Database: MEDLINE <: biomedical, nursing & dental literature, 1966 - Aug 2000.> Search Strategy (You Saved Citations 1-300 From Set 100): ----------------------------------------------------------------------------- 1 exp Tooth demineralization/ 22524 2 demineralization.mp. 1607 3 caries.mp. 15186 4 caires.mp. 1 5 craies.mp. 0 6 careis.mp. 4 7 carise.mp. 0 8 (teeth adj3 cavit:).mp. 420 9 (tooth adj3 cavit:).mp. 216 10 (dental adj3 cavit:).mp. 275 11 (dentin adj3 cavit:).mp. 251 12 (enamel adj3 cavit:).mp. 180 13 (teeth adj3 decay:).mp. 367 14 (tooth adj3 decay:).mp. 319 15 (dental adj3 decay:).mp. 246 16 (dentin adj3 decay:).mp. 12 17 (enamel adj3 decay:).mp. 20 18 (active adj decay).mp. 9 19 (rampant adj3 decay:).mp. 14 20 (recurrent adj3 decay:).mp. 30 21 (white adj spot:).mp. 504 22 carious.mp. 2063 23 cariology.ti,ab. 56 24 (non-cavitated adj3 lesion:).mp. 15 25 (noncavitated adj3 lesion:).mp. 2 26 Tooth remineralization/ 469 27 (dental adj3 fissure:).mp. 98 28 (tooth adj3 fissure:).mp. 50 29 (teeth adj3 fissure:).mp. 97 30 caries-free.mp. 596 31 cariesfree.mp. 17 32 Cariogenic agents/ 728 33 precavit:.mp. 8 34 (filled adj3 teeth).mp. 505 35 (filled adj3 tooth).mp. 115 36 (oral adj fissure:).mp. 6 37 (tooth adj3 remineraliz:).mp. 28 38 (teeth adj3 remineraliz:).mp. 24 39 dft.mp. 407 40 dfs.mp. 1240 41 dmf:.mp. 6343 42 cariogeni:.mp. 1777 43 or/1-42 32060 44 Sweetening agents/ 1675 45 exp Oligosaccharides/ 41781 46 exp Monosaccharides/ 104653 47 exp Carbonated beverages/ 436 48 Rehydration solutions/ 578 49 sugar:.mp. 38544 50 sucrose:.mp. 34367 51 disaccharide:.mp. 7089 52 monosaccharide:.mp. 8999 53 fructose:.mp. 19685 54 glucose:.mp. 199476 55 HFCS.mp. 63 56 "corn syrup:".mp. 92 57 sweet:.mp. 6020 58 confection:.mp. 277 59 honey:.mp. 3000 60 candy.mp. 629 61 candies.mp. 81 62 "sports drink:".mp. 42 63 maltose:.mp. 5020 64 polysaccharide:.mp. 31394 65 oligosaccharide:.mp. 19066 66 trisaccharide:.mp. 2475 67 hexose:.mp. 10688 68 fucose:.mp. 6371 69 galactose:.mp. 20531 70 mannose:.mp. 14265 71 rhamnose:.mp. 1866 72 sorbose:.mp. 442 73 exp Dietary carbohydrates/ 14087 74 or/44-73 357853 75 random:.mp. 216766 76 Odds ratio/ 11087 77 cohort:.mp. 49176 78 (case$1 adj control:).mp. 19668 79 risk:.mp. 407626 80 (odds adj ratio:).mp. 18411 81 causa:.mp. 39412 82 predispos:.mp. 29522 83 randomized controlled trial.pt. 130891 84 controlled clinical trial.pt. 53555 85 exp risk/ 223805 86 practice guideline.pt. 4605 87 exp epidemiologic studies/ 527882 88 follow-up.mp. 208245 89 (panel adj stud:).mp. 299 90 randomized controlled trial.mp. 3661 91 controlled clinical trial.mp. 2649 92 practice guideline.mp. 337 93 et.fs. 1103001 94 or/75-93 2078784 95 43 and 74 3076 96 limit 95 to (human and english language and yr=1980-2000) 1243 97 limit 96 to (preschool child < 2 to 5 years > or child < 6 814 to 12 years > or adolescence < 13 to 18 years > or adult < 19 to 44 years > or middle age < 45 to 64 years > or "aged < 65 and over >" or "aged, < 80 and over >") 98 94 and 97 485 99 "85198509".ui. 1 100 98 or 99 485 101 from 100 keep 1-300 300 *************************** <1> UI - 20268401 AU - Parajas IL IN - Dept. of Health, Policy and Administration, College of Public Health, University of the Philippines, Manila. TI - Sugar content of commonly eaten snack foods of school children in relation to their dental health status. SO - Journal of the Philippine Dental Association 1999 Jun-Aug;51(1):4-21 AB - Sugar is the principal substrate for micro-organisms causing dental caries. Yet it is impossible to eliminate sugar in the diet as almost all available foods particularly snack foods contain sugar. WHO recommended 10 kg. sugar or 27.40 gms. per person per year in non-fluoridated area and 15 kg. sugar/person year in non-flouridated areas for low caries prevalence. The FFQ and 24-Hour Food recall of 824 rural and urban schoolchildren showed that all their snacks foods are high in sugar except gelatine. Their sugar intake was three times more than the WHO recommendation with a mean daily intake of 90 gms. for urban and 88 grams of sugar for the rural. White sugar, hard candies, raisins, coco jam, and milk choco were the five most commonly eaten snack foods with high sugar content. Oral examination of the schoolchildren showed that dental caries was higher in the urban than in the rural. As a whole, the urban schoolchildren consumed more sugar and had higher dental caries compared to the rural schoolchildren. No significant correlation was found between sugar intake and dental caries. <2> UI - 20200898 AU - Peretz B AU - Faibis S AU - Ever-Hadani P AU - Eidelman E IN - Department of Pediatric Dentistry, Hebrew University, Hadassah School of Dental Medicine, Jerusalem, Israel. TI - Dental health behavior of children with BBTD treated using general anesthesia or sedation, and of their parents in a recall examination. SO - ASDC Journal of Dentistry for Children 2000 Jan-Feb;67(1):50-4, 9 AB - The aim of the study was to assess the dental status and dental health behavior of children with Baby Bottle tooth Decay treated using general anesthesia or sedation, and the dental health behavior of their parents in a recall examination. The study population consisted of sixty-five children, among whom thirty-four were treated using general anesthesia and thirty-one using sedation. The recall examination included a full dental examination from which the children's dif index could be drawn. Loe's plaque index was used to assess the amount of plaque on the teeth. Sociodemographic information and the dental health behavior of the parents and children were obtained. Plaque index was similar in the general anesthesia and sedation groups. The parents of the general anesthesia group were younger than the parents of the sedation group (35.0 +/- 6.7 and 38.8 +/- 6.2 for the fathers, and 32.4 +/- 5.9 and 34.9 +/- 5.3 for the mother, respectively). More firstborn children were treated using general anesthesia than using sedation. Significantly more siblings were treated in the sedation group. Children treated using sedation had significantly more siblings treated in the same mode. Parents of the children in the general anesthesia group were significantly more involved in brushing their children's teeth than the other group. In the sedation group, more children brush their teeth without parental help. Significantly more children in the general anesthesia group reduced their sweet consumption than in the sedation group. We conclude that preventive behaviors were more frequently adopted among the families of children treated using general anesthesia. <3> UI - 20200896 AU - Llena-Puy MC AU - Montanana-Llorens C AU - Forner-Navarro L IN - Dental Pathology and Therapeutics Unit, Faculty of Medicine and Dentistry, University of Valencia, Spain. TI - Cariogenic oral flora and its relation to dental caries. SO - ASDC Journal of Dentistry for Children 2000 Jan-Feb;67(1):42-6, 9 AB - Many attempts have been made to establish the risk profile of dental caries; however, no diagnostic procedures are yet available to reliably predict such risk particularly among the pediatric and adolescent population. Age of subject, a history of caries affecting the primary dentition, the prevalence of Streptococcus mutans, pH values, salivary flow, and the frequency and amount of sugar consumption have been the factors most studied. A cross-sectional study is made of schoolchildren in the 12-13-year age-range to evaluate the relationship between dental caries and CFU/ml of S. mutans and Lactobacillus, salivary buffer capacity, and salivary flow. Likewise, an evaluation is made of the predictive value of the variables, bacterial count and salivary pH with respect to caries. A total of 167 children were subjected to oral examination to establish the DMFT and DMFS indices, followed by the collection of saliva for quantitating S. mutans, Lactobacillus, pH and salivary flow, by the Dentocult (SM)(LB) and Dentobuff systems (Vivadent). The data obtained were subjected to descriptive analysis, comparisons among variables were made by nonparametric testing with a confidence level of 95 percent. Test predictive value was studied in terms of sensitivity, specificity, positive and negative predictive values, and probability ratio. Statistically significant (p < 0.001) correlations were observed between the caries indices and bacterial counts. No significant association was recorded with the rest of the variables studied. Bacterial counts as well as salivary buffer capacities exhibited greater negative than positive predictive values, i.e., they were more effective in identifying healthy individuals than patients who required treatment. <4> UI - 20235761 AU - Venugopal T AU - Kulkarni VS AU - Nerurker RA AU - Damle SG AU - Patnekar PN IN - Department of Pediatrics, Dr. R.N. Cooper Municipal General Hospital, Mumbai. TI - Epidemiological study of dental caries. SO - Indian Journal of Pediatrics 1998 Nov-Dec;65(6):883-9 AB - A total of 2000 children (1-14 year age group) attending pediatric OPD, school clinic & well body clinic of Dr. R.N. Cooper Municipal Hospital & K.E.M Hospital, Mumbai were examined for caries prevalence and 35.6% had dental caries. Parental income was not shown to have any bearing on caries prevalence. Parental literacy, particularly maternal literacy was shown to influence caries prevalence in children. The prevalence was low in well-nourished children and in those taking vegetarian type of diet. Frequency of sweet consumption was shown to be associated with prevalence of dental caries. In 1-4 year age group it was noted that bottle fed children were more affected by dental caries. Tooth brush with paste was the commonest method used for cleaning their teeth in all age groups in our study. Caries prevalence was low in those children using tooth brush than in those using tooth powder. Those children who were using neem datun were found to be less affected with dental caries. Dental caries was also found to be low in those who rinsed their mouth with water after food. <5> UI - 20260031 AU - Moynihan P IN - Department of Child Dental Health, University of Newcastle Dental School, Newcastle upon Tyne. p.j.moynihan@ncl.ac.uk TI - The British Nutrition Foundation Oral Task Force report--issues relevant to dental health professionals. SO - British Dental Journal 2000 Mar 25;188(6):308-12 AB - A recent report on diet and oral health by the British Nutrition Foundation reviews the anatomy, microbiology and pathology of a number of oral diseases including dental caries, tooth-wear, oral cancer, periodontal disease and enamel defects. The role of nutritional factors in the aetiology and prevention of these oral diseases is discussed. The report states that improvements in the levels of caries in the UK are halting and remain unacceptably high in some 'at risk groups'--including the socially deprived. It states that a two-pronged attack, i.e. reduced frequency of consumption of sugary foods and use of fluoride is necessary to address the problem. To address the increased prevalence of oral cancer avoiding tobacco, limiting alcohol and increasing fruit and vegetable consumption are recommended. Recommendations for approaches to improve oral health are made for health authorities, industry, schools and health professionals and it is recommended that the Government make adequate resources available to improve oral health preventive strategies. <6> UI - 20041235 AU - Tomar SL AU - Winn DM IN - Centers for Disease Control and Prevention, Division of Oral Health, Atlanta, Ga. 30341, USA. TI - Chewing tobacco use and dental caries among U.S. men [published erratum appears in J Am Dent Assoc 1999 Dec;130(12):1700]. SO - Journal of the American Dental Association 1999 Nov;130(11):1601-10 AB - BACKGROUND: Chewing tobacco has high levels of sugars and may be cariogenic, but few studies have investigated such an association. This study examined the relationship between chewing tobacco use and dental caries among U.S. adult men. METHODS: Participants in the