiene, gingivitis and caries. The caries examination was limited to the proximal surfaces of molars and premolars. Following this baseline examination the children were randomly divided into two treatment groups, A and B. Both groups of children were recalled for professional toothcleaning once every 2 weeks during an 18-month period. In each child the professional toothcleaning was restricted to either the right or the left jaws by random selection. In addition, the children of Group A at each recall appointment received careful oral hygiene instruction and practice in proper toothcleaning methods. In conjunction with the professional toothcleaning an abrasive paste was used including fluoride. The children were re-examined 18 months after the baseline examination. The result of the present investigation demonstrated that professional toothcleaning repeated every second week is a prophylactic measure which in children substantially improves the oral hygiene status, and effectively reduces clinical signs of gingivitis and caries. It was also observed that while oral hygiene instruction and practice in proper toothcleaning techniques reduced plaque and gingivitis, no such effect could be detected regarding the development of caries.     

Effect of fluoride on gingivitis and dental caries in a preventive program based on plaque control

ABSTRACT The purpose of the investigation was to estimate the relative effect of fluoride on caries in a preventive program based on meticulous plaque control. The material consisted of 82 children; 41 in the test and 41 in the control group. At the start of the study the children were 13–14 years of age. In August 1973 an examination was performed to obtain baseline data for the trial. Prophylactic treatment was given to the children once every second week. A total of 18 treatments were given during a 10-month period. In the control group an abrasive paste was used containing 5 % sodium monofluorophosphate (Jodka Fluor Polerpasta®). In the test group an abrasive paste was used which was identical with the control paste except that it did not contain any fluoride components. Twelve months after the baseline examination the test and control groups were reexamined. The trial demonstrated that, in children, fortnightly professional cleaning of the teeth combined with meticulous toothbrushing instructions result in (1) a high standard of oral hygiene and (2) only very few new carious surfaces. Though the control group children received fortnightly topical application of F^? during the prophylactic sessions and used a fluoridated dentifrice, there was no significant difference between the two groups regarding number of new carious tooth surfaces per child per year.     

The effect of controlled oral hygiene and topical fluoride application on caries and gingivitis in Swedish schoolchildren

ABSTRACT An attempt was made to assess the effect of regularly repeated professional mechanical tooth cleaning on caries development and gingivitis in schoolchildren. A total of 209 children from the first (7–8 years old), fourth (10–11 years), and seventh (13–14 years) classes of an elementary school in Sweden participated. Children from each age group were assigned to one test and one control group. At a baseline examination the state of the gingiva, the oral hygiene and the number of decayed and filled tooth surfaces were determined. Once every second week after the baseline examination the members of the test groups were given careful oral prophylaxis including topical application of monofluoro-phosphate. Once a month the members of the control group brushed their teeth under the supervision of a dental nurse. Twelve months after the initial examination the test and control groups were re-examined. The results show that children given frequent oral prophylaxis combined with topical fluoride applications had clean teeth, only negligible signs of gingivitis, and practically no caries.     

Effect on caries and gingivitis of a preventive program based on oral hygiene measures and fluoride application

Abstract The present investigation was performed to estimate the effect on caries and gingivitis of a plaque control program delivered at different intervals and supplemented with different fluoride compounds. The study ran for 2 years and was completed by 260 children who were 13–14 years old at the beginning. Professional toothcleaning in combination with detailed oral hygiene instructions repeated once a month or every 3 months significantly improved their oral hygiene status and reduced clinical signs of gingivitis. The addition of fluoride (NaF or MFP) in mouthrinses and toothpastes significantly reduced the number of new carious lesions. No significant differences were observed in gingival health and caries activity between the programs delivered once a month and every 3 months.     

