Database: MEDLINE <: biomedical, nursing & dental literature, 1966 - Sep 2000.> Search Strategy (You Saved Citations 1-252 From Set 82): ----------------------------------------------------------------------------- 1 Chlorhexidine/ 2887 2 chlorhexidine.mp. 3503 3 sebidin.mp. 3 4 tubulicid.mp. 21 5 or/1-4 3513 6 exp Cariostatic agents/ 19773 7 fluoride:.mp. 26298 8 ((sulfur or sulphur) adj3 hexafluoride:).mp. 519 9 difluoride:.mp. 457 10 tetrafluoride:.mp. 82 11 ossin.mp. 7 12 zymafluor.mp. 3 13 or/6-12 27675 14 exp Tooth demineralization/ 22611 15 demineralization.mp. 1616 16 caries.mp. 15276 17 caires.mp. 1 18 craies.mp. 0 19 careis.mp. 4 20 carise.mp. 0 21 (teeth adj3 cavit:).mp. 422 22 (tooth adj3 cavit:).mp. 217 23 (dental adj3 cavit:).mp. 276 24 (dentin adj3 cavit:).mp. 254 25 (enamel adj3 cavit:).mp. 182 26 (teeth adj3 decay:).mp. 374 27 (tooth adj3 decay:).mp. 321 28 (dental adj3 decay:).mp. 249 29 (dentin adj3 decay:).mp. 12 30 (enamel adj3 decay:).mp. 20 31 (active adj decay).mp. 9 32 (rampant adj3 decay:).mp. 14 33 (recurrent adj3 decay:).mp. 30 34 (white adj spot:).mp. 508 35 carious.mp. 2075 36 cariology.ti,ab. 56 37 (non-cavitated adj3 lesion:).mp. 15 38 (noncavitated adj3 lesion:).mp. 2 39 Tooth remineralization/ 475 40 (dental adj3 fissure:).mp. 98 41 (tooth adj3 fissure:).mp. 50 42 (teeth adj3 fissure:).mp. 97 43 caries-free.mp. 602 44 cariesfree.mp. 17 45 Cariogenic agents/ 728 46 precavit:.mp. 8 47 (filled adj3 teeth).mp. 510 48 (filled adj3 tooth).mp. 117 49 (oral adj fissure:).mp. 6 50 (tooth adj3 remineraliz:).mp. 28 51 (teeth adj3 remineraliz:).mp. 24 52 dft.mp. 411 53 dfs.mp. 1248 54 dmf:.mp. 6390 55 cariogeni:.mp. 1784 56 or/14-55 32213 57 (5 or 13) and 56 6551 58 exp Research design/ 125392 59 exp Clinical trials/ 113387 60 "comparative study"/ 896877 61 Placebos/ 19801 62 placebo$1.ti,ab. 61778 63 multicenter study.pt. 34559 64 clinical trial.pt. 284041 65 random:.ti,ab. 192625 66 (clinical adj trial:).ti,ab. 50230 67 (controlled clinical trial or randomized clinical trial).pt. 53737 68 practice guideline.pt. 4666 69 Feasibility studies/ 7254 70 clinical protocols/ 8146 71 (single blind: or double blind: or triple blind:).ti,ab. 56641 72 exp treatment outcome/ 95125 73 exp Epidemiologic research design/ 233512 74 Double-blind method/ 60389 75 or/58-74 1420940 76 risk:.mp. 412358 77 exp Risk/ 226237 78 or/75-77 1732532 79 57 and 78 1979 80 limit 79 to (human and english language) 1487 81 limit 80 to yr=1980-2000 1241 82 limit 81 to (adolescence < 13 to 18 years > or adult < 19 552 to 44 years > or middle age < 45 to 64 years > or "aged < 65 and over >" or "aged, < 80 and over >") 83 from 82 keep 1-300 300 84 from 82 keep 301-552 252 *************************** <1> UI - 93017321 AU - Zero DT AU - Raubertas RF AU - Fu J AU - Pedersen AM AU - Hayes AL AU - Featherstone JD IN - Department of Oral Sciences, Eastman Dental Center, Rochester, New York 14620. TI - Fluoride concentrations in plaque, whole saliva, and ductal saliva after application of home-use topical fluorides [published eerratum appears in J Dent Res 1993 Jan;72(1):87]. SO - Journal of Dental Research 1992 Nov;71(11):1768-75 AB - It is now well-accepted that the primary anti-caries activity of fluoride (F) is via topical action. The retention of F in the mouth after topical fluoride treatment is considered to be an important factor in the clinical efficacy of F. The purpose of this study was to evaluate F levels in ductal saliva, whole saliva, and pooled plaque after treatment with topical F agents intended for home use. Ten consenting adults, mean (SD) age 31.0 (8.2) years, participated in all aspects of the study. Two days before each test, subjects received a professional tooth cleaning and subsequently abstained from all oral hygiene procedures to permit plaque to accumulate, and from the use of F-containing dental products. Treatments consisted of a placebo dentifrice (PD), fluoride dentifrice (FD; 0.24% NaF), fluoride rinse (FR; 0.05% NaF), and fluoride gel (FG; 1.1% NaF). Unstimulated whole saliva and pooled plaque were sampled at multiple points over a 24-hour period. In a separate experimental series, stimulated parotid saliva was sampled over a two-hour period after treatment. Fluoride levels generally followed the same pattern in whole saliva and pooled plaque samples, with FG > FR > FD > PD. Night-time F application resulted in prolonged F retention in whole saliva but not in plaque. Fluoride levels in parotid saliva were only slightly higher after F treatment and returned to baseline levels within two h. The results of this study indicate that the method of F delivery, the F concentration of the agent, and the time of application (daytime vs. night-time) are important factors influencing F levels in the mouth.(ABSTRACT TRUNCATED AT 250 WORDS) <2> UI - 93030435 AU - Saemundsson SR AU - Bergmann H AU - Magnusdottir MO AU - Holbrook WP IN - Dental Surgery, Vopnafjordur, Iceland. TI - Dental caries and Streptococcus mutans in a rural child population in Iceland. SO - Scandinavian Journal of Dental Research 1992 Oct;100(5):299-303 AB - In spite of having a high socioeconomic standing, in Iceland caries prevalence has remained stubbornly high. This study reports findings from a mixed fishing and farming community in East Iceland that has traditionally been associated with the highest prevalence of caries. A total of 188 children aged 3-16 yr (96.4% of residents of that age group) were examined. At 6 yr the mean dmfs score was 4.1, DMFS 0 and 48% were caries-free. The mean DMFS score at 12 yr was 4.7 and 22.6% remained caries-free but at 16 yr the DMFS score was 11.6 and no children were caries-free. Caries was unevenly distributed within each age group and was more prevalent among residents of the fishing town than the surrounding farming district. In a pilot study conducted in 1989 mean counts of Streptococcus mutans for children aged 4-7 yr were 2.6 x 10(5) cfu/ml and declined to 4.6 x 10(4) cfu/ml in 1990 after a program of chlorhexidine brushing had been added to the routine caries preventive measures adopted in this community. It may therefore be possible to screen Icelandic children for caries risk and apply preventive measures to those demonstrated to be most in need. <3> UI - 92399328 AU - Randell DM AU - Harth S AU - Seow WK IN - University of Queensland Dental School, Australia. TI - Preventive dental health practices of non-institutionalized Down syndrome children: a controlled study. SO - Journal of Clinical Pediatric Dentistry 1992 Spring;16(3):225-9 AB - Although Down syndrome children are known to be greatly predisposed to periodontal disease when compared with normal children, the preventive dental health practices of non-institutionalized Down syndrome children have not been well reported. This questionnaire study of 25 Down syndrome children aged 1-14 years compared with 25 normal control children showed that Down syndrome children have poorer dental health practices compared with normal children. Significantly greater numbers of Down syndrome children were weaned from the bottle at greater than 18 months of age (56% vs 24%, p less than 0.05) or had taken a bottle to bed (40% vs 12%, p less than 0.05), indicating their increased risk for the development of nursing bottle caries. In addition, Down syndrome children were receiving less help during tooth brushing (60% vs 84%, p less than 0.05), were older when they first visited the dentist, and less likely to be taking regular fluoride supplements. These results indicate that Down syndrome children are further disadvantaged by poor preventive dental health practices and should be targeted for increased preventive dental care. <4> UI - 92398785 AU - Nemes J AU - Banoczy J AU - Wierzbicka M AU - Rost M IN - Semmelweis University of Medicine, Badapest, Hungary. TI - Clinical study on the effect of amine fluoride/stannous fluoride on exposed root surfaces. SO - Journal of Clinical Dentistry 1992;3(2):51-3 AB - The aim of this study was to assess the remineralizing effect of an amine fluoride (AmF)- and stannous fluoride (SnF2)-containing toothpaste and mouthrinse on exposed root surfaces. A total of 44 adults participated in the 20-week, double-blind study and were grouped as follows: (1) 20 participants (mean age 45.7 years) used an AmF/SnF2 experimental toothpaste plus AmF/SnF2 (Meridol) mouthwash, and (2) 24 participants (mean age 48.8 years) used an NaF-containing toothpaste and mouthrinse. Root caries index (RCI) and root surface scores were determined by a modified method of Katz (J Dent Res, 1984). RCI mean values showed decreases of approximately 47% in the AmF/SnF2 group, and 10% in the NaF group. With respect to root caries scores, the number of persons with decreased softened (non-carious) surfaces between the baseline and control examinations was statistically significant (p less than 0.05) in the AmF/SnF2 group but not significant in the NaF group. A statistically significant difference (p less than 0.05) in the results of the groups favored the AmF/SnF2 subgroup. Thus, the data point to a possible remineralizing effect of topically applied AmF/SnF2 on softened root caries surfaces. <5> UI - 92393769 AU - Manning RH AU - Edgar WM AU - Agalamanyi EA IN - Department of Clinical Dental Sciences, University of Liverpool, UK. TI - Effects of chewing gums sweetened with sorbitol or a sorbitol/xylitol mixture on the remineralisation of human enamel lesions in situ. SO - Caries Research 1992;26(2):104-9 AB - Intra-oral remineralisation of experimental caries-like lesions in human enamel, as determined by polarised light microscopy and quantitative microradiography, was promoted to a similar extent (% fall in delta Z, 18.6 and 19.0) by chewing a sorbitol or sorbitol/xylitol (3:1)-sweetened gum for 20 min after each of three meals and two sugary snacks daily. The results suggest that reported differences in the properties of the two sweeteners do not affect their ability to enhance remineralisation due to salivary stimulation. <6> UI - 92370495 AU - Morgan MV AU - Wright FA AU - Matram ZN AU - Sundoro E AU - Chesters RK IN - School of Dental Science, University of Melbourne, Australia. TI - The oral health status and health behaviour of 12 and 15 year-old adolescents in Jakarta, Indonesia. SO - Community Dental Health 1992 Jun;9(2):171-9 AB - Indonesia is a developing country with few dental services and a population at risk to deteriorating oral health. Five hundred and ninety-one 12 and 15 year-old children drawn from a low fluoride (F- less than 0.1 ppm) urban area of Jakarta, Indonesia were examined for dental caries, fluorosis, and periodontal diseases. In addition, a questionnaire was administered investigating socio-demographic background, use of dental services, and preventive oral care. Although the severity of dental caries experience was moderate, untreated caries on the occlusal surface formed the highest proportion of the dental caries experience. CPITN examination revealed a large proportion of the subjects had calculus as their highest score, combined with a substantial number of sites which exhibited bleeding on probing. Questionnaire data revealed a high home use of fluoridated toothpaste by the subjects but a predominant use of dental services for pain relief. Findings from this study suggest a need for primary preventive programmes focusing on occlusal sealants and plaque control. <7> UI - 92371522 AU - D'Hoore W AU - Van Nieuwenhuysen JP IN - School of Public Health, Catholic University of Louvain, Brussels, Belgium. TI - Benefits and risks of fluoride supplementation: caries prevention versus dental fluorosis. SO - European Journal of Pediatrics 1992 Aug;151(8):613-6 AB - To assess the risks (dental fluorosis) and the benefits (caries prevention) of fluoride (F) tablets and F toothpaste, we surveyed 2003 schoolchildren aged 5-20 years old (mean = 10.82, SD = 3.40). Children were scored for dental caries by means of the decayed, missing, filled teeth index (DMFT index). Frequent use of F toothpaste (toothbrushing frequency) is poorly linked to caries (Spearman r = 0.05, P = 0.02) and dental fluorosis (r = 0.05, P = 0.03). Children who use F tablets regularly and appropriately exhibit mild fluorosis more often than non- or occasional users (odds ratio = 9.58), and have a mean DMFT index 50% lower than other children. We conclude that using F tablets is an effective means of preventing caries. When used appropriately in non fluoridated areas, using F tablets results in minor damage. <8> UI - 92314997 AU - McDonald SP AU - Sheiham A IN - Wellington Area Health Board, New Zealand. TI - The distribution of caries on different tooth surfaces at varying levels of caries--a compilation of data from 18 previous studies. SO - Community Dental Health 1992 Mar;9(1):39-48 AB - The aim of this study was to examine the distribution of caries on different tooth surfaces, at varying levels of dental caries, in adolescent populations. Using data obtained from published reports, the relationship between reported mean surface-type caries scores were plotted against the total mean DFS and showed a good "closeness of fit." Mathematical expressions for the relationships were computed. A new "working rule" has been postulated from the data which states that: "As caries prevalence falls, the least susceptible sites (proximal and smooth surfaces) reduce by the greatest proportion, while the most susceptible sites (occlusal) reduce by the smallest proportion." This is true regardless of the presence of fluorides. This study questions the widely held view that fluorides have a special effect on proximal and smooth surface caries. The relationships between total DMFS/DFS and tooth surfaces affected could be useful to determine which preventive agent to use for a given caries prevalence level. <9> UI - 92331086 AU - Downer MC AU - Worthington HV IN - Institute of Dental Surgery, Eastman Dental Hospital, London, UK. TI - The status of bite-wing radiographs in enhancing discriminatory ability in caries prophylactic clinical trials. SO - Caries Research 1992;26(3):195-200 AB - Data were taken from six randomised controlled trials of caries prophylactic agents in order to investigate the capacity of bite-wing radiographs of posterior approximal tooth surfaces to enhance discrimination between test and control group measurements. The findings showed that, where an active control agent was employed, the addition of radiographic to clinical examination data failed to improve discriminatory power in comparisons between 3-year caries increments. <10> UI - 92323883 AU - Heidmann J AU - Poulsen S AU - Arnbjerg D AU - Kirkegaard E AU - Laurberg L IN - Department of Child Dental Health, Royal Dental College, Aarhus, Denmark. TI - Caries development after termination of a fluoride rinsing program. SO - Community Dentistry & Oral Epidemiology 1992 Jun;20(3):118-21 AB - In a municipality near Copenhagen, Denmark, where fortnightly fluoride rinses with 0.2% neutral sodium fluoride had been performed for more than a decade, 1306 children from kindergarten through 6th grade were stratified by school and grade and randomly distributed into two groups. One group continued the fluoride rinses, the other group had the fluoride solution replaced with distilled water. Both solutions were slightly flavored. 