Third National Health and Nutrition Examination Survey conducted from 1988 to 1994 were interviewed about tobacco use and examined by dentists. The authors included in their analysis dentate men 18 years of age or older. They calculated the mean number of decayed or filled permanent teeth, or DFT, and decayed or filled coronal tooth surfaces, or DFS, as well as the mean number and percentage of decayed or filled root surfaces, or RDFS, and decayed root surfaces, or RDS, by tobacco-use status. They used multiple logistic regression to examine the association between chewing tobacco use and root-surface caries. RESULTS: Men who currently used only chewing tobacco had a higher adjusted mean number of DFT than did those who currently used only snuff, only cigarettes or more than one form of tobacco or who never used tobacco. Mean DFS also was higher among chewing tobacco users than among those who used only snuff, only cigarettes or more than one form of tobacco. Chewing tobacco users had a higher mean RDFS and RDS than did the users of other forms of tobacco or nonusers. Current users of chewing tobacco were more than four times as likely as those who never used tobacco to have one or more RDFS or RDS, with a dose-response relationship between number of packages used per week and odds of having root-surface caries. CONCLUSIONS: In addition to its established role as a carcinogen, chewing tobacco may be a risk factor in the development of root-surface caries and, to a lesser extent, coronal caries. This may be due to high sugar content, increased gingival recession and enhanced collagenase activity. CLINICAL IMPLICATIONS: Interventions by dentists and other members of the oral health care team to prevent tobacco use and help users quit can reduce the risk of developing oral and systemic disease. <7> UI - 20228703 AU - Klein U AU - Nowak AJ IN - Munroe-Meyer Institute for Geriatrics and Rehabilitation, Nebraska Medical Center, Omaha 68195-5450, USA. TI - Characteristics of patients with autistic disorder (AD) presenting for dental treatment: a survey and chart review. SO - Special Care in Dentistry 1999 Sep-Oct;19(5):200-7 AB - A group of 43 patients with AD (mean age, 13.5; SD, 5.9 yrs) was identified from the University Hospital School Pediatric Dentistry Clinic. We reviewed the patients' charts to obtain demographic data, dental findings, and the management techniques used for treatment. The patients were divided into groups according to Frankl's categories of behavior, ranging from definitely negative to positive. Descriptive data are provided for each group. Commonly used communications and pharmacological management techniques, as well as physical restraints, enabled us to treat all the patients in the traditional dental setting, when simple procedures were planned. Treatment under general anesthesia in the operating room was necessary in 37% of all patients when comprehensive care was required or difficult procedures were carried out. A questionnaire was also sent out to the caregivers to gather data on patients' nutrition and eating/chewing habits. In the sample surveyed, two-thirds of the individuals reportedly exhibited a normal eating pattern, while 14% pouched food. Soft, sweet, or sticky foods were preferred by 41% of the patients. <8> UI - 20227031 AU - Soderling E AU - Isokangas P AU - Pienihakkinen K AU - Tenovuo J IN - Institute of Dentistry, University of Turku, Finland. eva.soderling@utu.fi TI - Influence of maternal xylitol consumption on acquisition of mutans streptococci by infants. SO - Journal of Dental Research 2000 Mar;79(3):882-7 AB - Xylitol is effective as a non-cariogenic sugar substitute. Habitual xylitol consumption appears to select for mutans streptococci (MS) with impaired adhesion properties, i.e., they shed easily to saliva from plaque. One hundred sixty-nine mother-child pairs participated in a two-year study exploring whether the mothers' xylitol consumption could be used to prevent mother-child transmission of mutans streptococci. All mothers showed high salivary levels of mutans streptococci during pregnancy. The mothers in the xylitol group (n = 106) were requested to chew xylitol-sweetened gum (65% w/w) at least 2 or 3 times a day, starting three months after delivery. In the two control groups, the mothers received either chlorhexidine (n = 30) or fluoride (n = 33) varnish treatments at 6, 12, and 18 months after delivery. The children did not chew gum or receive varnish treatments. MS were assessed from the mothers' saliva at half-year intervals and from the children's plaque at the one- and two-year examinations. The MS were cultured on Mitis salivarius agars containing bacitracin. The salivary MS levels of the mothers remained high and not significantly different among the three study groups throughout the study. At two years of age, 9.7% of the children in the xylitol, 28.6% in the chlorhexidine, and 48.5% in the fluoride varnish group showed a detectable level of MS. In conclusion, therefore, habitual xylitol consumption by mothers was associated with a statistically significant reduction of the probability of mother-child transmission of MS assessed at two years of age. The effect was superior to that obtained with either chlorhexidine or fluoride varnish treatments performed as single applications at six-month intervals. <9> UI - 20227030 AU - Mattila ML AU - Rautava P AU - Sillanpaa M AU - Paunio P IN - Dept. of Child Neurology, University of Turku, Public Health Center, Finland. TI - Caries in five-year-old children and associations with family-related factors. SO - Journal of Dental Research 2000 Mar;79(3):875-81 AB - It is generally understood that the teeth of pre-school-aged children are healthy, but the improvement in the dmft index has halted in the industrialized countries. Those few children who have caries have more of it than before. Little is known of the family-related factors which are associated with this polarization of caries. A representative population-based sample consisted of 1443 mothers expecting their first child. The children were followed at well-baby clinics and public dental health clinics for over five years. The objective was to study the prevalence of dental caries and its predictors in five-year-old children and to assess children's own dental health habits and the meaning of family-related factors in dental health. The findings were based on questionnaire data from parents and on clinical dental examinations of the five-year-old children as completed by 101 public health dentists. In firstborn five-year-old children, dental health was found to be good in 72%, fair in 20%, and poor in 8% of the cases. The final multivariate analysis illustrated that the dmft index > 0 was independently associated with the mother's irregular toothbrushing (OR 2.2; 95% CI 1.4-3.5), annual occurrence of several carious teeth in the father (OR 2.6; 95% CI 1.9-3.6), daily sugar consumption at the age of 18 months (OR 2.4; 95% CI 1.4-4.1), occurrence of child's headaches (OR 3.7; 95% CI 1.5-8.8), parents' cohabitation (OR 3.3; 95% CI 1.5-7.6), rural domicile (OR 2.4; 95% CI 1.2-4.5), and mother's young age (OR 5.0; 95% CI 1.3-19.8). The findings indicated that attention should be paid not only to the child's dental health care but also to that of the whole family. Parents should be supported in their upbringing efforts and encouraged to improve their children's dental health habits. In everyday life, parents function as role models for their children, and therefore, parents' own dental hygiene habits are very meaningful. <10> UI - 20152520 AU - Vogel GL AU - Zhang Z AU - Carey CM AU - Ly A AU - Chow LC AU - Proskin HM IN - American Dental Association Health Foundation, Paffenbarger Research Center, National Institute of Standards and Technology, Gaithersburg, MD 20899, USA. jerry.vogel@nist.gov TI - Composition of plaque and saliva following use of an alpha-tricalcium-phosphate-containing chewing gum and a subsequent sucrose challenge. SO - Journal of Dental Research 2000 Jan;79(1):58-62 AB - Previous studies demonstrated that the chewing of a 2.5% (mass fraction) alpha-tricalcium-phosphate-fortified (alpha-TCP) experimental chewing gum released sufficient calcium and phosphate to eliminate any fall in the tooth mineral saturation of plaque fluid after a sucrose rinse (Vogel et al., 1998). In contrast, the chewing of a conventional sugar-free gum did not eliminate this decrease in saturation. The purpose of this study was to examine if the release of ions from plaque calcium-phosphate pools induced by this gum could provide protection during subsequent exposure to cariogenic conditions. Fourteen subjects accumulated plaque for 48 hrs, fasted overnight, chewed a control or experimental gum for 15 min, and subsequently rinsed 1 min with a mass fraction 10% sucrose solution. Before gum chewing, and at 7 min and 15 min afterward, whole plaque, plaque fluid, and salivary samples were obtained and analyzed by micro-analytical techniques. Additional samples were collected and analyzed at 25 min (7 min after the sucrose rinse). Although the results confirmed the deposition of large amounts of calcium and phosphates in plaque seen in the previous study, only a small increase was seen in plaque-fluid-free calcium and phosphate before sucrose administration. This suggests that few of the mineral ions were mobilized under non-cariogenic conditions. However, 7 min after the sucrose rinsing, an increase in these concentrations was seen which, based on hydroxyapatite ion activity product calculations, indicated a decrease in the driving force for demineralization compared with that seen with the control gum. These results suggest that the chewing of the experimental gum deposits a labile mineral reservoir in plaque that can resist a subsequent cariogenic challenge. <11> UI - 20106113 AU - Wilson N AU - Quigley R AU - Mansoor O IN - Ministry of Health, Wellington, New Zealand. nwilson@actrix.gen.nz TI - Food ads on TV: a health hazard for children?. SO - Australian & New Zealand Journal of Public Health 1999 Dec;23(6):647-50 AB - OBJECTIVE: To examine the nutritional quality of food in television food advertisements that are targeted at children. METHOD: We videotaped 42 hours of children's programs and analysed the food advertisements' content and nutrient composition using the New Zealand Food Composition Database. RESULTS: Of 269 food advertisements, 63% were for foods 'high in fat and/or sugar'. Children who ate only the advertised foods would eat a diet too high in fat, saturated fat, protein, free sugars and sodium. Furthermore, their diets would have suboptimal levels of fibre and suboptimal intakes of a number of important micronutrients (depending on age), including magnesium, selenium and vitamin E. The food products advertised on this channel rarely included nutritious low-cost foods that are necessary for food security in low-income groups. There were also no food advertisements that included any of the healthy foods consumed by Maori and Pacific peoples. CONCLUSIONS: Food advertisements targeted at children generally reflect the dietary pattern associated with an increased risk of obesity and dental caries in childhood; and cardiovascular disease, diabetes and cancers in adulthood. <12> UI - 20162455 AU - Kwan SY AU - Williams SA IN - Oral Health and Ethnicity Unit, Leeds Dental Institute, United Kingdom. TI - Dental beliefs, knowledge and behaviour of Chinese people in the United Kingdom. SO - Community Dental Health 1999 Mar;16(1):33-9 AB - OBJECTIVE: This study explored oral health beliefs, knowledge and behaviour among a sample of United Kingdom Chinese. DESIGN: A quota sample of Chinese people, stratified by age and gender, were interviewed by trained and standardised Chinese interviewers using a piloted, validated semi-structured questionnaire. SUBJECTS: One hundred and fifty-six Chinese people--with similar number of teenagers, younger adults and older people--resident in the North East of England. SETTING: Chinese communities. OUTCOME MEASURE: Reported dental knowledge, beliefs and behaviours. RESULTS: Regardless of gender and age, the majority of respondents believed that it was natural for people to lose all their teeth in old age. Less than half were convinced that they would be able to keep their own teeth for life. The majority of the sample considered that they were susceptible to dental diseases, the consequences of which were thought to be serious. Approximately half presumed that dental diseases were preventable, although the aetiology of dental caries, periodontal disease and tooth loss was poorly understood. While 94% claimed to brush their teeth as part of routine dental care, dental visiting and dietary restriction of sugar intake were reported only in 61% and 30% of the sample respectively. Inter-generational differences were marked; older people tended to have a fatalistic attitude and were least likely to attend the dentist. CONCLUSIONS: A low level of dental awareness was found among the UK Chinese. In order to facilitate effective health promotion and treatment services, the extent of Chinese people's traditional oral health beliefs and behaviour must be taken into account. <13> UI - 20162452 AU - Downer MC IN - Eastman Dental Institute, University of London, UK. TI - Caries experience and sucrose availability: an analysis of the relationship in the United Kingdom over fifty years. SO - Community Dental Health 1999 Mar;16(1):18-21 AB - OBJECTIVE: A previous study suggested that the most likely explanation for the rise and subsequent fall in caries in children in England and Wales during the last 50 years was the concurrent increase and then reduction in the sugar challenge to the population, mitigated after the early 1970s by the preventive effect of fluoride toothpaste. The current objective was to quantify the relationship between sucrose available for consumption annually since 1948 and caries experience at 5 and 12 years. METHOD: In a retrospective, longitudinal ecological study, cross-sectional mean dmft values at 5 years and DMFT values at 12 years in England from 1948 to 1968 and England and Wales from 1973 to 1996/97, from three series of standardised surveys, were regressed on data for the relevant years on sucrose available for consumption in the UK. RESULTS: For sucrose consumption and 5-year-old dmft, Spearman's rho was +0.62 (P < 0.05) while for 12-year-old DMFT the value was +0.84 (P < 0.001). For the 12 year age group, Pearson's coefficient could also be calculated (r = +0.87; P < 0.001). CONCLUSION: For several reasons caution should be used in interpreting these findings. Nevertheless they do suggest a strong positive correlation over time between dmft/DMFT and sucrose availability nationally. <14> UI - 20110283 AU - Kinirons MJ AU - Stewart C IN - Division of Paediatric and Preventive Dentistry, School of Clinical Dentistry, Belfast, UK. TI - Adolescents' knowledge of common foods and drinks and the importance of the pattern of consumption: a study undertaken in an area of high dental needs. SO - Community Dental Health 1998 Sep;15(3):175-8 AB - OBJECTIVE: To assess the knowledge of adolescents concerning the cariogenic status of a range of foods and drinks. To determine the associations between this knowledge and their awareness of the importance of the ways sugars may be consumed in order to reduce tooth decay. DESIGN: Self-complete questionnaires assessing the above factors in a cross sectional study. PARTICIPANTS: Four hundred and fifteen 14-15-year-old young people attending second level schools. SETTING: North and West Belfast area, Northern Ireland. OUTCOME MEASURES: Students rated the dental safety of common foods and drinks, and their views on the necessity of reducing all sugars, and avoiding them between meals were recorded. RESULTS: Correct assessment of harmful items ranged from 96.9% for chocolate and 92.8% for cola to 39.0% for orange squash and 17.8% for plain biscuits. For non-harmful products there were high levels for most items and somewhat lower levels for crisps (57.6%). Significant links were established between this knowledge and children's awareness of the role of eating patterns, although the items involved varied. A majority recognised the importance of eating patterns in relation to dental caries. CONCLUSION: Health educators should be aware that many adolescents have poor knowledge of the cariogenic status of some of the foods and drinks they consume and some are unsure of the importance of eating patterns. <15> UI - 20105824 AU - Evans DJ AU - Howe D AU - Maguire A AU - Rugg-Gunn AJ IN - Newcastle and North Tyneside Health Authority, Newcastle upon Tyne, UK. TI - Development and evaluation of a sugar-free medicines campaign in north east England: analysis of findings from questionnaires. SO - Community Dental Health 1999 Sep;16(3):131-7 AB - OBJECTIVE: To develop a strategy for a campaign aimed at general medical practitioners (GPs) and pharmacists and to evaluate the effectiveness of the campaign on (a) awareness of the role of liquid oral medicines containing sugar in dental disease and (b) changing prescribing and dispensing of sugar-containing medicines. DESIGN: Pre- and post-campaign questionnaires were sent to community pharmacists and GPs and following a series of qualitative interviews with them, a campaign was developed. Following post campaign questionnaires, changes due to the effects of the campaign were evaluated. SETTING: The test area was Newcastle and North Tyneside Health Authority area with Sunderland and South Tyneside Health Authority areas as control. INTERVENTIONS: An information pack followed up by a personal contact was the main form of intervention. The pack comprised a Smile for Sugar-Free Medicines leaflet used in the north west campaign, abstracts from professional journals illustrating the benefits of sugar-free medicines, local dental health information and computing information which could be used to adapt computer terminals in surgeries to display sugar-free options more prominently. MAIN OUTCOME MEASURES: Changes in the knowledge and awareness of both pharmacists and GPs to liquid oral medicines containing sugar as assessed by questionnaires. RESULTS: Increased knowledge and awareness of both pharmacists and GPs to the role of liquid oral medicines containing sugar and the use of sugar-free medicines had taken place but these were not statistically significant. CONCLUSION: The campaign created awareness amongst GPs and pharmacists about dental issues and it is hoped that this awareness can be built upon in future oral health promotion campaigns. However, it is likely that facilitation of sugar-free medicines use will occur only if sustained and constant reinforcement is available. The methodology used presented several difficulties in evaluating change. <16> UI - 20105813 AU - Jones C AU - Woods K AU - Whittle G AU - Worthington H AU - Taylor G IN - North West Dental Public Health Resource Centre, Wesham Park Hospital, UK. TI - Sugar, drinks, deprivation and dental caries in 14-year-old children in the north west of England in 1995. SO - Community Dental Health 1999 Jun;16(2):68-71 AB - OBJECTIVES: To examine associations between dental caries and reported drink consumption. DESIGN: A cross-sectional caries prevalence study including reported drink consumption. SETTING: Secondary schools across the former North Western Region of England. SUBJECTS: A random sample of 6,014, 14-year-old children. RESULTS: The mean DMFT of the sample was 2.74. The reported mean weekly consumption of cans of carbonated drinks was 5.66, with a range of zero to 42. There was a significant gender difference in drink consumption and a significant correlation between the reported weekly consumption of cans of carbonated drinks and DMFT. Logistic regression analysis showed tea drinkers had a significantly lower DMFT than coffee drinkers and that this effect was independent of the addition of sugar and the number of cans of drink consumed. Reported use of sugar-free carbonated drinks was not associated with better dental health. CONCLUSIONS: Reported consumption of sugared drinks and carbonated drinks was associated with significantly higher levels of dental caries. Drinking tea was associated with lower levels of caries. Sugar-free drinks were not associated with better dental health. <17> UI - 20103524 AU - Petti S AU - Bossa MC AU - Tarsitani G AU - Falcolini G AU - Lumbau A AU - Campus G IN - G. Sanarelli Hygiene Institute, La Sapienza University, Rome. TI - Variables affecting salivary Streptococcus mutans counts in a cohort of 12-year-old subjects. [Review] [31 refs] SO - Minerva Stomatologica 1999 Sep;48(9):361-6 AB - BACKGROUND: Several factors such as toothbrushing, diet, acidogenic potential of the mutans streptococci strain and site of the carious lesion can modify the salivary Streptococcus mutans (Sm) counts. In the present investigation the effect of some behavioural, clinical and microbiological variables on Sm salivary counts was evaluated in a cohort of 12-year-olds. METHODS: Forty subjects were examined by two calibrated examiners (GC, AL). The number of surfaces either decayed occlusal, decayed smooth or filled and the number of bleeding sextants, (clinical index for oral hygiene) were reported. Saliva was collected using a tongue depressor and was plated onto mitis salivarius agar with bacitracin and 20% sucrose. The presumptive Sm colonies were counted and the concentrations were logarithmically transformed. One Sm strain per subject was identified and the cariogenic potential evaluated as the minimum pH value recorded, during 5 hrs of incubation in 5% sucrose solution. The children's parents or guardians completed a questionnaire concerning the frequency of toothbrushing, the consumption of sweet foods and soft drinks and at what age the children started brushing their teeth. The effect of the explanatory variables on Sm count logarithms was evaluated by stepwise multiple regression. RESULTS: The regressors with significant additional explanatory power were cariogenic potential (b = -1.335, p = 0.00001, R2 increment = 0.312), decayed smooth surfaces (b = -0.456, p = 0.009, R2 increment = 0.114) and bleeding sextants (b = -0.113, p = 0.004, R2 increment = 0.062), whereas the power of filled surfaces was marginally significant (p = 0.08). CONCLUSIONS: On the basis of these results, it is suggested that acidogenicity is not only a cariogenic factor, but also a factor promoting colonization of oral sites by Sm, especially in subjects with a high frequency of sugar consumption. [References: 31] <18> UI - 20069266 AU - Lingstrom P AU - Liljeberg H AU - Bjorck I AU - Birkhed D IN - Department of Cariology, Institute of Odontology, Goteborg University, Goteborg, Sweden. lingstrom@odontologi.gu.se TI - The relationship between plaque pH and glycemic index of various breads. SO - Caries Research 2000 Jan-Feb;34(1):75-81 AB - Plaque pH was studied during 60 min in situ in 10 subjects after eating various breads. The pH response was then compared to glycemic index (GI; calculated from the incremental blood glucose area) obtained from our earlier investigations. The following four products were tested: (1) barley kernel bread (BKB), (2) BKB, sourdough-fermented (BKBS), (3) white wheat bread (WWB), and (4) syrup-sweetened wheat-rye bread (SWRB). BKB was also tested with more intensive chewing and SWRB with the addition of fat. A 5% sucrose solution served as a control. The pH drops with all the breads were considerably smaller than with the sucrose solution during the first 15 min. From 30 min and onwards the breads gave similar, or even lower (SWRB) pH than sucrose. There was a great difference in pH response among the four breads, with the most pronounced pH fall for SWRB, followed by WWB (based on the AUC values). Intensive chewing of BKB increased, while the addition of fat to SWRB reduced the pH fall, in both cases by about 0.2 pH units. A high correlation (r = 0.94) between plaque pH and