Dental prophylaxis for youths in their late teens. II. Knowledge about dental health and diseases and the relation to dental health behavior

A study of the knowledge about dental health and diseases of youths in their late teens has been conducted. A 10-class questionnaire relating to dental caries and gingivitis/periodontitis was answered by three test groups (A, B, C) totalling seventy-eight 19-year-olds who, during a 3-year period, had undergone professional prophylaxis at different intervals. Nineteen young people of the same age without organized preventive measures since their last attendance at the public dental service constituted a control group (D). The test groups were found to have a significantly better knowledge of factors relating to gingivitis/periodontitis than the control group. In questions relating to caries there were no differences among the groups. Higher points were scored in knowledge of therapy and prevention than of the causes and symptoms of the dental diseases. Several regularly repeated sessions for professional prophylaxis did not lead to better knowledge than only a few. No consistent correlation was found for any of the groups between knowledge and both quantitative tooth cleaning, i.e. type and frequency of use of oral hygiene aids, and qualitative tooth cleaning, expressed as the occurrence of plaque and gingivitis. Nor were significant differences found in these respects between individuals with and without a caries increment during the observation period regardless of grouping.     

Effect of a preventive program based on professional toothcleaning and fluoride application on caries and gingivitis

The effect of a preventive program was studied in 12-14-yr-old children. 104 children (test group) participated in this program. After four visits in the first 6 wk, the children visited the oral hygienist five times a year to receive professional oral prophylactic treatment and instructions. Additionally a fluoride application (Duraphat) was given two times a year. Children of a control group (n = 117) received no prophylactic treatment. Diet was not controlled in either test or control group. After 2 yr mean caries increment amounted to 2.7 +/- 2.8 new DFS in the test group and 5.0 +/- 4.2 new DFS in the control group, respectively. The most pronounced differences between the two groups could be found on the proximal surfaces. In all, caries was reduced by 46% during the 2-yr period. Plaque accumulation and frequency of gingivitis were significantly reduced only in the test group (67% and 55%, resp.). The data revealed that the program reduced both caries and gingivitis to a remarkable extent.     

A correlation study of diet, oral hygiene and dental caries in 457 Canadian children

The interrelationship of diet, oral hygiene and caries was evaluated. Of the sample size of 457 children, 234 were in grade 1 and 223 grade 7. Five-day diet surveys were obtained, followed by clinical examinations for oral hygiene and caries. One examiner, using mouth mirror, explorer and extraoral light, conducted the caries examination. From the diet surveys, refined and total carbohydrate consumption was calculated per day; between meals, at meals, and totaled for the day. Five-day totals, which included one weekend, were recorded along with frequency of eating per day and for the 5-day periods. Computer analysis revealed no significant correlation between the diet variables and caries or oral hygiene indices and caries. The children with high caries indices did not have the poorest oral hygiene nor consume the most carbohydrates. Similarly, the children with low caries indices did not have the cleanest teeth nor consume lesser amounts of carbohydrates.     

The effect of a preventive programme on dental plaque, gingivitis and caries in schoolchildren. Results after one and two years

Abstract The effect on plaque, gingivitis and dental caries of regularly repeated professional mechanical tooth cleaning combined with topical application of monofluoro-phosphate was tested in a group of 192 schoolchildren, 7–14 years of age, during a 2-year trial. They were divided into test and control groups. A baseline examination revealed that the test and control groups had a very similar oral hygiene status, degree of gingival inflammation and caries experience. Once every second week during the 2-year period the children of the test groups were given professional oral prophylaxis including careful tooth cleaning and topical application of 5 % sodium mono-fluorophosphate. Once every month, the children of the control groups brushed their teeth at school, under supervision, using a 0.2 % sodium fluoride solution. The results after 1 and 2 years of experiment indicate that the test group children had low Plaque Index scores (～ 0.3), only negligible signs of gingivitis (～ 0.25) and very low caries increment (0.1 new carious surface per year). The control group children had higher Plaque Index scores (～ 1.0), showed signs of gingivitis (～ 0.75), and developed on an average 3.1 new carious surfaces per year. It is suggested that the efficacy of public health programmes, based on professional tooth cleaning and topical fluoride administration, should be tested in larger groups of children and adults.     