1083 children completed the 3-yr trial. Caries was recorded clinically by the dentists in the municipal dental service using the diagnostic criteria for the Child Dental Health Services, and on bitewing radiographs by one of the authors applying the criteria developed by GRONDAHL et al. Permanent molars and premolars were included in the study. Clinically, caries increment in the two groups was the same with pits and fissures containing 94% of the DMFS. According to the radiographs, caries progression in the water group was higher than in the fluoride group. This difference was statistically significant for the surfaces erupting during the study (P less than 0.05). <11> UI - 92276601 AU - Duckworth RM AU - Morgan SN AU - Gilbert RJ IN - Unilever Dental Research, Port Sunlight Laboratory, Merseyside, United Kingdom. TI - Oral fluoride measurements for estimation of the anti-caries efficacy of fluoride treatments. [Review] [46 refs] SO - Journal of Dental Research 1992 Apr;71 Spec No:836-40 AB - The aims of this work were (a) to assess the oral bioavailability of fluoride delivered from dentifrices and (b) to test for a possible link between the results and clinical data obtained with the same dentifrices. Oral fluoride concentrations were measured in samples of saliva and plaque taken from seven subjects, after use of dentifrices which contained 0, 1000, 1500, and 2500 micrograms F/g as sodium monofluorophosphate. Salivary fluoride in samples obtained within the first few hours after a single dentifrice application, or up to 20 h after four weeks' daily use, increased with increasing F content of the dentifrice. For example, the mean zero-time intercepts of the second phase of salivary fluoride clearance curves for the above dentifrices were 0.46, 1.48, 1.88, and 3.03 mumol F/L, respectively. Plaque fluoride measured after four weeks' daily use of the dentifrices exhibited similar dose-response behavior. Linear regression analysis showed these trends to be statistically significant for both saliva (p less than 0.001) and plaque (p less than 0.025). Mean saliva and plaque fluoride concentrations were inversely associated with mean three-year caries increments for the three fluoride-containing dentifrices obtained in a recent clinical trial: DMFS scores 6.80, 6.33, and 5.71, respectively (Stephen et al., 1988). This suggests that oral fluoride measurements are a valuable in vivo method for the evaluation of the potential anti-caries efficacy of fluoride-containing dental products. [References: 46] <12> UI - 92299739 AU - Mellberg JR AU - Petrou ID AU - Grote NE IN - Colgate-Palmolive Company, Technology Center, Piscataway, New Jersey 08854. TI - A study of the ability of an in situ remineralization model to differentiate between the effects of two fluoride dentifrices that produced significantly different clinical caries results. SO - Journal of Dental Research 1992 May;71(5):1169-72 AB - The purpose of this study was to determine whether an in situ remineralization model was able to show a difference in the effects of two dentifrices of different fluoride concentrations and significantly different clinical efficacies. Three dentifrices were tested in a double-blind, cross-over study design. The products contained 0 ppm F, 250 ppm F, or 1000 ppm F from sodium fluoride and were formulated with a silica base according to the formulations used in a human caries trial (Koch et al., 1990). Nineteen subjects each carried three or four thin sections of enamel in their partial dentures. The thin sections, containing artificial caries lesions, were covered with a steel mesh to provide space for plaque formation and then brushed in situ three times daily with the dentifrices. Following the two-week treatment periods, the specimens were removed from the dentures and analyzed for changes in mineral content. The findings showed that the placebo dentifrice (0 ppm F) resulted in 56.8 +/- 74.3% demineralization, the 250-ppm-F dentifrice produced 12.9 +/- 41.3% demineralization, thereby showing partial caries protection, and the 1000-ppm-F dentifrice produced 17.3 +/- 32.1% remineralization. Linear regression analysis showed that the percent remineralization was significantly related to the fluoride concentration in the dentifrice (p less than 0.001). The 250-ppm-F dentifrice was also significantly less effective than the 100-ppm-F dentifrice (p = 0.04, one-tailed Fisher Protected LSD test). These findings are in accord with the human caries trial and support the use of the present in situ remineralization model for prediction of the anticaries efficacy of fluoride dentifrice products. <13> UI - 92276616 AU - Stookey GK IN - Oral Health Research Institute, Indiana University School of Dentistry, Indianapolis 46202. TI - Reactor paper concerning patient selection and appliance design in intra-oral models. SO - Journal of Dental Research 1992 Apr;71 Spec No:911-2 AB - Patient selection and appliance design are important factors in the development of intra-oral models. Adults, rather than children, are recommended as panelists due to their similarity to children in response to fluoride for caries prevention, greater likelihood of compliance with all study requirements, and greater availability for appointments. It may be desirable for additional factors--including the presence of cariogenic micro-organisms and the characteristics of their saliva with regard to remineralization--to be used in the selection of panelists. Cross-over test designs may be desirable to minimize the impact of these variables as well as of dietary differences. Appliances should be designed to approximate the normal oral conditions to the maximum extent possible. Intra-oral models should be capable not only of detecting the effects of clinically-proven fluoride treatments but also of detecting fluoride dosage responses. <14> UI - 92276609 AU - Zero DT AU - Fu J AU - Anne KM AU - Cassata S AU - McCormack SM AU - Gwinner LM IN - Eastman Dental Center, Rochester, New York 14620. TI - An improved intra-oral enamel demineralization test model for the study of dental caries. SO - Journal of Dental Research 1992 Apr;71 Spec No:871-8 AB - The intra-oral enamel demineralization test (IEDT) was introduced by Brudevold et al. (1984). This caries model involves human subjects wearing palatal appliances each holding eight bovine enamel blocks covered by a bacterial cell layer prepared by the harvesting of cultures of Streptococcus mutants (test plaque). The original model used the iodide permeability test for assessment of the extent of demineralization of bovine enamel blocks resulting from acid production by the test plaque after dietary substrate challenge. The IEDT model has been expanded and improved by us in the following ways: (1) Based on encouraging findings from an in vitro study (Zero et al., 1990), the surface microhardness test has been adopted to measure the extent of demineralization occurring at three sites on the enamel blocks corresponding to an area over which the effective plaque thickness is 0.5, 1.5, and 2.5 mm; (2) intra-oral pH of the test plaque is measured by means of a Beetrode miniature pH electrode at baseline, then at five, 10, 15, 30, and 45 min after the start of a test; (3) plaque samples are collected at the end of a test and analyzed for organic acid content by means of HPLC; (4) the bacterial test challenge has been expanded to include different cariogenic bacteria which are grown under various growth conditions. The improved model has the capability of studying fundamental aspects of the caries process, namely, the relationships among dietary substrate challenge, plaque pH change, plaque organic acid profiles, microbial virulence properties, and enamel demineralization. Furthermore, the model has the potential for use in more applied research on caries-preventive agents such as fluoride. <15> UI - 92276606 AU - Wefel JS AU - Jensen ME IN - Dows Institute for Dental Research, University of Iowa, College of Dentistry, Iowa City 55242. TI - An intra-oral single-section demineralization/remineralization model. SO - Journal of Dental Research 1992 Apr;71 Spec No:860-3 AB - This paper reviews the use of our intra-oral crown single-section model for the evaluation of in situ demineralization and remineralization. The model uses normal, healthy adults who are in need of a gold crown. A slot is placed in the working crown which can hold 3-4 single sections. A typical experiment would use an enamel lesion, root lesion, and sound root section which are characterized with polarized light microscopy and/or microradiography prior to insertion in the crown. After the experimental regimen, the sections are removed and re-characterized for any changes. The model has been used to evaluate mineral changes from the use of fluoride dentifrices and rinses, chewing gum, and food sequencing. The advantages of the model system are the before-and-after measurements on the same section, a natural plaque formation, interaction with saliva, episodic demineralization and remineralization, no bulky appliances, and the use of reasonable time frames. This model, therefore, reduces the artificiality of the in situ study to a great extent and appears to be a useful predictor of demineralization/remineralization interactions. <16> UI - 92276602 AU - Afflitto J AU - Schmid R AU - Esposito A AU - Toddywala R AU - Gaffar A IN - Colgate-Palmolive Company, Corporate Technology Center, Piscataway, New Jersey 08855. TI - Fluoride availability in human saliva after dentifrice use: correlation with anticaries effects in rats. SO - Journal of Dental Research 1992 Apr;71 Spec No:841-5 AB - Studies were conducted to determine fluoride availability in saliva after dentifrice use and to relate this parameter to cariostatic efficacy in rat caries experiments. Three dentifrices--two commercial formulations (Colgate Winterfresh Gel and Crest Dentifrice with Na-Sr-polyacrylate) and an Experimental dentifrice--were compared with respect to salivary fluoride availability. All of the dentifrices tested contained 1100 ppm F as sodium fluoride. It was observed that the Experimental dentifrice and Crest dentifrice with Sr-polyacrylate exhibited low salivary fluoride availability relative to the Colgate Winterfresh Gel. Salivary fluoride availability was assessed by means of two parameters: (a) the fluoride concentration in the dentifrice saliva slurry expectorated after brushing, and (b) the area under the curve of salivary F concentration vs. time for up to two hours after dentifrice use. In two rat caries experiments, it was observed that both the Experimental dentifrice and the Sr-polyacrylate dentifrice provided less cariostatic efficacy than the clinically validated Positive Control (Colgate Winterfesh Gel). Analysis of these data provides further evidence in support of the concept that fluoride availability in saliva following dentifrice use is an important parameter related to anticaries efficacy. <17> UI - 92276599 AU - Corpron RE AU - More FG AU - Mount G IN - School of Dentistry, University of Michigan, Ann Arbor 48109-1078. TI - Comparison of fluoride profiles by SIMS with mineral density of subsurface enamel lesions treated intra-orally with a fluoride-releasing device. SO - Journal of Dental Research 1992 Apr;71 Spec No:828-31 AB - A variety of intra-oral model systems has evolved which allows for the study of remineralization of coronal and/or root-surface lesions following application of topical fluoride (F) agents. The problem of interpretation of the results has led to a variety of analytical methods (i.e., microhardness, F biopsy, microradiography, and polarizing light microscopy), each of which provides important but limited information related to the overall understanding of remineralization. Microhardness measures change in mineral content which is more precisely localized by microradiography and polarized light microscopy. F biopsy allows for assessment of the F uptake of lesions, but does not suggest the chemical state of the F. Previous work has demonstrated that patterns of mineral deposition during remineralization do not necessarily parallel the F uptake profiles, and fluoridated apatites cannot be distinguished from non-specifically-adsorbed F (Clark et al., 1988). Because artificial lesions demonstrate variations in depth and mineral content, complementary analytical methods that demonstrate profiles of both F content and mineral density curves on the same section are needed so that the process of remineralization can be more clearly understood. This study used secondary ion mass spectrometry (SIMS) for F profiles and quantitative microradiography for assessment of mineral deposition on the same section. These state-of-the-art methods demonstrate the precision with which information about remineralization can be obtained. Subsurface lesions in human enamel specimens were developed by immersion in 0.1 M lactate buffer with 1% CMC at a pH of 4.5 for 48 h.