GI was found, i. e. the more pronounced the pH drop in plaque, the higher the GI in blood. Therefore, both from a cariogenic and from a metabolic point of view, breads with a low GI should be recommended. <19> UI - 20069261 AU - Kielbassa AM AU - Schendera A AU - Schulte-Monting J IN - Department of Operative Dentistry and Periodontology, University School of Dental Medicine, Albert-Ludwigs-University, Freiburg i. Br. , Germany. kielbass@zmk2.ukl.uni-freiburg.de TI - Microradiographic and microscopic studies on in situ induced initial caries in irradiated and nonirradiated dental enamel. SO - Caries Research 2000 Jan-Feb;34(1):41-7 AB - The objective of this study was to evaluate the onset of initial demineralization in irradiated and nonirradiated human enamel. Enamel specimens were prepared from the lingual and buccal surfaces of 48 freshly extracted, caries-free third molars. Either the lingual or the buccal enamel specimen of each tooth was irradiated with 60 Gy. The remaining enamel sample was not irradiated. Two irradiated and two nonirradiated enamel specimens were inserted into both buccal aspects of each 12 intraoral mandibular appliances. The appliances were worn by 12 persons for 6 weeks throughout day and night. One side was brushed daily with a fluoride-free toothpaste. On the other side plaque was allowed to grow. Individual oral hygiene techniques were performed without any fluorides. During meals, the appliance was stored in 10% sucrose solution. The enamel specimens were cut perpendicular to the enamel surface. Subsequently, the slabs were ground to a thickness of 90 microm, and studied by means of TMR and microscopic techniques. Evaluated data did not show any differences between irradiated and nonirradiated enamel lesions (ANOVA). The onset of caries in irradiated enamel can be hampered by regularly performed oral hygiene techniques. <20> UI - 99451695 AU - McVeigh N AU - Kinirons MJ IN - Division of Paediatric and Preventive Dentistry, School of Clinical Dentistry, Belfast, UK. TI - Pharmacists' knowledge, attitudes and practices concerning sugar-free medicines. SO - International Journal of Paediatric Dentistry 1999 Mar;9(1):31-5 AB - AIMS: To examine the attitudes of pharmacists to sugar in medicine and sugar-free preparations and their levels of knowledge concerning sugar-free preparations and the implications for dental health. DESIGN: A questionnaire was designed with a mixture of closed and open-ended questions. SETTING: Pharmacists practising in the Greater Belfast area of Northern Ireland. METHOD: Seventy pharmacists were randomly chosen from the list of pharmacists practising in the area and were asked to participate in the study. RESULTS: Responses were obtained from 52 of the 70 selected pharmacists, representing a response rate of 74%. Seventy-five per cent of the pharmacists stated that they had not received formal education concerning sugar in medication and it's effect on dental health. Their main source of information on the subject was dental health literature. Eighty-seven per cent felt that all medication should be available in sugar-free form. Forty-six per cent stated that sugar in medication was definitely an important cause of dental caries in children and 44% felt that it was a possible factor. The major factors influencing the provision of sugar-free medicines were parental request, health promotion literature, reports and media advertising. Thirty-nine per cent of the pharmacists always offered a sugar-free preparation for over-the-counter medication (provided that a sugar-free alternative was available), and 56% sometimes did so. Fifty per cent always offered a sugar-free form for prescribed items wherever possible, the remainder depended on it being specified by the prescriber. CONCLUSION: There is a high level of interest in this issue among pharmacists, but there is a need for an increased educational input on a continuous basis. <21> UI - 99451680 AU - Gizani S AU - Vinckier F AU - Declerck D IN - Catholic University Leuven, School for Dentistry, Oral Pathology and Maxillofacial Surgery, Department of Operative Dentistry, Belgium. TI - Caries pattern and oral health habits in 2- to 6-year-old children exhibiting differing levels of caries. SO - Clinical Oral Investigations 1999 Mar;3(1):35-40 AB - The aim of the present study was to describe in detail the distribution of caries lesions among tooth types and surfaces in the primary dentition of young children with different levels of disease. A total of 125 children (between 2 and 6 years old) attending the pediatric dental clinic of the University Hospital of Leuven was allocated to three groups based on their caries experience: dmft = 1-5 formed the low caries experience group (LC, n = 27), dmft = 6-9 the moderate caries experience group (MC, n = 61) and those with dmft > = 10 the high caries experience group (HC, n = 37). Caries experience (at patient level, tooth and tooth surface level) and oral hygiene were evaluated. Oral health habits were recorded using a questionnaire (completed by parents). Caries lesions were not evenly distributed among different tooth types. Teeth most frequently affected were lower (first and second) primary molars. Primary incisors were rarely found to be carious. The distribution of the lesions followed a comparable pattern, irrespective of the disease level of the child. Decay on primary canines and buccal/lingual surfaces of primary molars was strongly indicative of a high caries experience. There was a clear link with reported oral hygiene habits and the use of a pacifier and baby bottle with sugared content. <22> UI - 99379473 AU - Ruxton CH AU - Garceau FJ AU - Cottrell RC IN - The Sugar Bureau, London. TI - Guidelines for sugar consumption in Europe: is a quantitative approach justified?. [Review] [55 refs] SO - European Journal of Clinical Nutrition 1999 Jul;53(7):503-13 AB - OBJECTIVES: There is incongruity between the sugar consumption guidelines set in different European countries. A number have adopted maximum limits ranging from 10-25% energy, while others have no quantitative recommendations at all. This raises the question whether or not there should be a common European guideline for sugar consumption. DESIGN: This paper examines if such a goal for sugar is merited and reviews the published literature on associations between sugar consumption and dental caries, obesity and micronutrient dilution. RESULTS: Evidence showed that higher intakes of sugar were related to leanness, not obesity, and had no detrimental effects on micronutrient intakes in most people. In the case of dental caries, there was a relationship between frequency of sugar intake and the incidence of decay. However, in populations where fluoride use was adequate, associations between sugar intake and caries rarely reached statistical significance. CONCLUSIONS: The available evidence does not justify a common quantitative recommendation for sugar. It is suggested that dental caries merits a more integrated public health approach where advice on the frequency of foods containing fermentable-carbohydrates is placed in context alongside oral hygiene. [References: 55] <23> UI - 99396016 AU - Pearce EI AU - Margolis HC AU - Kent RL Jr IN - Department of pathology, Wellington School of Medicine, New Zealand. dentalhp@wnmeds.ac.nz TI - Effect of in situ plaque mineral supplementation on the state of saturation of plaque fluid during sugar-induced acidogenesis. SO - European Journal of Oral Sciences 1999 Aug;107(4):251-9 AB - Dental plaque fluid is normally supersaturated with respect to enamel mineral but this may change to a state of undersaturation when plaque pH falls following sugar exposure, placing the adjacent enamel at risk of caries. We have determined the saturation status of the fluid in both resting and fermenting plaque following mineral supplementation. Eleven subjects abstained from oral hygiene and rinsed their mouth 3 times/d for 3 d with a placebo solution or with test solutions designed to enrich plaque with hydroxyapatite or fluorhydroxyapatite. On the morning of day 4, plaque samples were collected before and after exposure to 10% sucrose. Compared to the placebo, use of the test rinses resulted in significantly higher concentrations of Ca, P and F in plaque residue. In plaque fluid, higher post-sucrose Ca2+ free concentrations and saturation levels with respect to enamel mineral and fluorapatite were found after use of the hydroxyapatite rinse compared to the placebo, effects that probably resulted from the release of cell-bound Ca2+ as well as from the dissolution of apatite. Thus, some evidence was obtained that the test mouthrinses can counteract the fall in saturation level found when plaque is exposed briefly to sucrose. Potential long-term benefits of the test mouthrinses deserve further study. <24> UI - 99420776 AU - Folgert E AU - Fallon T AU - Schopfer G TI - On soda pop [letter; comment]. CM - Comment on: J Am Dent Assoc 1999 Mar;130(3):308-10, 312 SO - Journal of the American Dental Association 1999 Aug;130(8):1158 <25> UI - 99354539 AU - Toumba KJ AU - Duggal MS IN - Division of Child Dental Health, Leeds Dental Institute. TI - Effect on plaque pH of fruit drinks with reduced carbohydrate content. SO - British Dental Journal 1999 Jun 26;186(12):626-9 AB - OBJECTIVES: To assess the acidogenic response in dental plaque after challenge with four fruit drinks, including two blackcurrant drinks newly formulated, with low levels of carbohydrate. METHODS: 24 adult volunteers rinsed, in randomised order, with each of two new formulations of a blackcurrant drink (7% juice with 0.49% and 10% juice with 0.65% carbohydrate concentration respectively), an apple and blackcurrant drink with no added sugar (0.8%), and a mixed citrus fruit drink with a higher carbohydrate concentration (4.5% w/v). Solutions of 10% sucrose and 10% sorbitol were used as controls. Plaque pH was assessed, in vivo, before and after the acidogenic challenge using the plaque-harvesting technique. RESULTS: Results showed that the minimum plaque pH after the subjects rinsed with the new blackcurrant drinks was higher as compared with all the other test products and significantly so compared with the mixed citrus drink (P = 0.0001). It was also found that with the 7% blackcurrant juice drink none of the subjects and with 10% blackcurrant juice drink only one subject recorded a pH drop below the pH of 5.7. Ten minutes after consumption, both the new formulation blackcurrant drinks produced significantly higher plaque pH than the mixed citrus drink. In addition, overall change in the hydrogen ion concentration over the study period (sigma delta cH) was significantly less with both new blackcurrant drinks compared with the mixed citrus drink. CONCLUSIONS: It was concluded that the two new formulations with low levels of carbohydrate had a low acidogenic potential and did not depress the plaque pH below the critical level and their consumption could not be considered to pose a significant risk for enamel demineralisation. <26> UI - 99331518 AU - Astrom AN AU - Awadia AK AU - Bjorvatn K IN - Department of Odontology-Community Dentistry, University of Bergen, Norway. anne.nordrehaug@cih.uib.no TI - Perceptions of susceptibility to oral health hazards: a study of women in different cultures. SO - Community Dentistry & Oral Epidemiology 1999 Aug;27(4):268-74 AB - People typically attribute lower health risks to themselves than to others, a phenomenon called unrealistic optimism. OBJECTIVES: The purpose of this study was to investigate how women's perceived susceptibility to tooth decay is related to information from various sources, trust in these sources and personal experience with risk factors. Comparative risk judgments for oral health hazards were also investigated. METHODS: Two samples of women were included. In 1997, a random sample of adults (n = 1190) aged 25 years, from three counties of western Norway, were invited to complete postal questionnaires at home. A total of 