The effect of various plaque control measures on gingivitis and caries in schoolchildren

The aims of the present study were (1) to analyze the separate effects on plaque, caries, and gingivitis of several measures (oral hygiene instruction, professional tooth cleaning with mechanical instruments, topical application of sodium monofluorophosphate - MFP) which have been incorporated in a prophylactic treatment program, described by AXELSSON & LINDHE1, and (2) to prevent caries and gingivitis by applying the combined treatment but replacing the professional mechanical tooth cleaning with chemical cleaning using a chlorhexidine-containing gel. 164 children, 13-14 years old, divided into four groups, participated in a 2-year trial. All participants were recalled once every 2nd week for preventive treatment provided by dental nurses. During the 1st year Group 3 and 4 received prophylactic treatment identical to that described by AXELSSON & LINDHE1. During the 2nd year the professional tooth cleaning was omitted but oral hygiene instruction was given every 2nd week. During the 1st year Groups 1 and 2 were treated with 0.5% chlorhexidine but during the 2nd year they were subjected to professional tooth cleaning with mechanical instruments. Throughout the trial Groups 1 and 3 rinsed once every 2nd week with a 2% MFP solution. The results showed that by oral hygiene instruction and frequently repeated professional tooth cleanings it was possible to substantially reduce the frequency of gingivitis and prevent caries. When this treatment was used, mouthrinsings with 2% MFP had no additional effect on caries. The substitution of the mechanical cleaning procedure with topical application of a 0.5% chlorhexidine gel failed to (1) remove supragingival plaque accumulations, (2) reduce the frequency of gingivitis, and (3) retard the rate of caries development. The data also revealed that interdental cleaning with mechanical instruments was of decisive importance in the prevention of approximal surface caries.     

Dental prophylaxis for youths in their late teens III. Attitudes to teeth and dental health and their relation to dental health behavior

Abstract Attitudes to teeth and dental health have been tested in ninety-seven 19-year-olds. Of this number, 29 in group A and 32 in group B had for 3 years participated to varying extent in a systematic plaque control program based on professional tooth cleaning. Seventeen of the total, who after 1 year's participation in the program declined further treatment, constituted group C. The control group D consisted of 19 young people who had had only fluoride mouthrinsings each second week during the first year of the trial. Regardless of grouping, all had had fluoride mouthrinsings during the whole of their earlier schooling. Ten questions concerning their attitude to teeth and dental health were answered on a graphic rating scale, the ends of the scale marking the most positive and negative attitudes, respectively. The results showed no marked differences in attitudes among the four groups: only a few significant differences were found at the 5% level. The differences in clinical variables recorded among the groups did not correspond to significant differences in measured attitudes. Great differences, on the other hand, were found at an individual level. All subjects had consistently positive attitudes except in their views of their own future state of dental health; the large scatter (deviation) in the answers on this point reveals uncertainty of their ability to retain their present (good) state of dental health. Analysis of data showed close correlation between attitudes to their own present and future state of dental health and the number of decayed and filled tooth surfaces (DFS prevalence) at the end of the trial. There was no corresponding correlation between the opinion as to how to look after one's own teeth and the individual's gingival condition at the end of the trial.     

Impact of a periodontal course on oral hygiene and gingival health among senior dental students

This survey attempted to determine the impact of the periodontal course on oral hygiene and gingival health among 50 senior dental students. The course included the following: patient motivation, instruction in oval hygiene procedures and plaque control, scaling and curellage, temporary splinting and occlusal adjustment. Without advance notice, plaque deposits were scored using the Plaque Index and gingival health was determined using the Gingival Index. The results were collected at the beginning and at the end of the periodontal course (about 2 months). The results were analyzed using the paired t-test. No improvement of either oral hygiene or gingival health was noted at the end of the periodontal course. It seems that even some dental students, who should know the direct relationship between bacterial plaque and periodontal diseases and should be better motivated than the average patient, failed to demonstrate effective oral hygiene. It is difficult to expect an improvement of patient oral hygiene, when the patients have been motivated by students who are unable to perform satisfactory personal oral hygiene themselves. It is suggested that a greater emphasis be placed on patient motivation and instruction in oral hygiene throughout the dental curriculum.     