(ABSTRACT TRUNCATED AT 250 WORDS) <18> UI - 92276597 AU - Stookey GK AU - Katz BP AU - Beiswanger BB AU - Dunipace AJ IN - Oral Health Research Institute, Indiana University School of Dentistry, Indianapolis 46202. TI - Sample size considerations in designing studies with intra-oral models. SO - Journal of Dental Research 1992 Apr;71 Spec No:819-21 AB - Especially during recent years, the use of pre-clinical models for predicting the efficacy of fluoride systems has assumed greater importance within the scientific community. Originally utilized primarily to screen experimental fluoride delivery systems, preclinical models are now being considered as predictors of clinical efficacy in lieu of controlled clinical caries trials. Of the various preclinical models presently available, human intra-oral models have the greatest potential for reflecting intended usage conditions and therefore may be the most meaningful models for predicting clinical efficacy. However, only with the proper consideration of numerous critical variables can studies using intra-oral models be appropriately designed to achieve the desired objectives. Clearly, these models must provide relevant information in a manner which reflects clinically established cariostatic activity and be capable of detecting established differences in the amount of cariostatic activity, i.e., dose-response effects. Three sources of variation must be considered before an appropriate study design and sample size can be chosen. Based on fluoride uptake data from an intra-oral model with proximally-located enamel specimens, estimates of variation among subjects, within subjects, and among specimens within subjects were obtained. Multiple specimens per panelist do not affect the first two sources of variation. Thus, the number of panelists, and not the number of specimens, is of primary importance when pre-test data are used to choose the appropriate study design and calculate the required sample size. <19> UI - 92276596 AU - Vernon PG AU - Raven SJ AU - Gilbert RJ AU - Parr TA AU - Dundon KA IN - Unilever Dental Research, Port Sunlight Laboratory, Bebington, Wirral, United Kingdom. TI - The effect of study design on in situ treatment of carious enamel lesions. SO - Journal of Dental Research 1992 Apr;71 Spec No:814-8 AB - The aim of this exploratory study was to investigate the influence of several factors on changes in the mineral content of carious enamel lesions treated in situ. The study involved 36 adult volunteers who used either a non-fluoride toothpaste or one of two fluoride toothpastes (1000 or 1500 ppm F). Human enamel specimens were prepared and attached to partial dentures as described previously (Schafer, 1989) and treated in situ for between three and six weeks. The mineral content of lesions was determined by microradiography and computerized densitometry. The factors investigated in this study included study length, frequency of treatment, trial design, patient compliance, patient diet, and previous caries experience of the patient. The effects observed were small, relative to that of the treatment, and not statistically significant (p greater than 0.05). However, the trends in the data were all as would be intuitively predicted. Study duration correlated positively with observed lesion mineral content. Lesions worn by panelists using a fluoride toothpaste for six weeks contained greater levels of mineral with respect to placebo than did those in panelists on a three-week study. The residual variations in the three phases of the study were found to be similar, suggesting that there is no advantage in these studies having a cross-over design. Brushing frequency also correlated positively with observed lesion mineral content, with panelists brushing three times per day with a fluoridated dentifrice having lesions with greater levels of mineral, with respect to placebo, than those brushing twice per day. Overall, no clear relationship between reported diet and changes in lesion mineral levels was apparent.(ABSTRACT TRUNCATED AT 250 WORDS) <20> UI - 92276595 AU - Schafer F AU - Raven SJ AU - Parr TA IN - Unilever Dental Research, Port Sunlight Laboratory, Wirral, Merseyside, United Kingdom. TI - The effect of lesion characteristic on remineralization and model sensitivity. SO - Journal of Dental Research 1992 Apr;71 Spec No:811-3 AB - A major criterion for assessing the value of any experimental model in scientific research is the degree of correspondence between its results and data from the real-life process it is designed to model. Intra-oral models aimed at predicting the anti-caries efficacy of toothpastes or other topical treatments should therefore be calibrated against treatments proven to be effective in a caries clinical trial. For this to be achieved, it is necessary that a model with high sensitivity be designed, while at the same time retaining relevance to the process to be modeled. This means that the effects of the various experimental conditions and parameters of the model on its performance must be understood. The purpose of this paper was to assess the influence of two specific factors on the performance of an in situ enamel remineralization model, which is based on human enamel slabs attached to partial dentures. The two factors are initial lesion severity and origin of enamel sample. The results indicated that initial lesion size affected whether net remineralization or net demineralization occurred during in situ treatment. Samples with an initial range of from 1500 to 2500 (delta Z) tended more toward demineralization than did samples with delta Z greater than 3500. This means that treatment groups must be well-balanced with respect to initial lesion size. Differences in initial demineralization severity between different tooth locations must also be considered so that systematic treatment bias can be avoided. The solution used in the model discussed here is based on a balanced experimental design, which allows this effect to be taken into account in the data analysis. <21> UI - 92291359 AU - Nuuja T AU - Meurman JH AU - Murtomaa H AU - Kortelainen S AU - Metteri J IN - Military Academy of Finland, Helsinki. TI - The effect of a combination of chlorhexidine diacetate, sodium fluoride and xylitol on plaque wet weight and periodontal index scores in military academy cadets refraining from mechanical tooth cleaning for 7-day experimental periods. SO - Journal of Clinical Periodontology 1992 Feb;19(2):73-6 AB - 45 subjects participated in a double-blind cross-over mouthwash study where a new tablet-form combination of chlorhexidine, fluoride and xylitol (XYLIHEX) was studied together with solutions of chlorhexidine (CHX) and sodium fluoride (NaF). The preparation XYLIHEX was developed as a dental chemotherapeutic that could easily be added to the soldiers' kit to be used under circumstances where practising normal oral hygiene habits is restricted. For comparative purposes, XYLIHEX was prediluted in this study to make a solution. Before starting, professional prophylaxis was given to the subjects to bring their gingivitis index scores as close to 0 as possible. The subjects refrained from mechanical tooth cleaning for three 7-day test periods. Plaque wet weight and periodontal index scores were recorded before and after the test periods. The results showed that the preparations XYLIHEX and CHX did not statistically differ from each other in reducing plaque wet weight values and the recorded periodontal index scores. Both these preparations were statistically highly significantly more effective antiplaque agents than NaF, as expected. <22> UI - 92209206 AU - Vehkalahti M AU - Rytomaa I AU - Helminen S IN - Department of Cariology, University of Helsinki, Finland. TI - Assessment of quality of public oral health care on the basis of patient records. SO - Community Dentistry & Oral Epidemiology 1992 Apr;20(2):102-5 AB - The quality of public oral health care, especially the quality of preventive treatment in relation to patients' oral health, was investigated. The population studied consisted of 367 subjects representing the 15-yr-olds living in Helsinki in 1986. Data were taken from the patients' oral health charts, obtained from municipal dental clinics. Clinical examination of the teeth and periodontium had been adequately documented in 98% of cases. In 84% of cases, status recordings matched those recorded previously. Preventive treatment, on the whole, seemed insufficient and stereotyped. Of all patients 55%, and of those in high risk groups only 57 congruent to 60% had had a topical application of fluoride at least once during treatment. Periodontal treatment was insufficient and did not correlate with recorded clinical findings. The results indicate that the concept of prevention and its selective use had not been fully adopted as routine. <23> UI - 92227025 AU - Driscoll WS AU - Nowjack-Raymer R AU - Selwitz RH AU - Li SH AU - Heifetz SB IN - Disease Prevention Section, National Institute of Dental Research, National Institute of Health, Bethesda, MD 20816. TI - A comparison of the caries-preventive effects of fluoride mouthrinsing, fluoride tablets, and both procedures combined: final results after eight years. SO - Journal of Public Health Dentistry 1992 Winter;52(2):111-6 AB - This paper presents final results of an eight-year clinical trial designed to compare the caries-preventive benefits of two self-administered fluoride procedures when used separately and in combination with one another. Children in kindergarten and first grade residing in Springfield, Ohio, a nonfluoridated community, were assigned randomly within school to one of three groups that either (a) rinsed once a week in school with a 0.2 percent neutral NaF solution; (b) chewed, rinsed with, and then swallowed daily in school a neutral 2.2 mg NaF tablet; or (c) carried out both procedures. At baseline (1981), 1,640 participants were examined clinically using the DMF surface index. Findings for 640 children remaining after eight years show that subjects in the combination group experienced a mean caries increment of 2.40 DMFS, 15.2 percent lower than the mean score of 2.83 DMFS for children in the tablet group and 32.8 percent lower than the 3.57 DMFS for those in the rinse group. Only the difference in incremental caries scores between the combined fluoride procedure and the fluoride rinse was statistically significant (P less than .05). The pattern of these findings is similar to that found on the two interim examinations. Even though the combined regimen showed an additional caries-preventive benefit compared with the rinse, considerations of cost effectiveness and feasibility do not support changing an ongoing rinse program to one that employs both procedures. For new programs the best choice appears to be the tablet procedure alone. <24> UI - 92191523 AU - Lith A AU - Grondahl HG IN - Department of Oral Radiology, University of Goteborg, Sweden. TI - Predicting development of approximal dentin lesions by means of past caries experience. SO - Community Dentistry & Oral Epidemiology 1992 Feb;20(1):25-9 AB - The aim of this study was to assess the accuracy in predicting future development of approximal dentin lesions using radiographically observed numbers of restored and carious surfaces at age 13 as diagnostic criteria. ROC curve technique was applied employing the development of at least one new dentin lesion from age 13 to age 15 and 18 respectively, as validating criterion. Two groups of patients were considered, residing in communities with water fluoride content of 0.2 ppm and 1.2 ppm, respectively. Results showed that the development of dentin lesions could be predicted with an accuracy similar to that of many other dental radiographic procedures. This implies that it ought to be possible to use previous caries experience as a means of individualizing the scheduling of future radiographic procedures. <25> UI - 92152358 AU - Levy SM AU - Muchow G IN - Department of Preventive and Community Dentistry, College of Dentistry, University of Iowa, Iowa City 52242. TI - Provider compliance with recommended dietary fluoride supplement protocol. SO - American Journal of Public Health 1992 Feb;82(2):281-3 AB - Proper dosage of dietary fluoride supplements is important for children without access to optimally fluoridated water to balance dental caries prevention and risks of dental fluorosis. Subsequent to water fluoride assay, compliance by physicians and dentists with the recommended dietary fluoride supplement dosage schedule was determined for 446 children. Approximately one third of child patients and 42% of siblings did not receive the recommended supplement dosage. <26> UI - 92255850 AU - Moorhead JE AU - Conti AJ AU - Marks RG AU - Cancro LP IN - Div. of Biostatistics, University of Florida, Gainesville. TI - The effect of supervised brushing on caries inhibition in school age children. SO - Journal of Clinical Dentistry 1991;2(4):97-102 AB - A supervised brushing program was incorporated into a three-year caries clinical trial whose primary objective was to compare the efficacy between two fluoride levels of a dentifrice (1,000 and 1,500 ppm F MFP). For each of the 2,415 children completing the three-year study, the total number of supervised brushing sessions completed was available. Results indicated that children who complied well with the supervised brushing program by participating in at least 70% of the sessions had a significantly lower caries increment in both fluoride levels (p less than .001) than children who did not comply as well. After adjusting for age, sex, and baseline DMFS of the children, as well as the fluoride level received, a multiple regression model showed that supervised brushing further reduced the three year caries increment (p less than .04). The more frequent use of the higher fluoride dentifrice affords the greatest prevention of decay. The conclusion from this study is that compliance with the supervised brushing program resulted in a reduced caries increment regardless of the level of fluoride in the dentifrice. <27> UI - 92199196 AU - Holloway PJ IN - University Dental Hospital of Manchester. TI - International dental public health. SO - Current Opinion in Dentistry 1991 Jun;1(3):348-56 AB - Dental public health workers around the world are considering the service implications of changing patterns of dental health. In industrialized countries, with few exceptions, caries levels are declining among adolescents and young adults, but there are signs that this may not now be the case in the very young. The situation in developing countries is equivocal. In an effort to target resources