735 adults (62%) responded, of whom 374 (51%) were women. During July 1997, a convenient sample of 140 women, aged 15-40 years, participated in a structured interview at a Maternal Child Health clinic in Arusha town, Tanzania. RESULTS: Among the Tanzanian women, information from health workers and media, trust in these sources, symptoms of tooth decay and intake of sugared foods were significantly related to perceived risk for tooth decay. Pearson's correlation coefficients varied from r = 0.47, P < 0.001 (trust in health workers) to r = 0.20, P < 0.05 (intake of sugared foods). In both groups of women all mean ratings of comparative risk differed significantly (P < 0.001) from the midpoint of the scales (marked same risk as others), as tested by one sample t-test (test value = 0). The range of t-values was from t = -12.7 (dental fluorosis) to t = -18.2 (tooth decay) and from t = -4.9 (gum disease) to t = -8.3 (loss of teeth) among the Tanzanian and Norwegian women, respectively. CONCLUSIONS: When judging their susceptibility for tooth decay, Tanzanian women seem to consider both information from health workers and their personal risk experience. Optimism in comparative risk judgments for oral health hazards was evident among both the Tanzanian and the Norwegian women investigated. These findings are discussed in the context of implications for oral health education. <27> UI - 99312082 AU - Worthington H AU - Clarkson J AU - Davies R IN - Dental Health Unit, Turner Dental School, Manchester, UK. helen.worthington@man.ac.uk TI - Extraction of teeth over 5 years in regularly attending adults. SO - Community Dentistry & Oral Epidemiology 1999 Jun;27(3):187-94 AB - OBJECTIVES: This prospective study was conducted to describe the incidence of tooth extraction in a group of regularly attending adults and to assess factors that are predictive of tooth loss. METHODS: Baseline and annual incremental clinical data were obtained from 23 general dental practitioners on a group of their regularly attending, dentate adult patients over a 5-year period. The patients completed a postal questionnaire with questions relating to dental health behaviours, attitudes and knowledge, and social factors. RESULTS: Complete clinical data were obtained from 2799 patients. Four hundred and seventy (17%) patients underwent extractions, 72% of which were posterior teeth. The majority of extractions were for reasons other than caries (79%). Bivariate analyses revealed many significant differences between patients who underwent extractions and those who did not, with respect to the clinical, social, behavioural and attitudinal variables. The logistic regression model for tooth loss included three clinical variables, number of teeth, crowns and sites with recession. Other variables in the final model included the dentist's and patient's prediction of treatment need, having sensitive teeth, having a sweet tooth, living alone and smoking. The sensitivity for the model was 0.57 with specificity 0.72. CONCLUSIONS: This study is unique in its examination of patients and has highlighted that both clinical and other factors are important in predicting who will undergo extractions. Future investigations should assess the consequence of having extractions in terms of health benefit or detriment. <28> UI - 99288477 AU - Hattab FN AU - Al-Omari MA AU - Angmar-Mansson B AU - Daoud N IN - Department of Restorative Dentistry, Jordan University of Science and Technology, Irbid, Jordan. TI - The prevalence of nursing caries in one-to-four-year-old children in Jordan. SO - ASDC Journal of Dentistry for Children 1999 Jan-Feb;66(1):53-8 <29> UI - 99234667 AU - Walton AG AU - Welbury RR AU - Foster HE AU - Thomason JM IN - Department of Child Dental Health, Newcastle upon Tyne, UK. TI - Juvenile chronic arthritis: a dental review. [Review] [48 refs] SO - Oral Diseases 1999 Jan;5(1):68-75 AB - A review of the literature relating to juvenile chronic arthritis (JCA) is presented. It includes a description of the disease itself and identifies our knowledge of the increased risk of dental disease associated with this condition. In addition the impact of JCA therapy on the dental management of the patient is discussed. The review highlights the need for further research into the effects of the disease on dental caries, periodontal disease and saliva. [References: 48] <30> UI - 99213081 AU - Seow WK AU - Amaratunge A AU - Sim R AU - Wan A IN - Pediatric Dentistry, University of Queensland. TI - Prevalence of caries in urban Australian aborigines aged 1-3.5 years. SO - Pediatric Dentistry 1999 Mar-Apr;21(2):91-6 AB - PURPOSE: This study investigated the prevalence and etiological factors associated with caries in a group of young Australian aboriginal children from 1 to 3.5 years of age. METHODS: One hundred and forty-seven healthy infants, aged from 1 to 3.5 years, attending a community health center in Brisbane, a nonfluoridated state capital city, were randomly selected for the study. RESULTS: The caries prevalence was 39% by subjects and 32% by the total number of teeth present. The mean number of decayed, filled teeth (dtf) was 2.5 +/- 0.4, which is more than twice the figure for 3-year-old children in Australia. Furthermore, the filled (f) component represented only 1% of the total dft, suggesting very low treatment levels. Increased caries experience of the infants was strongly associated with high dental plaque scores, high levels of Streptococcus mutans infection, and sleep-time consumption of milk containing added sugar. CONCLUSION: The results suggest that urban Australian aboriginal infants are at high risk for caries, and that preventive strategies are urgently required. <31> UI - 99231867 AU - Kielbassa AM AU - Wrbas KT AU - Schulte-Monting J AU - Hellwig E IN - Department of Operative Dentistry and Periodontology, University Clinic of Dentistry, Albert-Ludwigs-University of Freiburg, Germany. kielbass@zmk2.ukl.uni-freiburg.de TI - Correlation of transversal microradiography and microhardness on in situ-induced demineralization in irradiated and nonirradiated human dental enamel. SO - Archives of Oral Biology 1999 Mar;44(3):243-51 AB - The objective was to evaluate whether a correlation exists between microhardness (MH) and transversal microradiographical (TMR) data for in situ-induced caries lesions in irradiated and nonirradiated human enamel. Enamel specimens were prepared from the lingual and buccal surfaces of 20 freshly extracted, caries-free third molars. The surfaces were polished (4000 grit). Either the lingual or the buccal specimen of each tooth was irradiated with 60 Gy; the other sample was not irradiated. Two irradiated and two nonirradiated specimens were inserted into both buccal aspects of each of five intraoral mandibular appliances. The appliances were worn by five persons for 6 weeks day and night. One side was brushed daily with a fluoride-free toothpaste; on the other side, dental plaque was allowed to grow. Individual oral hygiene was performed without any fluorides. During meals, the appliance was stored in 10% sucrose solution. Then the enamel specimens were cut perpendicular to their oral surface. The cut surface was polished (4000 grit) and the Knoop hardness number (KHN) was measured across the lesions, at 25, 50 and 75 microm from the oral surface. After MH testing the samples were polished again, thereby reducing the surface by about 10 microm. Subsequently, the slabs were ground to a thickness of 90 microm, and studied by means of TMR. Mineral loss was calculated with dedicated software at the locations corresponding to the MH testing. A total of 120 paired data was submitted to linear-regression analysis. Neither MH nor TMR showed significant differences between irradiated and nonirradiated enamel lesions. A linear relation was found between square root of KHN and the mineral volume percent. In naturally induced caries lesions, MH values can be converted to mineral volume percent using the equation [21.19 + 3.66 x square root of KHN]. This equation fits the data with a reliable correlation coefficient (r2=0.915). <32> UI - 99194120 AU - Hujoel PP AU - Makinen KK AU - Bennett CA AU - Isotupa KP AU - Isokangas PJ AU - Allen P AU - Makinen PL IN - Department of Dental Public Health Sciences, School of Dentistry, University of Washington, Seattle 98195, USA. TI - The optimum time to initiate habitual xylitol gum-chewing for obtaining long-term caries prevention. SO - Journal of Dental Research 1999 Mar;78(3):797-803 AB - Habitual xylitol gum-chewing may have a long-term preventive effect by reducing the caries risk for several years after the habitual chewing has ended. The goal of this report was (1) to determine if sorbitol and sorbitol/xylitol mixtures provide a long-term benefit, and (2) to determine which teeth benefit most from two-year habitual gum-chewing - those erupting before, during, or after habitual gum-chewing. Children, on average 6 years old, chewed gums sweetened with xylitol, sorbitol, or xylitol/sorbitol mixtures. There was a "no-gum" control group. Five years after the two-year program of habitual gum-chewing ended, 288 children were re-examined. Compared with the no-gum group, sorbitol gums had no significant long-term effect (relative risk [RR], 0.65; 95% confidence interval [c.i.], 0.39 to 1.07; p < 0.18). Xylitol gum and, to a lesser extent, xylitol/sorbitol gum had a long-term preventive effect. During the 5 years after habitual gum-chewing ended, xylitol gums reduced the caries risk 59% (RR, 0.41; 95% c.i., 0.23 to 0.75; p < 0.0034). Xylitol-sorbitol gums reduced the caries risk 44% (RR, 0.56; 95% c.i., 0.36 to 0.89; p < 0.02). The long-term caries risk reduction associated with xylitol strongly depended on when teeth erupted (p < 0.02). Teeth that erupted after 1 year of gum-chewing or after the two-year habitual gum use ended had long-term caries risk reductions of 93% (p < 0.0054) and 88% (p < 0.0004), respectively. Teeth that erupted before the gum-chewing started had no significant long-term prevention (p < 0.30). We concluded that for long-term caries-preventive effects to be maximized, habitual xylitol gum-chewing should be started at least one year before permanent teeth erupt. <33> UI - 99185567 AU - Meskin LH TI - Outrageous [editorial] [see comments]. CM - Comment in: J Am Dent Assoc 1999 Apr;130(4):474, Comment in: J Am Dent Assoc 1999 Aug;130(8):1158 SO - Journal of the American Dental Association 1999 Mar;130(3):308-10, 312 <34> UI - 99110705 AU - Angelillo IF AU - Torre I AU - Nobile CG AU - Villari P IN - Medical School, University of Catanzaro, Italy. TI - Caries and fluorosis prevalence in communities with different concentrations of fluoride in the water. SO - Caries Research 1999;33(2):114-22 AB - The need to defluoridate and fluoridate the water supplies in areas with drinking water naturally containing above-optimal (>/=2.5 mg/l) and suboptimal ( UI - 99110704 AU - Gibson S AU - Williams S IN - Nutrition Consultant Guildford, Surrey, UK. sigrid.gibson@compuserve.com TI - Dental caries in pre-school children: associations with social class, toothbrushing habit and consumption of sugars and sugar-containing foods. Further analysis of data from the National Diet and Nutrition Survey of children aged 1.5-4.5 years. SO - Caries Research 1999;33(2):101-13 AB - This project examined the relative significance of dietary sugars, toothbrushing frequency and social class as predictors of caries experience (caries vs. no caries) among 1,450 British pre-school children who took part in the National Diet and Nutrition Survey. This cross-sectional survey was based on a representative sample of children aged 1.5-4.5 years studied in 1992/3. Children were classified into four groups according to social class and toothbrushing habit. Diet/caries associations were examined for biscuits and cakes, sugar confectionery, chocolate confectionery and soft drinks, and the percentage of energy from non-milk extrinsic sugars, using data on amount and frequency of