Accuracy at radiography and probing for the diagnosis of proximal caries

In 63 teenagers the proximal surfaces of premolars to be extracted for orthodontic reasons and the adjacent surfaces of neighboring teeth, 598 surfaces in all, were examined radiographically and by probing. Direct inspection after extraction revealed that 51% of the surfaces had incipient carious lesions and 5% lesions with cavities. Of the surfaces with cavities 82.1% were correctly diagnosed radiographically if any radiolucency, regardless of its extent, was used as a diagnostic criterion. However, this yielded a false positive rate of 19.6%. If only radioluccncies extending at least into the inner third of the enamel were called positive the true positive rate was 36.7% and the associated false positive rate 1.6%. At a 5% cavity frequency the predictive positive values were 17% and 53%, respectively. Probing yielded a true positive rate of about 29% and a false positive rate of 1.1% with a predictive positive value of 50-57%. All radiolucencies extending into the dentin were associated with cavities. When the most liberal radiographic criterion was used 37.5% of all carious lesions, whether associated with a cavity or not, were detected and 3.8% of sound surfaces were falsely called carious. The corresponding predictive positive value at the actual rate of incipient lesions and lesions with cavities was 92.6%.     

Salivary conditions and cariogenic microorganisms in 55, 65, and 75-year-old Swedish individuals

Abstract – Secretion rate, buffer capacity, and cariogenic microorganisms of resting and stimulated whole saliva were examined in 208 55-, 65-, and 75-yr-old Swedes. The secretion rate for both resting and stimulated saliva decreased with age. When the use of drugs was taken into account the difference in terms of age group was significant for resting saliva alone (P<0.01). In 22%, the resting saliva was <0.1 ml/min, and in 5% the stimulated saliva was <0.7 ml/min. Persons with subjective dryness in the mouth had a lower salivary flow. Men had higher secretion rates than women irrespective of medication (P<0.05). The buffer capacity was strongly correlated to the secretion rate of both resting and stimulated saliva (r=0.39 and r=0.44, respectively). The number of mutans streptococci and lactobacilli increased with age, although significant in terms of age group for lactobacilli alone (P<0.05). The number of these microorganisms was lower in resting saliva than in stimulated saliva (P<0.0001). Individuals harboring both Streptococcus mutans and Streptococcus sobrinus had higher values of mutans streptococci in resting and stimulated saliva than those harboring only S. mutans (P<0.001). Actinomyces viscosus and Actinomyces naeslundii comprised 1% of the total CFU in 89% of the plaque samples. The corresponding figures for lactobacilli and mutans streptococci were 6% and 38%, respectively.     

Supervisor experiences of supervising nursing staff in the care of older people

Aim To describe supervisors’ experiences of supervising nursing staff who care for older people in order to develop an understanding of the opportunities and limitations involved in supervision. Background Little is known of what group supervision of nursing staff means for the supervisor, particularly in regards to care of the old. Methods A reflective life‐world research approach, based upon phenomenological epistemonology was used. Two supervisors with 2 years experience of supervising nursing staff caring for older people were interviewed. Conclusions Results point to the need for support for supervisors in order to enable them to develop their supervisory abilities and skills. Implications for nursing management Support is of crucial importance for both the ability to supervise and the quality of supervision.     

High frequency of false‐positive signals in a real‐time PCR‐based “Plus/Minus” assay

Molecular biological methods using real‐time polymerase chain reaction (RT‐PCR) for detection of bacterial and viral genes in different environments have been developed into assays from different commercial sources. Applied Biosystems include and support two applications with their TaqMan instrument: the “Plus/Minus” and the “Allelic Discrimination” assays. These approaches are RT‐PCR based, use short primers and fluorescent‐labeled TaqMan probes and include three processes: a pre‐read run, a PCR‐amplification run, and a post‐read run. In the “Plus/Minus” assay, samples and controls (distilled water) are loaded into the instrument, which calculates a positive or a negative outcome based on differences in signals between samples and the controls. When testing the “Plus/Minus” assay for detection of usp genes encoding a uropathogenic specific protein in Escherichia coli, an inordinately high proportion of false‐positive signals was observed. This was shown to be due to a serious methodological deficiency. Our observations indicate that an adequate no‐template control closely matching the target samples in all aspects, including amount of DNA, is required to establish a correct threshold in the pre‐read run that forms the basis for further calculations in the post‐read run of the “Plus/Minus” assay.     