more efficiently, efforts to detect those at high risk to caries continue. However, there still seems no better predictor than the caries experience of the individual or group. With reducing levels of dental caries, greater interest is being shown in the epidemiology of periodontal disease. Despite the acceptance by Federation Dentaire Internationale of the Community Periodontal Index of Treatment Needs as a suitable measure of community periodontal health, some workers still have reservations of its value. With increasing numbers of elderly people retaining greater numbers of teeth, investigations into patterns of adult caries, particularly root caries, are increasing. Collaboration among health workers on an international basis would enhance knowledge in these disciplines. <28> UI - 92133219 AU - Vehkalahti M AU - Rytomaa I AU - Helminen S IN - Department of Cariology, University of Helsinki, Finland. TI - Decline in dental caries and public oral health care of adolescents. SO - Acta Odontologica Scandinavica 1991 Dec;49(6):323-8 AB - The adequacy and appropriateness of the oral health service were evaluated from patient records of 15-year-olds in Helsinki in 1976 and 1986. The subjects selected for the study represented the whole age group participating in public oral health service in the 2 years in question. During the 10 years, substantial decreases were seen in the mean numbers of dental visits (from 4.0 to 2.4) and fillings (from 2.9 to 1.2). The greatest decrease was seen in the number of fillings made in incisors. Slightly fewer preventive measures were carried out in 1986 than 10 years earlier, but no focusing on risk patients was seen. In the 2 years studied, 15-year-olds in the high-risk group received applications of topical fluorides and instructions on oral hygiene as often as those in the low-risk group. A major problem seemed to be the increasing number of unfinished courses of treatment among high-risk patients. We conclude that patients with a higher risk of caries should receive more attention with regard to both the preventive treatment given and ways of motivating them to complete their treatment courses. <29> UI - 92131819 AU - Luoma H IN - Department of Preventive Dentistry and Cariology, University of Kuopio, Finland. TI - Experience and views of caries research and oral health. [Review] [57 refs] SO - Proceedings of the Finnish Dental Society 1991;87(4):659-70 AB - The main clinical and theoretical studies on caries etiology and prevention and on general health published by the author and his coworkers since the beginning of the 1960s are briefly reviewed. Among the caries prevention methods published by previous authors, the Finnish trials on fissure sealing and fluoride varnishing showed distinct preventive effects. On the basis of these and later supporting findings, these methods were rapidly and widely adopted in the dental health care of Finnish children and adolescents. A chlorhexidine-fluoride mouthrinsing solution, developed by the author, exhibited simultaneous reduction of both caries and gingivitis among high -risk children and this preparation or chlorhexidine-fluoride gels have been widely prescribed for risk subjects, especially those with a caries risk. Despite the good caries prevention results obtained through fluoridation of sugar products and in respective model studies, this procedure has not been passed for commercial use in Finland. The translocation of phosphorus, potassium and fluoride between microbes of dental plaque origin and their environment, including the respective elements of enamel origin, were presented as a partial explanation for the role of phosphates and fluoride in caries etiology and/or prevention. Animal experiments elucidated the killing mechanism of a high single fluoride intake and its prevention by magnesium with explanatory changes in cardiac calcium. On the other hand, experiments on prolonged intakes of low dietary fluoride by rats confirmed earlier findings on the potential of fluoride in preventing calcium salt imbalances in internal organs. This was accomplished with a fluoride intake sufficient for caries reduction. The ability of two strains of the mutans streptococci and a Lactobacillus to invade enamel and dentine and to destory these structures from the inside before the cavitation phase of caries was demonstrated with gnotobiotic rats. The marked caries reduction among Finnish children and adolescents within the past 20 years appears to be due to a number of factors. [References: 57] <30> UI - 92131808 AU - Banoczy J AU - Nemes J IN - Department of Conservative Dentistry, Semmelweis University of Medicine, Budapest, Hungary. TI - Effect of amine fluoride (AmF)/stannous fluoride (SnF2) toothpaste and mouthwashes on dental plaque accumulation, gingivitis and root-surface caries. SO - Proceedings of the Finnish Dental Society 1991;87(4):555-9 AB - The aim of the study was to assess the effect of a toothpaste and mouthwashes containing amine fluoride (AmF) and stannous fluoride (SnF2) on dental plaque, gingivitis and root-surface caries. Forty-four adults participated in a five-month double-blind study. The following combinations of toothpastes and mouthwashes were used: (1) AmF/SnF2 toothpaste and AmF/SnF2 (Meridol) mouthwash (20 patients, mean age 45.7 years), (2) sodium fluoride (NaF) toothpaste and NaF mouthwash (24 patients, mean age 48.8 years). The mean values for dental plaque (Silness-Loe index) were clinically and statistically significantly reduced in both groups, the difference being greater in the AmF/SnF2 group. Sulcus-bleeding index values were clinically and statistically significantly decreased in both groups. There was no marked difference between the groups. The root caries index (RCl, Katz) had decreased by the end of the experiment by 10% in the NaF group and by 47.4% in the AmF/SnF2 group. <31> UI - 92131806 AU - Seppa L IN - Department of Preventive Dentistry and Cariology, Faculty of Dentistry, University of Kuopio, Finland. TI - Studies of fluoride varnishes in Finland. [Review] [36 refs] SO - Proceedings of the Finnish Dental Society 1991;87(4):541-7 AB - Despite the artificial fluoridation of drinking water in Kuopio, part of the children have high caries incidence. We therefore started our studies on fluoride varnishes in 1977 in an attempt to find a feasible means of applying fluoride topically in children at high risk of caries. In our first trial, the sodium fluoride varnish Duraphat was found to be effective in preventing caries, but the effectiveness of the silane fluoride varnish Fluor Protector could not be unequivocally established, despite the fact that Fluor Protector deposited markedly more fluoride in enamel than Duraphat. In a second study in children in a low-fluoride area, use of Duraphat was found to be more effective than fortnightly fluoride rinses or Fluor Protector. Increasing the frequency of application from two to four times a year did not increase the effectiveness of Duraphat even in highly caries-prone children in a 2-year trial. On the basis of peak values of fluoride in parotid saliva after application, use of either fluoride varnishes was considered safe. Although the fluoride content of the enamel remained elevated for at least two years after discontinuation of treatment with both varnishes, the caries preventive effect did not continue after the applications were stopped. This shows that increasing the fluoride content of enamel is not the main mechanism by which fluoride varnishes prevent caries, and that the applications need to be continued as long as caries is a problem. [References: 36] <32> UI - 92094311 AU - Ostela I AU - Karhuvaara L AU - Tenovuo J IN - Department of Cariology, University of Turku, Finland. TI - Comparative antibacterial effects of chlorhexidine and stannous fluoride-amine fluoride containing dental gels against salivary mutans streptococci. SO - Scandinavian Journal of Dental Research 1991 Oct;99(5):378-83 AB - Forty-five young adults were divided into three groups of equal size and given a professional toothcleaning (3 times during 1 wk) with dental gels containing either chlorhexidine (CHX, 1%), or a SnF2-amine fluoride (AmF) combination (F- content 1.20%). The control group received toothcleaning with a placebo gel. The study was done double blind. The number of salivary mutans streptococci was monitored for 11 wk after the gel treatment using both mitis-salivarius-bacitracin agar plates and the chairside method based on the adhesion of mutans streptococci on plastic strips (Dentocult-SM Strip mutans). Professional toothcleaning with a CHX gel was clearly most effective (P less than 0.001) but the baseline levels of streptococci returned in 11 wk. SnF2-AmF gel also reduced significantly (P less than 0.001) mutans streptococci but recolonization occurred already in 7 wk. Placebo gel, i.e. professional toothcleaning as such, did not show any statistically significant effect on the numbers of salivary mutans streptococci. None of the treatments affected the levels of lactobacilli or the total aerobic flora in saliva samples. Professional toothcleaning with a CHX gel, or with a SnF2-AmF gel, can be regarded as an alternative to the commonly used, but more patience demanding, application of gel in mouth trays at home for individuals with high caries activity. <33> UI - 92071405 AU - Mellberg JR AU - Blake-Haskins J AU - Petrou ID AU - Grote NE IN - Colgate-Palmolive Company, Technology Center, Piscataway, NJ 08854. TI - Remineralization and demineralization in situ from a triclosan/co-polymer/fluoride dentifrice. SO - Journal of Dental Research 1991 Nov;70(11):1441-3 AB - An in situ study was conducted to evaluate the effect of a dentifrice containing 1100 ppm F (NaF) and triclosan, an anti-plaque agent, on remineralization of artificially-formed caries lesions in thin sections of human enamel. The thin sections were placed in mandibular partial dentures of 15 subjects and covered with a steel mesh to provide an area for plaque accumulation. The subjects brushed their teeth and dentures three times daily for two-week periods in a cross-over design, after which the specimens were removed and analyzed by quantitative microradiography for changes in mineral content. Results showed that lesions treated with the triclosan-fluoride product were remineralized 18.0 +/- 23.4% compared with 19.0 +/- 32.3% from a 1100-ppm F (NaF) positive control. Use of a placebo dentifrice resulted in 71.9% demineralization. The findings showed that triclosan neither enhanced nor interfered with the promotion of remineralization by fluoride. <34> UI - 92071398 AU - Sandham HJ AU - Brown J AU - Chan KH AU - Phillips HI AU - Burgess RC AU - Stokl AJ IN - Faculty of Dentistry, University of Toronto, Ontario, Canada. TI - Clinical trial in adults of an antimicrobial varnish for reducing mutans streptococci. SO - Journal of Dental Research 1991 Nov;70(11):1401-8 AB - An abbreviated treatment with a chlorhexidine-containing varnish was compared with a similar treatment with a placebo varnish and with a prophylaxis alone for its effects on the numbers of detectable salivary mutants streptococci in 51 adults. The varnishes, applied once weekly for four weeks, were held in place with a covering layer of either of two polyurethane sealants (FluorProtector or Adhesit). On the first appointment, the varnish-sealant combination was applied to all tooth surfaces, but on succeeding appointments only the occlusal and approximal surfaces were covered. The chlorhexidine varnish, covered with either sealant, reduced the salivary mutans streptococci by an average of 3 logs (99.9%) in all of the 20 subjects treated, and below detectable levels for at least four weeks in nine of them. In the groups receiving placebo varnish-sealant combinations, the mean log number of mutans streptococci of the subjects was reduced only by approximately 0.5 log (32%), and none of the subjects experienced loss of their detectable mutans streptococci for four weeks, although one subject did so for three weeks. No significant difference between the effects of the two polyurethane sealants was observed. Treatment with a single prophylaxis had no effect on mutans streptococcus levels. Subjects treated with chlorhexidine varnish also experienced an increase in S. sanguis and a small decrease in yeasts. Loss of detectable mutans streptococci did not cause changes in the numbers of other micro-organisms examined, beyond those observed with chlorhexidine varnish treatment alone. <35> UI - 92075418 AU - Murray JJ AU - Breckon JA AU - Reynolds PJ AU - Tabari ED AU - Nunn JH IN - Department of Child Dental Health, Dental School, University of Newcastle upon Tyne. TI - The effect of residence and social class on dental caries experience in 15-16-year-old children living in three towns (natural fluoride, adjusted fluoride and low fluoride) in the north east of England. SO - British Dental Journal 1991 Nov 23;171(10):319-22 AB - Caries experience in 1374 children aged 15-16 years from three towns in the north east of England with varying concentrations of fluoride in drinking water, was determined. The mean DMFT values for 15-year-old continuous residents was 1.7 in Hartlepool (natural F 1.0-1.3 ppm), 2.5 in Newcastle (F adjusted to 1.0 ppm) and 3.3 in Middlesbrough (F = 0.2 ppm). Forty per cent of Hartlepool 15-year-olds were caries free, compared with 30% in Newcastle and 24% in Middlesbrough. Caries prevalence for both Hartlepool and Newcastle 'continuous residents' was lower than for non-continuous residents, whereas in Middlesbrough, the low fluoride area, non-continuous residents had a lower DMF value than those who had lived in Middlesbrough all their lives. There was a slight trend in both Newcastle and Middlesbrough for DMFT values to increase from social class I to social class V, but no discernable trend was observed in Hartlepool. The results for Hartlepool 15-year-olds were very similar to those reported by Weaver in 1949. <36> UI - 92067053 AU - Dahllof G AU - Bjorkman S AU - Lindvall K AU - Axio E AU - Modeer T IN - Department of Pedodontics, School of Dentistry, Karolinska Institute, Stockholm, Sweden. TI - Oral health in adolescents with immigrant background in Stockholm. SO - Swedish Dental Journal 1991;15(4):197-203 AB - Dental caries and periodontal health was studied in 225 18- and 19-year-old adolescents with different ethnic background. The results showed that immigrant adolescents exhibit an increased prevalence of periodontal disease compared to the Swedish control group whereas no differences were found concerning the prevalence of dental caries. Alveolar bone loss was diagnosed on one or more surfaces in 4.3% of the Swedish adolescents compared to 16.2% in the immigrant group. Subgingival calculus was found among 5.3% of the Swedish adolescents compared to 35.1% in the immigrant group. This study shows that immigrant adolescents must be considered at high risk to develop periodontal disease during adolescents while dental caries can be managed. <37> UI - 92076747 AU - Sogaard AJ AU - Grytten J AU - Holst D IN - Institute of Community Medicine, University of Tromso, Norway. TI - Recent changes in health related dental behaviors in Norway. SO - Community Dentistry & Oral Epidemiology 1991 Oct;19(5):241-5 AB - There has been a substantial decrease in the prevalence of caries in younger age groups in the western world during the last 15 years. A corresponding increase has been reported regarding use of preventive remedies. Since prevention and control of dental disease is highly dependent upon personal behavior, investigations of dental health behaviors within subgroups of the population are important for future preventive strategies. Occurrence and changes in individual dental health behaviors in Norway were studied through four sets of cross-sectional data collected in 1981, 1983, 1985, and 1987. Personal interviews performed by trained interviewers were held with probability samples, each of about 1400 persons, covering the Norwegian population aged 15 and above. During the 6-yr period the proportion of individuals who brushed their teeth and used fluoride dentifrice every day increased. The number of people who used toothpicks or dental floss every day also increased from 1981 to 1985. A marked decrease was, however, observed in use of interdental remedies from 1985 to 1987. Daily use of dental floss was reduced by 10 percent points. Logistic regression showed that the reduction in the probability of using interdental aids was most pronounced among those with few teeth. Lower importance attached to dental health education, at all levels, combined with difficult economic times since 1987, might account for the decrease in daily use of interdental aids in Norway. <38> UI - 92076756 AU - al-Khateeb TL AU - al-Marsafi AI AU - O'Mullane DM IN - King Abdulaziz University, Jeddah, Saudi Arabia. TI - Caries prevalence and treatment need amongst children in an Arabian community. SO - Community Dentistry & Oral Epidemiology 1991 Oct;19(5):277-80 AB - A total of 1400 Saudi Arabian children in age groups 6-12 and 15 yr in private and public schools were examined for dental caries and treatment need in the cities of Jeddah (less than 0.30 ppm fluoride in drinking water), Rabagh (0.77 ppm F-) and Mecca (2.47 ppm F-). The mean dmft in 6-yr-olds in private schools in Jeddah was 2.9 compared with 6.3 in public schools (P less than 0.001). The d component accounted for 65% of the total dmft in private schools and 76% in public schools in Jeddah. The mean dmft values in private and public schools in Rabagh were 1.5 and 2.8 respectively and 2.7 and 2.8 in Mecca; the d component accounted for approximately 65% in all groups. The figures for permanent teeth in 12- and 15-yr-olds show similar trends with caries levels being the highest in public schools in Jeddah; approximately 60% of the total DMFT was attributable to the D component in both school types in all three cities. Most of the treatment required in all three cities comprised one- or two-surface fillings. The need for treatment was significantly higher in public schools. <39> UI - 92050901 AU - Eisenberg AD AU - Mundorff SA AU - Featherstone JD AU - Leverett DH AU - Adair SM AU - Billings RJ AU - Proskin HM IN - Eastman Dental Center, Rochester, New York. TI - Associations of microbiological factors and plaque index with caries prevalence and water fluoridation status. SO - Oral Microbiology & Immunology 1991 Jun;6(3):139-45 AB - Plaque indices, numbers of mutans streptococci, lactobacilli and total viable flora in plaque and saliva were assessed as part of a large-scale cross-sectional study designed to determine the factors that are associated with high caries activity in children. Subjects, 12 to 15 years old, residing in areas where the water supplies were either fluoridated (n = 140) or fluoride-deficient (n = 173) were studied. Mutans streptococci and lactobacilli numbers in saliva were positively correlated with plaque index. Plaque indices were significantly higher in the high-caries group than in the zero-caries group of the fluoride-deficient community. In the fluoridated community, there was no difference in the plaque index between the zero- or high-caries groups. In each community, pooled dental plaque and saliva harbored fewer mutans streptococci and lactobacilli in the zero-caries than the high-caries group. Greater numbers of mutans streptococci were found in the dental plaque and saliva of the zero-caries subjects in the fluoridated community than in the fluoride-deficient community, suggesting that a greater caries challenge can coexist with zero-caries status in the fluoridated community. <40> UI - 92038190 AU - McCormack-Brown KR AU - McDermott RJ IN - Department of Health Sciences at Western Illinois University, Macomb. TI - Dental caries: selected factors of children at risk. [Review] [49 refs] SO - Dental Assistant (Chicago) 1991 Jul-Aug;60(4):10-4 AB - This article reviews the dental caries risk factors of children by using an epidemiological model which has three interrelated factors--agent, host, and environment. Dental caries agent factors include microorganisms with cariogenic potential; host factors include gender, race, tooth arrangement, sugar consumption, knowledge, attitudes, and behaviors; environmental factors include type of community (rural vs. urban), socioeconomic status, use of dental services and fluoride. This article reviews these selected dental caries risk factors and describes how dental assistants can practically apply this information. [References: 49] <41> UI - 92012598 AU - Pendrys DG IN - Department of Behavioral Sciences and Community Health, University of Connecticut, School of Dental Medicine, Farmington 06030. TI - Dental fluorosis in perspective. SO - Journal of the American Dental Association 1991 Sep;122(10):63-6 AB - The relationship between fluoride in drinking water, caries and fluorosis was established 50 years ago. But additional sources that duplicate or expand fluoride benefits may not carry the same low risk for fluorosis and should be monitored. <42> UI - 92005612 AU - Page DJ IN - Unilever Dental Research, Port Sunlight Laboratory, Bebington, UK. TI - A study of the effect of fluoride delivered from solution and dentifrices on enamel demineralization. SO - Caries Research 1991;25(4):251-5 AB - An in vitro demineralization model has been developed and used to examine the effect of various fluoride treatments on early enamel demineralization. The effect of fluoride treatments on the calcium demineralization rate of enamel was studied by analyzing the amount of calcium which demineralized from teeth into solution when the teeth were exposed to weak acid solutions. Continuous (72 h total) exposure of enamel to very low levels of fluoride, 0.014 ppm, was observed to have a protective effect against demineralization, as was intermittent exposure to higher levels of fluoride delivered from solution and from dentifrices for shorter periods of time (40 min total). This work suggests that the residual salivary fluoride concentrations reported to be reached by water fluoridation (0.016 ppm) or brushing with a fluoride-containing dentifrice (0.014 ppm) give a level of fluoride in saliva which may give some protection to the dental enamel from demineralization. <43> UI - 92005618 AU - Duckworth RM AU - Knoop DT AU - Stephen KW IN - Unilever Dental Research, Port Sunlight Laboratory, Bebington, UK. TI - Effect of mouthrinsing after toothbrushing with a fluoride dentifrice on human salivary fluoride levels. SO - Caries Research 1991;25(4):287-91 AB - In a recent clinical trial of sodium monofluorophosphate dentifrices, oral rinsing habits were found to influence dental caries. Thus an oral fluoride clearance study has been undertaken which was designed to test a possible mechanism for the observed effects. Eight subjects brushed with one of the trial dentifrices and then rinsed using 1 of 8 procedures of varying thoroughness. The salivary fluoride concentration measured 5 min after dentifrice application decreased significantly with increasing rinse volume, rinse duration, and rinse frequency (p less than 0.01, analysis of variance). The area under the clearance curve determined over a further 3 h was significantly higher (300%; p less than 0.01) following use of the least thorough rinsing procedure (5 ml x 2 s once) as compared with the corresponding area under the clearance curve following the most thorough procedure (20 ml x 10 s twice). These findings indicate that rinsing habits may play an important role in the oral retention of fluoride from dentifrices which may, in turn, affect their clinical efficacy. <44> UI - 92019664 AU - Persson RE AU - Truelove EL AU - LeResche L AU - Robinovitch MR IN - Department of Oral Medicine, Health Sciences Center, University of Washington, Seattle. TI - Therapeutic effects of daily or weekly chlorhexidine rinsing on oral health of a geriatric population. SO - Oral Surgery, Oral Medicine, Oral Pathology 1991 Aug;72(2):184-91 AB - The effects of a chlorhexidine rinse on salivary Streptococcus mutans, Lactobacillus, and Candida albicans counts and on periodontal conditions (gingival index, plaque index, pocket depths) were studied in 42 elderly subjects. Under supervision, they rinsed either daily or weekly for 6 weeks with a 0.12% chlorhexidine solution (Peridex). Saliva samples were taken for chemical and microbiologic examinations, and periodontal conditions were assessed at baseline, week 6, and 6 weeks after final rinse. Significantly lower S. mutans counts were found at week 6 for both rinsing groups (p less than 0.001). Lactobacillus and Candida counts were also generally lower at week 6, with the clearest improvement among persons with the highest counts of bacteria and yeast. Periodontal conditions were improved at week 6 (p less than 0.001) in both groups. Such improvements were not maintained 6 weeks after the rinsing regimen was completed. At baseline poor oral conditions were noticed, which placed most of the subjects at risk for tooth decay and periodontal disease. Without any other dental procedures but daily or weekly supervised rinsing, oral conditions were improved and this risk was reduced. Daily rinsing was not superior to weekly rinsing with 0.12% chlorhexidine. <45> UI - 91360311 AU - Griffen AL AU - Goepferd SJ IN - Department of Pediatric Dentistry, Ohio State University College of Dentistry, Columbus. TI - Preventive oral health care for the infant, child, and adolescent. [Review] [23 refs] SO - Pediatric Clinics of North America 1991 Oct;38(5):1209-26 AB - Although we have the knowledge and technology necessary to prevent it, most children experience dental disease, and a few children continue to experience high rates of decay. The appropriateness and effectiveness of preventive measures vary throughout the life of a child, and recommendations should be tailored to the needs of the individual. Water fluoridation continues to be the most cost-effective preventive measure available. For patients who do not have access to fluoridated water, dietary supplementation offers similar benefits. A wide variety of professionally applied and home use topical fluoride products such as dentrifrices, gels, and rinses can also reduce the risk of dental caries, particularly on the smooth surfaces of the teeth. The most common site of decay in children is the fissures of the molar teeth. These areas can be protected by the professional application of plastic sealants. Dietary practices influence caries rates, and patients should be advised to limit the frequency of carbohydrate exposures rather than the total amount of carbohydrates consumed. Parents of infants should be advised to discontinue bottle feeding around the age of 12 months to avoid nursing caries. Although oral hygiene practices are not as effective in reducing caries rates as is generally believed, daily toothbrushing and flossing are unquestionably effective in preventing periodontal disease. In order to be maximally effective, preventive efforts should be initiated early in the life of the child. Although most children experience dental disease, a mouth free of caries and periodontal disease is a potentially attainable goal for all children when they use currently available techniques. [References: 23] <46> UI - 91361239 AU - Clark DC AU - Morgan J AU - MacEntee MI IN - Department of Clinical Dental Sciences, The University of British Columbia, Vancouver. TI - Effects of a 1% chlorhexidine gel on the cariogenic bacteria in high-risk elders: a pilot study. SO - Special Care in Dentistry 1991 May-Jun;11(3):101-3 AB - Root caries in dentate elderly patients is a problem which may be controlled with chlorhexidine. The purpose of this pilot study was to establish the extent and duration of the antimicrobial effects from an intensive regimen of a 1% chlorhexidine gel in institutionalized elders who had experienced high caries activity in the previous year. Stimulated saliva samples from all subjects before treatment produced more than 105 colony forming units/milliliters of Streptococcus mutans (mean: 2.0 x 10(7); s.d.: 2.0 x 10(7)) when diluted and cultured on Mitus Salivarius-bacitracin agar for 48 hours. Findings suggest that daily treatments for 1 week with a 1% chlorhexidine gel can reduce the number of cariogenic bacteria in elderly people for approximately 3 weeks after treatment. <47> UI - 91366473 AU - Ran F AU - Gedalia I AU - Fried M AU - Hadani P AU - Tved A IN - Dental Research Unit, Hebrew University, Hadassah School of Dental