consumption from 4-day weighed dietary records. In stepwise logistic regressions, the strength of the association between social class and caries experience was twice that between toothbrushing and caries, and nearly three times that between sugar confectionery and caries (other dietary variables were not significant). The association of caries with sugar confectionery (both in amount and frequency) was only present among children whose teeth were brushed less than twice a day. Toothbrushing frequency appeared to have a stronger impact on caries prevention in non-manual compared with manual children. Household expenditure on confectionery was associated with caries only among children from the manual group. The findings suggest the hypothesis that regular brushing (twice a day) with a fluoride toothpaste may have greater impact on caries in young children than restricting sugary foods. <36> UI - 99051261 AU - Giertsen E AU - Emberland H AU - Scheie AA IN - Department of Odontology-Cariology, Faculty of Dentistry, University of Bergen, Norway. Elin.Giertsen@odont.uib.no TI - Effects of mouth rinses with xylitol and fluoride on dental plaque and saliva. SO - Caries Research 1999;33(1):23-31 AB - The aim of this study was to test the hypothesis that xylitol, alone and in combination with fluoride, affects the salivary flow rate and micro-biota, dental plaque accumulation, gingivitis development, and the acidogenic potential of plaque. Three groups, each of 10 subjects, rinsed for 1 min 3 times daily over two 4-week periods, first with 10 ml water (control), and thereafter with either 0.05% NaF, 40% xylitol, or with 0.025% NaF plus 20% xylitol according to a double-blind controlled design. They performed habitual mechanical tooth cleaning during the first 2 weeks of each period but abstained from interdental cleaning during the final 2 weeks. While mouth rinsing was continued, all mechanical oral hygiene was discontinued the last 2 days of each period to permit plaque accumulation. The last mouth rinse was administered in the clinic before the final examination. The following parameters were assessed: (1) unstimulated and paraffin-stimulated salivary secretion rates; (2) salivary micro-biota; (3) plaque index; (4) papillar bleeding; (5) plaque pH response to sucrose, and (6) lactate formation by dental plaque. No statistically significant differences in any of the parameters were found. In conclusion, three daily mouth rinses with fluoride and xylitol, separately or in combination, did not affect the salivary flow rate or micro-biota, dental plaque accumulation, gingivitis development, or the acidogenic potential of plaque. <37> UI - 99051258 AU - Bowen WH IN - Center for Oral Biology, University of Rochester, N.Y., USA. William:Bowen@urmc.rochester.edu TI - Wither or whither caries research? [editorial]. SO - Caries Research 1999;33(1):1-3 <38> UI - 20002314 AU - Dong YM AU - Pearce EI AU - Yue L AU - Larsen MJ AU - Gao XJ AU - Wang JD IN - School of Stomatology, Beijing Medical University, Beijing, People's Republic of China. TI - Plaque pH and associated parameters in relation to caries. SO - Caries Research 1999 Nov-Dec;33(6):428-36 AB - Intensified plaque acidogenicity in caries-prone subjects was reported many years ago, but emerging evidence has suggested that the relationship may not be as strong as once thought. We have now determined a range of acidogenicity variables in subjects having both caries prevalence and incidence data, and have included plaque mineral data in the analysis. pH measurements were made in 20 randomly selected subjects from a high-caries group (mean DMFS = 8. 95) and 20 from a caries-free group of Beijing children aged 12 years participating in a caries prediction study. Subgroups with a 12-month DMFS increment >/=2 or = 0 were also formed from the two groups, respectively. Measurements were made with an iridium oxide electrode inserted between teeth 13/14, 23/24, 34/35 and 44/45, before and every 5 min for 30 min after rinsing with 10% sucrose, and the 4 resulting 'Stephan curves' averaged using a plaque pH analysis program. Supragingival plaque was collected from buccal and lingual smooth surfaces of posterior and upper anterior teeth and its acid extract analysed for Ca, P and F. Caries-free subjects (based on past experience) had a significantly higher maximum plaque pH and pH value after 30 min (reflecting a faster return to resting pH), a lower minimum enamel dissolution capacity of plaque and recorded less time below pH 7.0 than did high-caries subjects. No other differences were significant, including those of the principal acidogenic parameters 'minimum pH attained after a sugar rinse', 'curve area below the critical pH of 5.5' and 'time below the critical pH'. Selection of the caries groups on the basis of both experience and incidence did not reveal significant differences in more parameters. Upper arch plaque was significantly more acidogenic than lower arch plaque, and there was a consistently strong association between upper and lower arch values in individuals. Ca, P and F in the subjects' plaque had little or no influence on the principal acidogenic parameters. Our failure to find a relationship between caries prevalence or activity and these principal acidogenicity parameters may be related to differences between fissure and smooth surface plaque, temporal variations in acidogenicity and/or to use of F toothpaste during the 1-year observation period. These results support the view that factors such as the frequency of acidogenic episodes may be more important in caries progression than the degree of acidogenicity during any one episode. <39> UI - 99412950 AU - Dellinger TM AU - Livingston HM AU - Holder R AU - Streckfus CF IN - Restorative Dentistry Department, University of Mississippi School of Dentistry, Jackson 39216, USA. TI - Glycogen storage disease and von Willebrand's disease implications for dental treatment: dental management of a pediatric patient. SO - Special Care in Dentistry 1998 Nov-Dec;18(6):243-6 AB - Glycogen storage diseases (GSD) are metabolic disorders which impair the body's ability to store glucose and utilize it later, requiring patients to take multiple daily dietary supplementation with a high carbohydrate content. Patients undergoing this treatment modality are placed at increased risk for gross dental caries and other oral abnormalities. Additionally, GSD may prolong the patient's bleeding time, which may necessitate consultation with the treating physician. In the following case, our patient required a multidisciplinary approach to address not only her dental needs, but also to coordinate the management of both her GSD and an additional complication, von Willebrand's disease. This was best achieved in a hospital setting. <40> UI - 99319181 AU - Mattila ML AU - Paunio P AU - Rautava P AU - Ojanlatva A AU - Sillanpaa M IN - Department of Public Health, University of Turku, Finland. TI - Changes in dental health and dental health habits from 3 to 5 years of age. SO - Journal of Public Health Dentistry 1998 Fall;58(4):270-4 AB - OBJECTIVES: This study sought to determine how dental health and dental health habits change from 3 to 5 years of age and to consider whether preventive dental health care helped in preventing or halting caries in children. METHODS: The study included 67 maternity health care clinics, 72 well-baby clinics, and 69 dental health care clinics. Of the 1,292 newborn children, 1,003 (90.8%) were included in this study. RESULTS: Preventive dental health care contributed to dental caries being halted in only 13.2 percent of those children who had enamel caries at 3 years of age. The dmft index did not increase in 22.6 percent of those children who had dentinal caries at 3 years of age. For all others, the disease became more severe. Toothbrushing habits of 3-year-old children were very consistent over the two years studied. Children were at a risk for caries when their mothers had nine years of basic education, when they already had plaque and caries at 3 years of age, and when the frequency of eating sweets increased the most during the two-year study period. CONCLUSIONS: Among 3-year-old children, plaque is an indicator of caries risk and therefore should be a key element in health education. Those children who already have evidence of caries at 3 years of age should be the target of preventive dental services because of their increased risk. <41> UI - 99193228 AU - Thompson GW AU - Schuller PD AU - Lewis DW IN - University of Alberta, Edmonton, Canada. TI - Dental caries knowledge in a group of Northwest Territories children. SO - International Journal of Circumpolar Health 1998;57 Suppl 1:169-73 AB - A total of 953 children in schools in communities in the Northwest Territories was surveyed to determine their attitudes and knowledge about dental decay. A questionnaire was answered by these Native and non-Native children in the Northwest Territories. The median age of the children was 12.5 years. The girls tended to brush their teeth more frequently and consumed less sugared sweets between meals. More of the girls and in particular the Native girls knew about "nursing" caries. The Native students more often than not went for dental treatment when it was necessary. The Native students brushed their teeth less frequently and often learned to brush their teeth on their own. The consumption of sugared sweets between meals was greater in the Native sample. The knowledge level of the factors that affect dental decay rates was lower in the Native group, but was not extremely high in either group. These children should receive more information on oral health practices and be given an opportunity to improve their oral health knowledge. <42> UI - 99080808 AU - Bradley M AU - Kinirons MJ TI - Provision of sugar-free medicines for young children: the views of a sample of parents in Northern Ireland. SO - Journal of the Irish Dental Association 1998;44(3):70-3 AB - Sugar in liquid medicines is a factor in dental caries for many children. There has been an increase in the availability of sugar-free medicines in recent years, but they need to be prescribed specifically, because most generic liquid medicines still contain sugar. The object of the present study was to examine parental and child factors which may be linked to the provision of sugar-free alternatives by their medical practitioner. A random sample of 291 parents of children aged four years was obtained. A questionnaire was used to ascertain the extent of their knowledge concerning liquid medicines and their effect on dental health and the frequency with which such medicines are requested by them was assessed. The levels of provision of sugar-free medication and the frequency of used common types of medication were recorded and long term users identified. There was a total of 212 children in the study representing an inclusion rate of 73 per cent of the original sample. Just more than 17 per cent were always provided with a sugar-free liquid medicine, 58.3 per cent sometimes received this form of medication and 24.6 per cent never received it. The strongest individual predictor of a high frequency of provision of the medication in sugar-free form was the frequency of parents requesting this type of medication from their medical doctor and the next strongest predictor was the frequency of use of antibiotics. Parental awareness or knowledge of the importance of the issue for dental health did not affect the outcome in the present study. It is concluded that there is a need for specific campaigns to promote the use of sugar-free medications and further increases in their availability should be sought from manufacturers. <43> UI - 99035990 AU - Beiswanger BB AU - Boneta AE AU - Mau MS AU - Katz BP AU - Proskin HM AU - Stookey GK IN - Clinical Research, Oral Health Research Institute, Indiana University, School of Dentistry, Indianapolis, USA. TI - The effect of chewing sugar-free gum after meals on clinical caries incidence. SO - Journal