Root surface caries and associated factors

Abstract – The prevalence of root surfaces caries in 208 randomly selected 55, 65, and 75-yr-old Swedes was related to the frequency of coronal caries, the number of remaining teeth and to bacteriologic, salivary, and dietary variables. At least one decayed or filled root surface was found in 89% of the individuals and all of those had also experienced coronal caries. The frequency of root surface caries was positively correlated to the frequency of coronal decay and negatively correlated to the number of remaining teeth and exposed root surfaces. The study shows that the same factors which are associated with enamel caries seem to be of importance in determining the development of root surface caries. The variation in the frequency of root surface caries was best explained by the salivary levels of mutans streptococci and lactobacilli, the percentage of surfaces harboring plaque and the frequency of carbohydrate intake. Other contributory factors were the saliva secretion rate and the buffer capacity.     

Effect of a fluoride-containing varnish on Streptococcus mutans in plaque and saliva

Abstract – The effect of topical application of a fluoride-containing varnish, Duraphat®, on the level of Streptococcus mutans in saliva and in dental plaque was investigated in schoolchildren. Samples of saliva and pooled buccal plaque were taken before varnish application and 4, 10 and 21 d after treatment. Fluoride varnish treatment with or without a preceding dental prophylaxis had no significant effect on the plaque and salivary levels of S. mutans. The findings suggest that the caries-reducing effect of fluoride varnish cannot be explained by an alteration of the incidence of 5. mutans in dental plaque or in saliva.     

An in vitro study with various vehicles of diffusion of formocresol and its components

abstract — Pulpotomy in primary teeth using the formocresol method results in varying degrees of devitalization of the root pulp. The extent of this devitalization depends on, among other things, the ability of the components of formocresol to leave the dressing. The purpose of this study was to evaluate the rate and duration of diffusion of the components of formocresol when incorporated in different vehicles. The antimicrobial effect of the drugs was used to assess the diffusion of the components of formocresol in blood agar, with a sensitive microorganism as an indicator. Evaluation of the MICs assessed in broth medium for formalin, formocresol and cresol, respectively, and the zone size of growth in hibition on blood agar from these components when incorporated in ZnO or ZnO-eugenol cement, suggested that the initial zone of inhibition from formocresol was due mainly to the diffusion of formaldehyde. Cresol diffused more slowly from the dressing. The presence of eugenol in the dressing, as in ZnO-eugenol cement, gave smaller initial release of formaldehyde, formocresol and cresol compared with the release from ZnO, but more prolonged diffusion. A higher initial release of formaldehyde was obtained when the formocresol was incorporated in ZnO alone compared with ZnO-eugenol cement or Pharmatec®.     

Effect of a moderate vitamin A deficiency on saliva secretion rate and some salivary glycoproteins in adult rat

Abstract – The study presents the effect of a low vitamin A intake on saliva secretion rate and some salivary glycoproteins in the adult rat. Sixteen rats in the experimental group were fed a vitamin A deficient diet (0.11 μg retinol/g diet) and 14 rats in the control group a diet with adequate content of vitamin A (4.74 μg/g diet). At the end of the experimental period of 10 wk, whole saliva, blood, and liver samples were collected. No difference in the serum content of retinol was seen between the two groups. The liver values were significantly lower for the rats in the experimental group compared to the values in the control group. No difference was seen between the two groups in saliva secretion rate, salivary peroxidase activity, or the concentrations of total protein and markers for total glycoprotein secretion. However, the activity of a bacteria agglutinating glycoprotein, BAGP, was significantly reduced in the rats fed the vitamin A deficient diet.     

Glass ionomer and resin-based fissure sealants: a clinical study

Abstract – The aim of this study was to compare the retention rate of a glass ionomer cement formulated for fissure sealing with two resin-based sealants. 208 occlusal fissures of permanent molars and premolars were sealed with either Fuji III, Delton or Concise WS by four dentists. Clinical assessments and a replica scoring technique were used to register the performance of the sealants at baseline, after 6–12 months, and then yearly up to 5 yr. As judged clinically, 61% of the glass ionomer sealants were lost within 6–12 months and 84% after 30–36 months. Although total loss was recorded clinically for the majority of the glass ionomer sealants, some retained sealant was observed in the tooth replicas in 93%, of them. The clinical evaluation of the resin-based sealants showed an average complete retention rate of 90% after 4.5–5 yr. The corresponding figure with the replica technique was 58%. Caries was recorded in 5% of the resin-based and in none of the glass ionomer sealed surfaces.