Medicine, Jerusalem, Israel. TI - Effectiveness of fortnightly tooth brushing with amine fluorides in caries-prone subjects. SO - Journal of Oral Rehabilitation 1991 Jul;18(4):311-6 AB - The aim of this study was to assess the caries incidence and plaque accumulation in schoolchildren at caries risk, after brushing the teeth fortnightly with gels containing 0, 0.4% F, 1.25% F as amine fluoride (AmF) or the common amine fluoride toothpaste containing 0.125% F. The study was conducted double blind over an 18-month period, and after 6 months discontinuation of brushing. Only the group that brushed with the 1.25% AmF gel showed a significant decrease in caries development compared to the group that brushed with the 0.125% AmF toothpaste. During the 6-month discontinuation period, the incidence of caries increased in all groups; the differences in caries development between all groups were not significant. Plaque indices were significantly lower in the AmF-treated groups. The highest fluoride concentration in the gel reduced the development of caries to zero, probably due to increased fluoride levels in the oral milieu of caries risk children. In order to maintain a positive effect of fluoride over an extended time period, caries-prone subjects should continue an initiated fluoride programme. <48> UI - 91300507 AU - Mellberg JR AU - Petrou ID AU - Fletcher R AU - Grote N IN - Colgate-Palmolive Technology Center, Piscataway, N.J. TI - Evaluation of the effects of a pyrophosphate-fluoride anticalculus dentifrice on remineralization and fluoride uptake in situ. SO - Caries Research 1991;25(1):65-9 AB - Enamel slabs and thin sections with artificially formed caries lesions were placed in the removable dentures of 15 subjects who brushed them three times daily for 2 weeks with a 1.3% pyrophosphate/1,100 ppm F/1.5% Gantrez dentifrice, a 1,100-ppm F dentifrice without pyrophosphate or Gantrez, or a placebo dentifrice in a double-blind, crossover study. Analysis of the thin sections by quantitative microradiography showed that the pyrophosphate/F dentifrice remineralized the lesions 15.9% (p less than 0.05) and the fluoride dentifrice 11.2%, whereas the placebo produced 4.4% demineralization. Fluoride uptake by the enamel slabs was similar for both fluoride dentifrices and significantly greater from the placebo dentifrice (p less than 0.05). The findings suggest that the anticaries mechanisms of fluoride include not only the prevention of demineralization, but also the promotion of remineralization. <49> UI - 91275904 AU - Denes J AU - Gabris K IN - Semmelweis University of Medicine, Budapest, Hungary. TI - Results of a 3-year oral hygiene programme, including amine fluoride products, in patients treated with fixed orthodontic appliances. SO - European Journal of Orthodontics 1991 Apr;13(2):129-33 AB - This paper reports the results of a 3-year study on children treated with fixed orthodontic appliances. They were all regularly instructed in oral hygiene maintenance and used a standardized fluoride-free toothpaste during the course of the study. The patients were divided into three groups. Groups one and two, respectively, had a fluoride gel and fluoride fluid (Elmex amine fluoride products, GABA International Ltd, Basle, Switzerland) applied. Group three used only the toothpaste supplied, had oral hygiene instruction, but not topical applications. Caries increments were lowest and gingival health best in the two groups using amine fluorides, especially the gel group. <50> UI - 91284132 AU - Duckworth RM AU - Morgan SN IN - Unilever Dental Research, Unilever Research Port Sunlight Laboratory, Bebington, UK. TI - Oral fluoride retention after use of fluoride dentifrices. SO - Caries Research 1991;25(2):123-9 AB - Fluoride is the only extensively clinically proven means of reducing dental caries. Despite a large body of epidemiological data on the effectiveness of fluoride, delivered in the form of dentifrices, mouthrinses, drinking water, etc., the precise mode of action of fluoride is not completely understood. The purpose of this paper is to report an investigation of the link between oral fluoride levels and applied fluoride dose from dentifrices. Human salivary fluoride clearance studies and equilibrium baseline studies of fluoride in saliva and plaque have been carried out with dentifrices which contained 1,000, 1,500 and 2,500 micrograms fluoride per gram as sodium monofluorophosphate. After a single brushing with a fluoride dentifrice, salivary fluoride decreased in two distinct phases: an initial rapid phase which lasted for 40-80 min, depending on the individual, and a second slow phase lasting for several hours. The latter phase is believed to be due to fluoride released from an oral fluoride reservoir. During regular repeated use of the test dentifrices, the equilibrium baseline fluoride concentration, attained in both saliva and plaque between one application and the next, increased significantly compared with placebo values. Such elevated baseline fluoride concentrations also increased with increasing Na2FPO3 content of the dentifrices. The present work supports the concept that labile fluoride, stored in an oral fluoride reservoir at the time of treatment application, may maintain a prolonged protective effect against dental caries. <51> UI - 91284133 AU - Raven SJ AU - Schafer F AU - Duckworth RM AU - Gilbert RJ AU - Parr TA IN - Unilever Dental Research, Unilever Research Port Sunlight Laboratory, Bebington, UK. TI - Comparison between evaluation methods for the anti-caries efficacy of monofluorophosphate-containing dentifrices. SO - Caries Research 1991;25(2):130-7 AB - A comparison is described of three methods of preclinical assessment of potential anti-caries efficacy for topical fluoride treatments. Methods are compared using dentifrices containing 1,000, 1,500 and 2,500 ppm F as sodium monofluorophosphate (SMFP). These formulations have been shown elsewhere to give a statistically significant dose response of increasing anti-caries efficacy [Stephen et al., 1988]. An in situ enamel insert model, oral fluoride pharmacokinetics and F uptake to demineralised enamel are all shown to correlate with clinical efficacy for the test dentifrices studied. <52> UI - 91286432 AU - Axelsson P AU - Lindhe J AU - Nystrom B IN - Department of Preventive Dentistry, Public Dental Health Service, Karlstad, Sweden. TI - On the prevention of caries and periodontal disease. Results of a 15-year longitudinal study in adults. SO - Journal of Clinical Periodontology 1991 Mar;18(3):182-9 AB - In 1971-72, a total of 375 adult subjects were recruited for a clinical trial aimed at assessing the effect of a preventive program, based on plaque control and topical application of fluoride, on the incidence of caries and periodontal disease. After a baseline examination, the volunteers were subjected to scaling, root planning and conventional caries therapy. During the course of the subsequent 6 years, they were recalled for preventive measures once every 2-3 months. After the 6-year follow-up examination, however, it was decided to extend the interval between the preventive sessions. Thus, during the next 9-year period, about 95% of the participants returned for preventive measures only 1 to 2 times per year. A small subgroup of about 15 subjects, who, during the initial 6 years had developed new caries lesions or had exhibited additional periodontal attachment loss, however, were also during the following 9 years recalled 3-6 times per year for oral hygiene control and preventive therapy. The re-examination performed in 1987 disclosed that the 317 subjects, who participated during the entire 15-year period, had a low incidence of caries and almost no further loss of periodontal tissue support. It was suggested that improved self performed oral hygiene, daily use of fluoridated dentifrice and regularly repeated professional tooth cleaning effectively prevented recurrence of dental disease. <53> UI - 91300510 AU - Petersson LG AU - Birkhed D AU - Gleerup A AU - Johansson M AU - Jonsson G IN - Medical and Dental Health Center, Halmstad, Sweden. TI - Caries-preventive effect of dentifrices containing various types and concentrations of fluorides and sugar alcohols. SO - Caries Research 1991;25(1):74-9 AB - The caries-inhibiting effect of unsupervised daily use of four different toothpastes was compared in a 3-year clinical and microbiological study: (1) 0.8% sodium monofluorophosphate (MFP) with 3% xylitol and 6% sorbitol; (2) 0.03% sodium fluoride with 3% xylitol and 6% sorbitol; (3) 0.8% MFP with 9% sorbitol, and (4) 0.03% sodium fluoride with 9% sorbitol. In all 284 children, 12-13 years old at baseline, took part in the study. After 3 years, no statistically significant differences were found between the different toothpaste groups concerning either development of initial or gross caries lesions or number of mutans streptococci and lactobacilli in saliva. However, children with no detectable approximal caries at baseline, who used the MFP toothpaste with the xylitol-sorbitol mixture, showed a lower (p less than 0.05) caries increment as compared with children who used the MFP toothpaste with sorbitol alone. <54> UI - 91266562 AU - Russell JI AU - MacFarlane TW AU - Aitchison TC AU - Stephen KW AU - Burchell CK IN - University of Glasgow, Scotland. TI - Prediction of caries increment in Scottish adolescents. SO - Community Dentistry & Oral Epidemiology 1991 Apr;19(2):74-7 AB - Salivary, clinical, and microbiological factors were compared with subsequent 2-yr caries increment in a group of 372 Scottish adolescents. The caries increment was significantly correlated with previous caries experience, salivary buffering capacity and counts of lactobacilli, mutans streptococci and candida. Veillonella levels and salivary flow rate were not correlated with caries increment. Significant improvements in the predictions were obtained when the results of more than one test were included using stepwise regression analysis. On an individual basis, using stepwise discriminant analysis, the caries increment group (low, medium, or high) was identified correctly in 49% of all subjects, but this was reduced to 45% if previous caries experience was excluded from the analysis. <55> UI - 91267748 AU - Cohen S AU - Sarnat H AU - Rakocz Z AU - Amir E IN - Section of Pediatric Dentistry, Maurice and Gabriela Goldschleger School of Dental Medicine, Tel Aviv University, Israel. TI - Increased caries prevalence in adolescents who immigrated from Ethiopia to Israel. SO - Israel Journal of Medical Sciences 1991 May;27(5):297-9 AB - The prevalence of caries in adolescents who immigrated from Ethiopia increased rapidly, the longer their residence in Israel. A total of 159 newly immigrated adolescents, aged 11-19, who lived in small absorption institutions, as well as 52 Ethiopian adolescents and 173 Israeli-born adolescents living together in a larger institution, were examined. Caries was recorded using the DMFT index, which indicates caries experience. The mean caries prevalence (DMFT) of the newly immigrated Ethiopians was 0.49 and of those residing in Israel 12-24 months was 1.76. The caries rate was highest in the Israeli group (DMFT-10.0). The percentages of caries-free individuals were 10.0% for the Israelis, 58.8% for the Ethiopians who immigrated earlier and 81.8% for the newly immigrated. The abrupt change in dietary habits seems to have created a new high risk caries group. Caries preventive measures, the use of fluoride products, and patient education and motivation are urgently required. <56> UI - 91225920 AU - Ripa LW IN - Department of Children's Dentistry, School of Dental Medicine, State University of New York, Stony Brook 11794-8701. TI - A critique of topical fluoride methods (dentifrices, mouthrinses, operator-, and self-applied gels) in an era of decreased caries and increased fluorosis prevalence. [Review] [185 refs] SO - Journal of Public Health Dentistry 1991 Winter;51(1):23-41 AB - Within the last 20 years there has been a decrease in the caries prevalence of US schoolchildren, a change in the intraoral caries pattern, and a slowing of the progress of lesions. Simultaneously, the prevalence of enamel milder, cosmetically acceptable forms and is more noticeable in fluoride-deficient communities than those with optimal or above-optimal water fluoride concentrations. Circumstantial evidence indicates that a principal contributor to the caries decline is the extensive use of fluoride dentifrices. Conversely, although use of a fluoride dentifrice can add to the total daily amount of ingested fluoride in preschool children, there is little evidence to suggest that dentifrice ingestion is a principal factor causing the fluorosis increase. The value of fluoride methods may be assessed in relative or absolute terms. The relative, or percentage, caries reduction attributed to fluoride mouthrinses and gels appears to be a property intrinsic to the methods themselves and generally is little affected by the caries activity of the population being treated. Conversely, the absolute, or numerical, caries reduction is dependent upon the level of disease in the population. Thus, the reported caries decline reduces the number of surfaces prevented from developing caries, even though the percentage reduction remains substantially unchanged. Although inadvertent ingestion of fluoride can result from the use of mouthrinses and gels, there is little evidence to suggest that they have contributed to the fluorosis increase. When using topical methods, prudence should prevail to avoid ingestion of fluoride. Fluoride dentifrices should continue to be used routinely, and although lower potency dentifrices may be considered, the literature does not provide strong support for their need. Use of fluoride mouthrinses and gels for individual patients should be predicted upon their caries activity or risk. Use of these methods in public health programs is a matter of cost-effectiveness, which will be influenced by the caries prevalence of the target population. [References: 185] <57> UI - 91163913 AU - Epstein JB AU - McBride BC AU - Stevenson-Moore P AU - Merilees H AU - Spinelli J IN - Cancer Control Agency of British Columbia, Vancouver, Canada. TI - The efficacy of chlorhexidine gel in reduction of