of the American Dental Association 1998 Nov;129(11):1623-6 AB - To determine the effect of chewing sugar-free gum on caries incidence, the authors conducted a randomized clinical study. A total of 1,402 children in Puerto Rico, in grades 5 through 7 at baseline, completed the study. They were randomized by classroom into a control group or chewing gum group; those in the gum group were instructed to chew sugar-free gum for 20 minutes after each of three meals a day. Clinical and radiographic evaluations were performed at baseline and after two and three years. The results show that all subjects and high-risk subjects, respectively, in the gum group developed 7.9 percent and 11.0 percent fewer decayed, missing or filled surfaces than subjects in the control group. Based on these findings, the authors concluded that chewing sorbitol-based sugar-free gum after eating significantly reduces the incidence of dental caries. <44> UI - 98453128 AU - Sela MO AU - Shapira L AU - Grizim I AU - Lewinstein I AU - Steinberg D AU - Gedalia I AU - Grobler SR IN - Maxillofacial Unit, Hebrew University-Hadassah School of Dental Medicine, Jerusalem, Israel. TI - Effects of honey consumption on enamel microhardness in normal versus xerostomic patients. SO - Journal of Oral Rehabilitation 1998 Aug;25(8):630-4 AB - The aim was to investigate the effect of honey on the microhardness of enamel in normal and xerostomic patients. Normal subjects and patients who were xerostomic after neck irradiation, wearing prosthetic appliances with slabs of human enamel inserted, were asked to consume a single teaspoonful of pure honey, pH 3.9. Measurements of the saliva pH were taken before, during and after a 5 min exposure to the honey. The pH of the honey-saliva mixtures decreased significantly from about 6 to 4 in both groups, returning to the baseline pH after the mixture was swallowed. The initial microhardness of the surface of the enamel slabs decreased significantly after consumption of a teaspoonful of the honey in the subjects with a regular saliva flow, whereas in the irradiated dry-mouth patients, no enamel microhardness decrease occurred. The supposed solubility-reducing factor present in honey which, according to the literature remains active in the absence of saliva, but will be inactivated by salivary enzymes, gives some support to the hypothesis that honey is less cariogenic in dry-mouth subjects. The absence of adequate controls in the present study prevents the investigation of how specific this effect is to honey. <45> UI - 98436038 AU - Kashani H AU - Emilson CG AU - Birkhed D IN - Department of Cariology, Faculty of Odontology, Goteborg University, Sweden. TI - Effect of NaF-, SnF2-, and chlorhexidine-impregnated birch toothpicks on mutans streptococci and pH in approximal dental plaque. SO - Acta Odontologica Scandinavica 1998 Aug;56(4):197-201 AB - The antimicrobial effect of birch toothpicks impregnated with 4% NaF, 8% SnF2, or 2% chlorhexidine was studied both in vitro and in vivo. A non-impregnated toothpick served as a control. In vitro, suspensions of Streptococcus mutans were exposed to the various toothpicks for 20 min and then cultured on blood agar. The results of this susceptibility test revealed the following ranking order with respect to inhibition: chlorhexidine > SnF2 > NaF and non-impregnated; with significant differences in colony-forming units (CFU) between these three groups. In vivo, 12 individuals used the 4 types of toothpick 3 times a day for 5 days in a procedure with a crossover design. Saliva and approximal plaque samples were collected at baseline and on various occasions up to 23 days after the treatment. At the same time, plaque-pH was measured at approximal sites 10 min after rinsing with 10% sucrose. The results of these in vivo experiments revealed lower proportions of mutans streptococci after using all four types of toothpick, but the reduction was significant only after 2 days for the toothpicks impregnated with SnF2 and chlorhexidine (P< 0.05). On the sampling occasions 9 and 23 days after the treatment, the mutans streptococci were more or less back to baseline levels again. In saliva no significant differences in the number of mutans streptococci were found either within or between the four treatments. No significant differences were found regarding decline in the plaque-pH between the NaF-, SnF2-, chlorhexidine-, and non-impregnated toothpicks on any of the sampling occasions. <46> UI - 99025051 AU - Foster LV IN - Department of Oral and Dental Science, University of Bristol Dental School. TI - Three year in vivo investigation to determine the progression of approximal primary carious lesions extending into dentine. SO - British Dental Journal 1998 Oct 10;185(7):353-7 AB - OBJECTIVE: To investigate the proportion of a sample of approximal carious lesions extending up to 1 mm into dentine which progressed over a 3-year period and to examine factors which influenced that progression. DESIGN: Prospective, single centre, clinical study. SETTING: Restorative Clinic at Bristol Dental School, UK. SUBJECTS AND METHODS: Sixty-five adult patients were identified who each had an approximal carious lesion which extended up to 1 mm into the dentine and which were assessed at intervals of up to 36 months. All patients were given appropriate preventive advice. MAIN OUTCOME MEASURES: Progression of the lesions was determined by assessment of sequential bitewing radiographs. RESULTS: 29% of the lesions progressed within 8 months, 56% by 20 months and 69% by 36 months. After 36 months, lesions which extended over 0.5 mm and up to 1 mm into the dentine were significantly more likely to have progressed (92%) compared with shallower lesions which extended up to only 0.5 mm into dentine (50%). CONCLUSIONS: The depth of an approximal dentine lesion was the main clinical marker which related to its progression. It is recommended that operative intervention is considered for approximal lesions which extend deeper than 0.5 mm into the dentine, while preventive treatment and re-assessment may be considered for shallower lesions. <47> UI - 99019877 AU - Walton AG AU - Rutland RF TI - Glyceryl trinitrate preparation (Suscard Buccal) causes caries and changes to the denture base material. SO - British Dental Journal 1998 Sep 26;185(6):288-9 AB - Angina is the most common symptom of ischaemic heart disease and is frequently treated by the administration of nitrates. These three cases highlight dental sequelae of prolonged administration of sustained-release glyceryl trinitrate applied to the oral mucosa. <48> UI - 99007432 AU - Hubbard LG TI - Laser-assisted restorative dentistry. SO - Dentistry Today 1998 Apr;17(4):92-5 AB - A case of rampant decay influenced by the use of a high-sugar, high-caffeine, citrus drink was presented. A pulsed Nd:YAG was used to achieve a clear operative area by removal of redundant tissue. An argon curing laser was used to effectively cure a sandwich technique of glass ionomer and microfill-resin restoration. While lasers increased the effectiveness and efficiency of routine dental care, diet control of sugar intake is crucial for long-term success. <49> UI - 99009683 AU - Manning RH AU - Edgar WM IN - Department of Clinical Dental Sciences, School of Dentistry, University of Liverpool, UK. r.manning@eastman.ucl.ac.uk TI - In situ de- and remineralisation of enamel in response to sucrose chewing gum with fluoride or non-fluoride dentifrices. SO - Journal of Dentistry 1998 Nov;26(8):665-8 AB - OBJECTIVES: Enhancement of the remineralisation of artificial enamel lesions has been observed in an intraoral model whether subjects chewed gum sweetened with a non-cariogenic sweetener such as sorbitol [1-3] or sucrose [4] after meals or snacks, and with use of a conventional (1500 ppm F) fluoride dentifrice. Since most of the clinical surveys which have shown the potential cariogenicity of sucrose chewing gum [5] were conducted before use of fluoridated dentifrices became widespread, the effect of fluoride dentifrice on de- and remineralisation of artificial lesions in enamel in response to chewing sucrose-sweetened gum has been examined with the aim of attempting to resolve this apparent discrepancy. METHODS: Subjects wore an intraoral device bearing an enamel lesion and chewed one piece of sucrose gum for 20 min after each of three meals and two snacks daily for two 3-week periods, during which they used a dentifrice containing either 0 or 1500 ppm F in a double-blind, cross-over design. Measurement of the mineral content of the lesions was determined by microradiography or polarised light microscopy. RESULTS: It was found that remineralisation tended to occur with 1500 ppm F dentifrice, but demineralisation with non-F dentifrice; the difference in enamel mineral content between the two periods was significant (P < 0.05). CONCLUSIONS: The results indicate that the potential cariogenicity of sucrose-containing chewing gum may indeed be negated by the use of a conventional fluoride dentifrice. <50> UI - 99000627 AU - Straetemans MM AU - van Loveren C AU - de Soet JJ AU - de Graaff J AU - ten Cate JM IN - Department of Cariology, Academic Centre for Dentistry Amsterdam (ACTA), The Netherlands. TI - Colonization with mutans streptococci and lactobacilli and the caries experience of children after the age of five. SO - Journal of Dental Research 1998 Oct;77(10):1851-5 AB - Some authors suggest that there is a "window of infectivity" for mutans streptococci (MS) at an early age, after which colonization is not likely to occur. Moreover, children with low or non-detectable levels of MS at an early age are at lower risk for caries. It was our aim to study caries experience and colonization with MS and lactobacilli in a group of children at 11 years of age who had been documented to have been MS-free until 5 years of age. For this group, the mfs and MFS values at 11 years of age were found to be 1.12+/-2.81 and 0.44+/-0.88, respectively. These values are much lower than those of a control group of 11-year-old children who had always been MS-positive since the age of 2, being 3.10+/-3.43 and 1.20+/-1.91, respectively. Of the 30 children without detectable MS up to the age of 5, 22 had acquired MS at 11 years of age, but their MS counts were significantly lower than those of the control group. No correlation was observed between the levels of MS of the children and the mothers. In children at 11 years of age, no differences were found in the numbers of lactobacilli and sugar intakes per week between the children MS-free and the children MS-colonized at 5 years of age. The present study indicates that the acquisition of MS is still possible after the so-called "window of infectivity" and that a delayed acquisition of MS may reduce the caries experience in the primary and permanent dentition at a later age. <51> UI - 99007518 AU - Ismail AI IN - Department of Dental Clinical Sciences, Faculty of Dentistry, Dalhousie University, Halifax, Nova Scotia, Canada. TI - The role of early dietary habits in dental caries development. [Review] [48 refs] SO - Special Care in Dentistry 1998 Jan-Feb;18(1):40-5 AB - Early Childhood Caries (ECC) is a serious dental condition that occurs during the first three years of life and is associated with the early intake of sugary foods, drinks, or snacks. There is now evidence that early malnutrition episodes could lead to delay in the eruption of primary teeth and possibly to increased caries prevalence. Significant correlations are present between the intakes of carbohydrates, proteins, and fats during infancy and several years later in life. Infants' dietary intake is also significantly correlated with the dietary intake of their mothers. Supplementing milk with vitamins during the first several years of life leads to reduction in the prevalence of linear enamel hypoplasia, a condition that may be associated with future development of dental caries. There are equivocal findings concerning the value of using dietary habits to predict