National statistics on caries and oral hygiene derived from the Danish Child Dental Health recording system

ABSTRACT The new recording system for the Danish Child Dental Services is based on registrations of clinical examination findings for all children receiving public dental care in pursuance of the Act on Child Dental Health. During the school year 1972/73, dental information was derived from about 84,000 children in 127 municipalities. Recordings applying to the children in the first grade were obtained from all participating dental services, some of which also reported the findings for earlier age groups or higher grades. National statistics, comprising def-s and DMF-S indices and plaque and gingivitis indices are presented. Similar statistics applying to the individual dental services have been made available to the participating services, and certain applications of this annual documentation are emphasized. No working time in the dental services was used solely for the purpose of obtaining the statistics, the examination findings for the individual children being used routinely in the clinic.     

Effect of three different dental health preventive programmes on young adult individuals: a randomized, blinded, parallel group, controlled evaluation of oral hygiene behaviour on plaque and gingivitis

Aim: To evaluate, in young adults, the effect of different preventive programmes on oral hygiene and to determine whether the variables investigated are predictors of gingival health. Material and Methods: This randomized, blinded, parallel, controlled clinical study examined the effectiveness of three dental health programmes. Four hundred subjects aged 20–27 years, 211 males and 189 females, participated in the study. They were recruited from a Public Dental Service clinic and from a private dental practice in Jönköping, Sweden. The effect of the programmes on plaque and gingivitis was evaluated over a 3‐year period. The programmes included activities that were adapted for individuals as well as for groups. The plaque indices (PLI) and gingival indices (GI) were used to evaluate the programmes. Results: All programmes resulted in a decrease in PLI and GI. The greatest decrease was found in the group that was followed‐up every 2 months. Professional tooth cleaning was non‐significant for the clinical result. Gingival health at baseline, participation in any of the test programmes, and knowledge of the dental diseases caries, gingivitis or periodontitis were significant predictors of good gingival health. Conclusions: The study confirms the efficacy of three different preventive programmes in reducing supragingival plaque and gingival inflammation. Professional tooth cleaning provided no clinical benefit beyond that derived from individual and group‐based health education.     

The effect of sorbitol-containing chewing gum on the incidence of dental caries; plaque and gingivitis in Danish schoolchildren

ABSTRACT – The purpose of the present study was to determine the effect of long-term systematic chewing of sugarless, sorbitol-containing chewing gum on the incidence of dental caries, plaque and gingivitis. Eight- to 12-year-old children from two schools in the town of Nörresundby, Denmark participated in the study, which took place from 1968–1970. A total of 174 children from School T were given 3 pieces of sorbitol-containing chewing gum daily (Sor-bits®, identical to Ben-bits®) to be chewed after breakfast, lunch and supper; 166 children from School K acted as a control group. After two years the caries increment in children from School T was 5.6 decayed and filled surfaces per child as compared to 6.2 in children from School K. This difference (approx. 10 %) was statistically significant. The results indicate a depression in the caries progression rate in children who have been chewing sorbitol-containing chewing gum for 2 years. On the other hand, a series of practical circumstances in connection with the planning and performance of the study would suggest that the results obtained cannot with certainty be attributed to Sor-bits alone, but only taken as an indication thereof. Chewing of Sor-bits did not cause any change in the occurrence of gingivitis and plaque.     

Effect of monthly prophylaxis on caries and gingivitis in schoolchildren

ABSTRACT The effect of professional prophylaxis given each month to individual children was investigated. A total of 225 schoolchildren, 10–12 years of age, participated during the experimental year. Each prophylactic session required about 15 min, and included tooth-brushing instructions, professional tooth cleansings and fluoride rinses. Significantly fewer new interproximal carious lesions were obtained in the experimental group compared with the control group. No differences were observed for occlusal, buccal or lingual surfaces. The frequency of gingivitis was significantly reduced during the year of trial in the experimental group. The efficacy of the preventive treatment was most noticeable in children with high caries experience. For clinical practice monthly prophylaxes could be recommended to the most susceptible individuals.