Streptococcus mutans and Lactobacillus species in patients treated with radiation therapy. SO - Oral Surgery, Oral Medicine, Oral Pathology 1991 Feb;71(2):172-8 AB - Xerostomia may develop in patients with cancer who receive radiotherapy that includes the salivary glands in the field. These patients are at high risk of rampant dental caries. Streptococcus mutans and Lactobacillus species have been associated with dental caries. Quantitative counts of these organisms demonstrated high caries risk due to streptococci in 66% and due to lactobacilli in 100% of patients studied. Use of chlorhexidine rinse was shown to reduce S. mutans counts 1.1 logs and lactobacilli 1.1 logs. The use of chlorhexidine gel resulted in a reduction of S. mutans 1.2 logs and lactobacilli 2.2 logs. In the subjects using the rinse, caries risk due to streptococci was reduced to low levels in 44% and due to lactobacilli in only one subject, with reduction to moderate risk in one third and no change in risk in the remaining patients. The use of chlorhexidine gel was found to reduce the caries risk associated with streptococci to low levels in all patients, and the risk associated with lactobacilli to low and moderate risk in two thirds of patients. <58> UI - 91118921 AU - Rezk-Lega F AU - Ogaard B AU - Arends J IN - Department of Orthodontics, Dental Faculty, University of Oslo, Norway. TI - An in vivo study on the merits of two glass ionomers for the cementation of orthodontic bands. SO - American Journal of Orthodontics & Dentofacial Orthopedics 1991 Feb;99(2):162-7 AB - The purpose of this study was to investigate the cariostatic effect of two glass ionomer cements on in vivo demineralization of partly uncovered enamel beneath orthodontic bands. A 4-week clinical trial was conducted on a group of five patients with nine pairs of premolars to be extracted for orthodontic purposes. Specially designed orthodontic bands were cemented with either Ketac-Cem (K-C) or Aqua-Cem (A-C). A local cariogenic milieu was created between the buccal surface of the premolars and the inner surface of the bands to secure plaque accumulation. The mineral content of the teeth was quantified by microradiography. The data were compared with data from a previous study of patients in the same age group with bands that had been cemented with a non-F cement. After comparison with the non-F group, the lesion depth (ld) was reduced by 63% for K-C and by 55% for A-C. This reduction was statistically significant at the 2.5% level (t test). The total mineral loss in teeth cemented with glass ionomer cements (delta Z) was reduced, in comparison with the loss in teeth cemented with non-F cement, by 49% with K-C and by 27% with A-C. The differences were statistically significant only for the K-C group (t test, p less than 0.025). There were no significant differences between the two glass ionomer cements with respect to either lesion depth or total mineral loss values (paired t test; p greater than 0.05). This investigation shows that fluoride released from glass ionomer cements contributes substantially to demineralization "reduction." However, these cements do not provide complete caries protection in sites where access is difficult. <59> UI - 91123519 AU - Schaeken MJ AU - Keltjens HM AU - Van Der Hoeven JS IN - Institute of Preventive and Community Dentistry, University of Nijmegen, The Netherlands. TI - Effects of fluoride and chlorhexidine on the microflora of dental root surfaces and progression of root-surface caries. SO - Journal of Dental Research 1991 Feb;70(2):150-3 AB - The effects of fluoride and chlorhexidine varnishes on the microflora of dental root surfaces and on the progression of root-surface caries were studied. Forty-four patients, surgically treated for advanced periodontal disease, were distributed at random among three groups. All patients received a standardized preventive treatment. Furthermore, the dentition of the patients in the two experimental groups was treated, at three-month intervals, with chlorhexidine and fluoride varnish, respectively. Patients in the control group received no additional treatment. In the experimental groups, plaque samples were collected from selected sound and carious root surfaces at baseline and at three, six, and nine months after the onset of the study. The presence of root-surface caries was scored at baseline and after one year. In addition, the texture, depth, and color of the root-surface lesions were monitored. Mutans streptococci on root surfaces were suppressed significantly (p less than 0.05) during the whole experimental period in the chlorhexidine varnish group, but not in the fluoride varnish group. A non-significant increase in the number of Actinomyces viscosus/naeslundii was noted after treatment with chlorhexidine and fluoride varnish. The increase in the number of decayed and filled root surfaces after one year was significantly lower in the experimental groups than in the control group. After treatment with chlorhexidine varnish, significantly more initial root-surface lesions had hardened than in the other groups. <60> UI - 91357231 AU - Rugg-Gunn AJ AU - Murray JJ IN - The Dental School, Newcastle upon Tyne. TI - Current issues in the use of fluorides in dentistry. SO - Dental Update 1990 May;17(4):154-8 AB - Britain, along with many other developed countries, has experienced a dramatic decline in prevalence of dental caries. This has been attributed to the widespread use of fluoride toothpastes, which has done much to improve children's dental health. Studies indicate that fluoridation of water supplies would confer an additional benefit to dental public health, while other fluoride vehicles (mouthrinses, topical gels and varnishes, tablets and drops) are valuable in preventing caries in high-risk patients. The authors review the issues involved. <61> UI - 91262860 AU - Ljungberg G AU - Birkhed D IN - Department of Cariology, Faculty of Odontology, University of Goteborg, Sweden. TI - Dental caries in players belonging to a Swedish soccer team. SO - Swedish Dental Journal 1990;14(6):261-6 AB - Since dental caries is associated with frequent use of sugar-containing products and since there is a potential risk for such a consumption among sportsmen, we conducted a clinical study of a group (n = 30) of 17-30-year old elite soccer players, including DFS and various caries-related factors, such as plaque index, numbers of cariogenic microorganisms in saliva and sugar intake frequency. Each player was asked to identify one friend of the same age, sex and social background but not active in any sport (n = 28). The mean values for DFS, plaque index, mutans streptococci and lactobacilli were less favourable for the players, but none of the differences were statistically significant, except for the dietary score (p less than 0.05). Thus, soccer players on an elite level seem to have a somewhat higher risk to develop dental caries than nonplayers. However, their regular use of fluoride-containing toothpaste probably to some part compensates for this increased risk. <62> UI - 91207112 AU - Winter GB IN - Department of Children's Dentistry, Eastman Dental Hospital, London, England. TI - Epidemiology of dental caries. [Review] [87 refs] SO - Archives of Oral Biology 1990;35 Suppl:1S-7S AB - The most recent epidemiological data on the prevalence of dental caries in children indicate a halting of the increasing levels in many developing countries and a continuing decrease in many highly industrialized countries of the world. However, a further fall in caries levels predicted for 5-yr-old children in the U.K. has not occurred and the decline in caries may have begun to level out. 'Polarization' of caries to a minority of high-risk individuals is occurring in the developed world, with 20-25% of children accounting for more than 50% of the disease. Socio-economic factors are important in determining the proportion of high-risk children in these countries. The multifactorial aetiology of caries allows a number of different interpretations to account for changes in the prevalence of the disease with time, in both the developing and developed countries. These changes are variously ascribed to alterations in dietary habits, especially the consumption of sugar; variations in the patterns of oral hygiene; increased contact with trace elements, especially fluoride, in the environment; changes in the ecology and/or virulence of oral and dental plaque microflora and alterations in the oral protective mechanisms including the immune status. The epidemiological evidence available on the relationship of all these social, environmental and other factors to changes in the prevalence levels of caries does not, however, fully explain all the changes that have been observed. The claim that caries is no longer a public health problem is premature, as it ignores the still high proportion of individuals with tooth decay throughout the world. [References: 87] <63> UI - 91158597 AU - Walsh LJ AU - Seow WK IN - Department of Social and Preventive Dentistry, University of Queensland. TI - Fermentable simple sugars in self-administered medications as aetiologic agents in rampant caries. Case report. SO - Australian Dental Journal 1990 Oct;35(5):419-25 AB - Sucrose is recognized as the most cariogenic carbohydrate. However, other simple sugars may act as substrates for cariogenic micro-organisms. The clinical features of an adult patient suffering from rampant caries are described. It was considered that the predominant aetiologic factor was prolonged intake of mineral supplements which contained the disaccharide lactose. The principal caries risk factors included drug-induced xerostomia and prolonged contact time with the substrate in a retentive form. Chemical analysis of the products revealed the presence of lactose together with starch or glucose. A strategy for preventive management prior to restorative therapy based on chlorhexidine and fluoride-containing products was followed. Possible contributions of sugar-containing medications to caries risk status are discussed. <64> UI - 91145973 AU - Arends J AU - Ruben JL AU - Christoffersen J AU - Jongebloed WL AU - Zuidgeest TG IN - Laboratory for Materia Technica, University of Groningen, The Netherlands. TI - Remineralization of human dentine in vitro. SO - Caries Research 1990;24(6):432-5 AB - In this paper the in vitro remineralization of human dentine with 0, 0.5, 2 and 10 ppm F in the remineralization solution is presented and analyzed by microradiography. Furthermore, the remineralization data of human and bovine dentine are quantitatively compared. The main results of this paper are: (1) the efficacy of human (and bovine) remineralization is about proportional to the square root of the F level in the remineralizing solution, and (2) the amount of mineral effectively deposited in the dentine is most likely controlled by the diffusion of fluoride into the tissue. This study shows furthermore that although numerical differences exist in the remineralization of human and bovine dentine, the general remineralization behaviour is quite similar. The presence of F- in the parts per million range is essential for the remineralization efficacy in vitro and also for the 'overremineralization' of the outer dentine surface. <65> UI - 91168006 AU - Angelillo IF AU - Romano F AU - Fortunato L AU - Montanaro D IN - Institute of Hygiene, Medical School, University of Reggio Calabria, Catanzaro, Italy. TI - Prevalence of dental caries and enamel defects in children living in areas with different water fluoride concentrations. [Review] [30 refs] SO - Community Dental Health 1990 Sep;7(3):229-36 AB - The prevalences of dental caries and developmental enamel defects were assessed in 643 randomly selected children aged 11 to 13 years who were lifelong residents of three areas of Naples with high (4 ppm), optimal (1 ppm), and low (0.3 ppm) concentrations of fluoride in their drinking water. The children living in the high fluoride area had significantly lower dental caries scores (DMFT 0.59, DMFS 1.01) than those in the optimal fluoride area (DMFT 1.67, DMFS 2.87) and those in the low fluoride area (DMFT 1.97, DMFS 3.48). The FDI index of developmental defects of dental enamel (DDE) was used to record enamel defects. There was a significant increase in the number of children with at least one tooth affected by an enamel defect as the fluoride level in their drinking water increased; the prevalences were 9.8 per cent in the low fluoride area, 23 per cent in the optimal area and 53.1 per cent in the high fluoride area. The prevalences of teeth affected were 2.2 per cent in the low fluoride area, 5.7 per cent in the optimal, and 20.3 per cent in the high. Demarcated opacities were the most common defect seen. Diffuse opacities were found to be the discriminating factor between fluoride and non-fluoride areas. In the high fluoride area 64.3 per cent of children with enamel defects had at least six teeth affected. In the maxilla the central incisors were the most affected teeth followed by the second and first premolars; in the mandible the first premolars and first molars were the most affected teeth. [References: 30] <66> UI - 91114088 AU - Ismail AI AU - Brodeur JM AU - Kavanagh M AU - Boisclair G AU - Tessier C AU - Picotte L IN - Faculty of Dentistry, Dalhousie University, Halifax, Canada. TI - Prevalence of dental caries and dental fluorosis in students, 11-17 years of age, in fluoridated and non-fluoridated cities in Quebec. SO - Caries Research 1990;24(4):290-7 AB - The purpose of this study was to evaluate the difference in dental caries and fluorosis prevalence in 936 randomly selected life-long residents selected from public and private schools in Trois-Rivieres (1.0 ppm F in 1987) and Sherbrooke (less than 0.1 ppm F), Que., Canada. Students, 11-17 years of age, were examined for dental caries using the National Institute for Dental Research criteria and for dental fluorosis using the Tooth Surface Index of Fluorosis. Because of an inconsistent fluoridation history in Trois-Rivieres, comparisons were carried out between two age strata: students 11-14 years of age who consumed for a longer duration suboptimally fluoridated water than those in the second stratum: students 15-17 years of age. Only public school students, 15-17 years of age, from Trois-Rivieres had significantly lower mean filled surface and decayed, missing, and filled tooth surface (DMFS) scores (28 and 24%, respectively) than similar students in Sherbrooke. Among private school students, differences were not found, except in the youngest age group in Sherbrooke who had significantly lower mean DMFS than similar students from Trois-Rivieres. The prevalence of fluorosis was 45.6% and 58.0% in Trois-Rivieres public and private schools, respectively, and 31.1% and 30.1% in Sherbrooke public and private schools, respectively. The use of fluoride tablets was significantly associated with fluorosis. This study showed that water fluoridation benefitted students from public schools and that the risk factors for dental fluorosis were the use of fluoridated water and fluoride tablets. <67> UI - 91114077 AU - Hallgren A AU - Oliveby A AU - Twetman S IN - Medical and Dental Health Center, Halmstad, Sweden. TI - Salivary fluoride concentrations in children with glass ionomer cemented orthodontic appliances. SO - Caries Research 1990;24(4):239-41 AB - Salivary fluoride concentrations were determined in 10 children (mean age 12.0 years) undergoing fixed orthodontic therapy. The orthodontic appliances, a minimum of 4 bands and 8 brackets, were cemented with a glass ionomer cement. Unstimulated whole saliva was collected 4 times a day before (baseline value) and at 1, 7, 14 and 28 days after cementation. The samples of saliva were centrifuged and the supernatants were analyzed with a fluoride-sensitive electrode. At baseline, the mean salivary fluoride concentration was 0.85 mumol/l. There was a significant increase during the day after cementation (1.88 mumol/l). After 7, 14 and 28 days, salivary fluoride levels were slightly elevated, but not statistically different from the baseline values. The ingested fluoride dose during the 1st day was estimated to be 0.02 mg. It is concluded that in orthodontic treatment with fixed appliances, a slow release of fluoride from glass ionomer cements could exert a local cariostatic effect on adjacent caries-susceptible enamel. <68> UI - 91084811 AU - Keltjens HM AU - Schaeken MJ AU - van der Hoeven JS AU - Hendriks JC IN - Department of Oral Function and Prosthetic Dentistry, University of Nijmegen, The Netherlands. TI - Caries control in overdenture patients: 18-month evaluation on fluoride and chlorhexidine therapies. SO - Caries Research 1990;24(5):371-5 AB - The aim of this study was to test the clinical effects of preventive regimens using fluoride and chlorhexidine on caries development in abutment teeth in patients with overdentures. 30 patients with immediate overdentures were distributed at random among three experimental groups. In these groups three different gels (placebo, fluoride, and chlorhexidine-fluoride) were tested by daily application. The patients were recalled at 6-month intervals for a period of 18 months. The life table survival ratios at patient level showed that in the chlorhexidine group caries development in the abutments was significantly reduced. In this group no caries developed. On comparison with the control group (placebo), no preventive effects of the gel were noticed for those in the fluoride group. <69> UI - 91075337 AU - Kallestal C AU - Holm AK AU - Ollinen P IN - Department of Pedodontics, University of Umea, Sweden. TI - Dental health in 13-year-olds in Vasterbotten County, Sweden. Changes over twenty years. SO - Swedish Dental Journal 1990;14(4):193-200 AB - An epidemiological study of the prevalence of dental caries and gingivitis in 13-year-olds was carried out in the county of Vasterbotten, Sweden, in 1987. Besides providing information on the dental health of this age group, prevalence data were compared with data from earlier surveys of the same age group carried out in 1967 and 1977, covering the same areas and applying the same diagnostic criteria and methods. The results showed a marked decrease in the prevalence of caries and gingivitis. The mean number of DMF surfaces was 4.6, compared to 9.0 in 1977 and 19.0 in 1967. The mean GBI% was reduced from 33% to 21% between 1977 and 1987. In contrast to the results from 1967 and 1977 the differences in mean DMF values between the three areas were nonsignificant in 1987. The decline in dental caries is most probably due to an extended regular dental care with a strong preventive approach. Only slight differences in dental health were found between the three areas in 1987 in contrast to in 1977 and 1967. The most likely reason was probably that larger resources had been allocated to preventive programmes in the rural areas than in the city of Umea. <70> UI - 90362385 AU - Chovanec GK AU - Majerus GJ AU - Duffy MB AU - Bernet JK AU - Frazier PJ AU - Newell KJ IN - Program in Dental Hygiene Normandale Community College, Bloomington, MN 55431. TI - Dental hygienists' knowledge and opinions about fluorides and fluoridation. SO - Journal of Public Health Dentistry 1990 Summer;50(4):227-34 AB - This article reports results of a study of 563 practicing Minnesota and Wisconsin dental hygienists' knowledge and opinions about fluorides and water fluoridation. Two independent samples were selected randomly from the populations of licensed dental hygienists residing in the two states. Data were collected using a pretested, 42-item, mailed questionnaire. An 84 percent response was achieved with two followup reminders. These data provide baseline information about the caries prevention knowledge and attitudes of practicing dental hygienists in two states. Respondents from both states held similar levels of knowledge about fluorides and opinions about decision making on fluoridation. Fluoride topics, especially water fluoridation, were not receiving high priority in patient education, although nearly all believed that dental hygienists should promote water fluoridation actively. Two-thirds of respondents from both states believed fluoridation decisions should be made by health authorities, rather than by elected officials or through public vote. Greater attention to patient education about fluoride and community water fluoridation is needed by dental hygienists. <71> UI - 90335680 AU - al-Khateeb TL AU - Darwish SK AU - Bastawi AE AU - O'Mullane DM IN - King Abdulaziz University, Medical School Dental Unit, Jeddah, Saudi Arabia. TI - Dental caries in children residing in communities in Saudi Arabia with differing levels of natural fluoride in the drinking water. SO - Community Dental Health 1990 Jun;7(2):165-71 AB - Children aged 6, 12 and 15 years were examined for dental caries in three cities in Saudi Arabia, with varying levels of naturally occurring fluoride in the drinking water; Jeddah (less than 0.3 ppm), Rabagh (0.8 ppm) and Mecca (2.5 ppm). For each age group, caries levels were considerably higher in Jeddah than in Rabagh or Mecca. Occlusal surfaces were most frequently affected. Children attending public schools experienced a considerably higher caries prevalence than those attending private schools. All age groups had high levels of untreated dental decay. Preliminary results indicate that residents of Mecca exercise unacceptable levels of dental fluorosis. <72> UI - 90352946 AU - Stockwell AJ AU - Medcalf GW AU - Rutledge GJ AU - Holman CD AU - Roberts M IN - Health Department of Western Australia, Perth. TI - Dental caries experience in schoolchildren in fluoridated and non-fluoridated communities in Western Australia. SO - Community Dentistry & Oral Epidemiology 1990 Aug;18(4):184-9 AB - A cross-sectional survey was undertaken in 1987 to measure the difference in caries experience in schoolchildren between a fluoridated (0.8 mg/L F-) and a non-fluoridated region (0.1-0.4 mg/L F-). 3436 children aged 5-15 yr were examined. Children in the non-fluoridated region had a higher caries experience than those in the fluoridated region. Mean differences were 1.06 dfs (95% CI = 0.66 to 1.47, P less than 0.001) and 0.48 DFS (95% CI = 0.23 to 0.72, P less than 0.001). After adjusting for potential confounding factors (fluoride tablet consumption, socioeconomic status, number of fissure-sealed surfaces, and mobility between regions) the relative risk of not being caries-free in the non-fluoridated region compared with the fluoridated region was 1.43 (95% CI = 1.21-1.70, P less than 0.0001) for the primary dentition and 1.39 (95% CI = 1.18-1.63, P less than 0.0001) for the permanent dentition. <73> UI - 90291275 AU - Rugarabamu P AU - Frencken JE AU - Amuli JA AU - Lihepa A IN - Department of Preventive and Community Dentistry, University of Dar es Salaam, Tanzania. TI - Caries experience amongst 12- and 15-year-old Tanzanian children residing on a sugar estate. SO - Community Dental Health 1990 Mar;7(1):53-8 AB - A study to assess the caries experience in 12- and 15-year-old children living on a sugar estate was carried out in Kilombero, Tanzania. The average sugar distribution figure per capita per year was estimated to be six times higher for the estate population than for the Tanzanian population at large. No restorations were found. The mean DMT scores (+/- SD) for 12- and 15-year-old children were 0.48 +/- 0.82 and 1.02 +/- 1.61 respectively. The mean DMT score in 12-year-old children did not differ significantly from results recently reported in other Tanzanian studies carried out on the same age groups. The data suggest that care should be taken in explaining changes in caries prevalence over time on the basis of sugar sales figures alone. <74> UI - 90267312 AU - Carr LM TI - Fluoridation: the Brisbane fallacy [letter]. SO - Australian Dental Journal 1990 Apr;35(2):191-2 <75> UI - 90254734 AU - Huizinga ED AU - Ruben J AU - Arends J IN - Materia Technica, University of Groningen, The Netherlands. TI - Effect of an antimicrobial-containing varnish on root demineralisation in situ. SO - Caries Research 1990;24(2):130-2 AB - The effect of an antimicrobial-containing varnish on root demineralisation was investigated. The in situ demineralisation effect on the varnish, with or without the active ingredients chlorhexidine and thymol, was measured by means of microradiography in comparison with no application after a 2-week period in vivo. Furthermore, the effect of one or two applications was investigated by the 10 participants who carried sound intact roots in an appliance for four consecutive 2-week periods. In each period, different roots were mounted in the buccal flanges of a lower prosthesis, the experiment being of a randomized cross-over design. The results show that: (1) A single varnish treatment with active ingredients reduced lesion depth and mineral loss by about 77 and 82%, respectively. (2) The control varnish had no effect, and it can be concluded that antimicrobial-releasing varnishes are promising materials for root caries prevention. <76> UI - 90260576 AU - Seppa L AU - Tolonen T IN - Faculty of Dentistry, University of Kuopio, Finland. TI - Caries preventive effect of fluoride varnish applications performed two or four times a year. SO - Scandinavian Journal of Dental Research 1990 Apr;98(2):102-5 AB - The efficacy of Duraphat varnish applications performed two or four times a year was compared in a 2-yr clinical trial. 254 children aged 9-13 yr and having higher than average DMFS values participated in the study. The children were randomly divided into two treatment groups. Clinical and radiographical examinations were performed at baseline and after 2 yr by one dentist. For the group receiving applications every 3 months, the 2-yr DMFS increment was 2.90 (SD 4.45) and for the group receiving applications every 6 months, 2.92 (4.47). There were no significant differences in DMFS increments between the groups for any type of tooth surfaces. Neither was there any difference between the groups when the children were divided into two subgroups on the basis of baseline DMFS values. The increments for the children with high (greater than or equal to 10) baseline DMFS values were 4.25 (4.81) and 4.30 (5.53) in the groups receiving applications four times and twice a year, respectively. The results suggest that fluoride varnish applications performed more frequently than twice a year may not provide additional caries protection in a population with relatively low caries activity. <77> UI - 90259141 AU - Wright WE IN - National Institute of Dental Research, National Institutes of Health, Bethesda, MD 20892. TI - Pretreatment oral health care interventions for radiation patients. SO - NCI Monographs 1990;(9):57-9 AB - Individuals undergoing head and neck radiation treatments and cytotoxic chemotherapy for cancer are at risk for a variety of deleterious oral side effects. This added potential for oral problems places the cancer patient in a special category for oral health care management. Pretreatment intervention regimens directed at the supporting tissues of the teeth can effectively remove dental calculus deposits and cementum-imbedded bacterial toxins and reverse the inflammatory state of the periodontium back to normal. A variety of patient-applied fluoride agents are extremely effective in preventing severe radiation-associated dental decay, which is likely to occur after salivary gland dysfunction. Deficiencies in current patient management protocols and areas of current research are noted. Two essentials for a successful patient management program are emphasized: early referral of the patient to a knowledgeable dental team to ensure pre-cancer treatment oral health care intervention and long-term maintenance, and a family-oriented education and motivation program to enhance patient understanding and compliance. <78> UI - 90254736 AU - Hargreaves JA AU - Cleaton-Jones PE IN - Faculty of Dentistry, University of Alberta, Edmonton, Canada. TI - Dental caries changes in the Scottish Isle of Lewis. SO - Caries Research 1990;24(2):137-41 AB - The Scottish Isle of Lewis has an island community which traditionally is a stable population that has little migration of its school children. The island has low levels of fluoride (less than 0.1 ppm) in the drinking water supplies, but the island inhabitants have the availability of all UK commodities. The island has well detailed dental data going back to 1937. The present study (1987) examined dental caries and oral hy