caries incidence during the first three years of life. There is a need for development of educational, nutritional, and prevention programs targeting mothers and infants and for research on effective methods to prevent Early Childhood Caries. [References: 48] <52> UI - 98368978 AU - Mattos-Graner RO AU - Zelante F AU - Line RC AU - Mayer MP IN - Department of Pediatric Dentistry, Faculty of Dentistry of Sao Paulo, University of Sao Paulo, Brazil. p-graner@siso.fo.usp.br TI - Association between caries prevalence and clinical, microbiological and dietary variables in 1.0 to 2.5-year-old Brazilian children. SO - Caries Research 1998;32(5):319-23 AB - The association between caries prevalence and clinical (presence of visible plaque in the labial surfaces of maxillary incisors), microbiological (salivary levels of mutans streptococci) and dietary variables was evaluated in 142 1.0- to 2.5-year-old children attending public day-care nurseries in the city of Piracicaba - Sao Paulo. A significant difference in caries prevalence was observed between those children with and without visible plaque (chi2 = 12.08, p < 0.001). The mean ds (decayed surfaces) was significantly higher in children with visible plaque on the maxillary incisors than in children without it (p < 0.001). Mutans streptococci were detected in 114 (80.3%) of the children. A significantly higher caries prevalence was observed in children with high levels of mutans streptococci compared to children with low levels (chi2 = 28.67, p < 0.001). The mean ds was significantly higher in children with levels of mutans streptococci greater than 50 CFU when compared to children with 0 CFU or 1-50 CFU of mutans streptococci (p < 0.05). Children who were either never breast-fed or only until 3 months exhibited a significantly higher caries prevalence than those breast-fed for a longer time (chi2 = 4.11, p < 0.05). A significantly higher caries prevalence was also observed between children that used bottle containing milk with sucrose and cereal than children using bottle with milk with or without sucrose (chi2 = 6.24, p < 0.05). Children who started to eat salty meals at or after 7 months of age showed a significant higher caries prevalence than children who started earlier (chi2 = 10.30, p < 0.01). These data support the evidence of an association between caries prevalence in young children and mutans streptococci levels, clinical and dietary factors. <53> UI - 98429608 AU - Uhari M AU - Kontiokari T AU - Niemela M IN - Department of Pediatrics, University of Oulu, Oulu, Finland. TI - A novel use of xylitol sugar in preventing acute otitis media [see comments]. CM - Comment in: Pediatrics 1998 Oct;102(4 Pt 1):971-2, Comment in: Pediatrics 1998 Oct;102(4 Pt 1):974-5 SO - Pediatrics 1998 Oct;102(4 Pt 1):879-84 AB - BACKGROUND: Xylitol, a commonly used sweetener, is effective in preventing dental caries. As it inhibits the growth of pneumococci, we evaluated whether xylitol could be effective in preventing acute otitis media (AOM). DESIGN: Altogether, 857 healthy children recruited from day care centers were randomized to one of five treatment groups to receive control syrup (n = 165), xylitol syrup (n = 159), control chewing gum (n = 178), xylitol gum (n = 179), or xylitol lozenge (n = 176). The daily dose of xylitol varied from 8.4 g (chewing gum) to 10 g (syrup). The design was a 3-month randomized, controlled trial, blinded within the chewing gum and syrup groups. The occurrence of AOM each time the child showed any symptoms of respiratory infection was the main outcome. RESULTS: Although at least one event of AOM was experienced by 68 (41%) of the 165 children who received control syrup, only 46 (29%) of the 159 children receiving xylitol syrup were affected, for a 30% decrease (95% confidence interval [CI]: 4.6%-55.4%). Likewise, the occurrence of otitis decreased by 40% compared with control subjects in the children who received xylitol chewing gum (CI: 10.0%-71.1%) and by 20% in the lozenge group (CI: -12.9%-51.4%). Thus, the occurrence of AOM during the follow-up period was significantly lower in those who received xylitol syrup or gum, and these children required antimicrobials less often than did controls. Xylitol was well tolerated. CONCLUSIONS: Xylitol sugar, when given in a syrup or chewing gum, was effective in preventing AOM and decreasing the need for antimicrobials. <54> UI - 98353063 AU - Angelillo IF AU - Anfosso R AU - Nobile CG AU - Pavia M IN - Medical School, University of Reggio Calabria, Catanzaro, Italy. TI - Prevalence of dental caries in schoolchildren in Italy [published erratum appears in Eur J Epidemiol 1998 Oct;14(7):733]. SO - European Journal of Epidemiology 1998 Jun;14(4):351-7 AB - The caries experience and its potential risk indicators such as socioeconomic status, sweets consumption, toothbrushing habits, dental visit attendance pattern and salivary mutans streptococci (in 12 year old only), were assessed in schoolchildren raised and living in low fluoridated areas (Catanzaro, Italy). Caries-free prevalence in the 6-year-old was 52.9% in their primary dentition; the dmft and dmfs were 2.1 and 5.1, and both DMFT and DMFS were 0.1. Almost 91% of the dmft was attributable to active decay. The proportion of children with a dmft+DMFT > or = 1 and the dmft and dmfs were significantly higher in those with low socio-economic status. In the 12-year-old, 52.7% had a history of caries and the DMFT and DMFS were 1.5 and 2.6; the filled component was the dominant proportion. The more likely they visited a dentist for routine checkup, the higher socio-economic status (it was not associated with DMFT), the less frequently they had sweets, and the low level of Streptococcus mutans, the more likely they were caries-free and the less likely they were to have a high DMFT, DMFS, and DT. In the 15-year-old, 68.8% had a history of caries and the DMFT and DMFS were 2.8 and 4.8, with a higher prevalence of the F component. The children who visited a dentist for routine checkup had a significantly lower caries experience, DMFT, DMFS, and DT than the irregular attenders, and those with low socio-economic background were more likely to have a high DMFS. <55> UI - 98310356 AU - Borssen E AU - Stecksen-Blicks C IN - Department of Pedodontics, University of Umea. TI - Risk factors for dental caries in 2-year-old children. SO - Swedish Dental Journal 1998;22(1-2):9-14 AB - This paper describes risk factors for dental caries identified among 491 2-year-olds in the city of Umea, Sweden. The study was performed as a risk screening for dental caries according to a method developed for use by dental assistants. The sugar consumption was high, 80% of the 2-year-olds had sweets once a week or more and 25% had sweet beverages once a day or more frequently. In addition, 14% of the children had a meal at night and most common were formula, bovine milk or breastmilk. The majority of the parents brushed the child's teeth at least daily using fluoride toothpaste. Among the children 6% had a chronic somatic disorder and 6% had an intolerance towards specific foods, milk being the most common. The high level of sugar consumption indicates that improved dental health education focusing on the importance of limiting sugar consumption is needed among parents with young children. <56> UI - 98334271 AU - Seow WK IN - School of Dentistry, University of Queensland, Brisbane, Australia. k.seow@mailbox.uq.edu.au TI - Biological mechanisms of early childhood caries [see comments]. [Review] [259 refs] CM - Comment in: Community Dent Oral Epidemiol 1998 ;26(1 Suppl):28-31 SO - Community Dentistry & Oral Epidemiology 1998;26(1 Suppl):8-27 AB - The present paper reviews biological issues in early childhood caries (ECC) in light of the current understanding of the field. Despite the general global decline in dental caries in the past decades, ECC has become a significant problem in many developing countries and some minority communities in western industrialized nations. Like other types of caries, ECC is caused by mutans streptococci that ferment dietary carbohydrates to produce acid attacks on susceptible teeth over a period of time. However, while the general etiology of ECC appears similar to that of other types of caries, the predisposing factors are still unclear. The biology of ECC may be modified by several factors unique to young children, related to the implantation of cariogenic bacteria, immaturity of the host defense systems, as well as behavioral patterns associated with feeding and oral hygiene in early childhood. [References: 259] <57> UI - 98334275 AU - Ismail AI IN - Department of Cariology, Restorative Sciences, and Endodontics, School of Dentistry, The University of Michigan, Ann Arbor 48109-1078, USA. ismailai@umich.edu TI - Prevention of early childhood caries. [Review] [96 refs] SO - Community Dentistry & Oral Epidemiology 1998;26(1 Suppl):49-61 AB - This paper reviews the methods used for the prevention of early childhood caries (ECC). The education of mothers or caregivers to promote healthy dietary habits in infants has been the main strategy used for the prevention of ECC. This review found that education has a modest impact on the development of ECC. While education should be promoted especially in high risk communities and population groups (low-income families and native populations), it should not be the only preventive strategy of ECC. Early screening for signs of caries development, starting from the first year of life, could identify infants and toddlers who are at risk of developing ECC and assist in providing information to parents about how to promote oral health and prevent the development of tooth decay. High risk children include those with early signs of ECC, poor oral hygiene, limited exposure to fluorides, and frequent exposure to sugary snacks and drinks. These children should be targeted with a professional preventive program that includes fluoride varnish application, fluoridated dentifrices, fluoride supplements, sealants, diet counseling, and chlorhexidine. Prevention of ECC also requires addressing the social and economic factors that face many families where ECC is endemic. [References: 96] <58> UI - 98334283 AU - Davies GN IN - University of Queensland, St. Lucia, Brisbane, Australia. g.davies@uq.net.au TI - Early childhood caries--a synopsis. [Review] [60 refs] SO - Community Dentistry & Oral Epidemiology 1998;26(1 Suppl):106-16 AB - All the papers presented at the conference are reviewed and comparisons are made with past beliefs on the topic. Early childhood caries (ECC) is a serious public health problem in disadvantaged communities in both developing and industrialized countries in which under-nutrition is common. ECC involves the maxillary primary incisors within months after their eruption and spreads rapidly to involve other primary teeth. The early implantation of mutans streptococci, the use of a feeding bottle containing sugary solutions and prolonged breast-feeding, especially at night, are important predisposing factors. Attention is drawn to the need for more research into the factors which determine the resistance of the enamel and particularly the elucidation of the relationship established in several countries between early enamel caries, enamel hypoplasia, and perinatal under- or malnutrition. Primary preventive measures should be applied during the ante- and immediate post-natal periods. Secondary preventive measures include the use of chemotherapeutic agents such as fluoride, and antimicrobials. The most appropriate tertiary preventive measure is the atraumatic restorative technique (ART). Broadly based committees should be established by governments to address the issues of caries risk in young children. Parents and all personnel involved in infant health and welfare should be shown how to recognize early signs of the condition, as well as to promote early intervention and referral. [References: 60] <59> UI - 98397342 AU - al Ghanim NA AU - Adenubi JO AU - Wyne AA AU - Khan NB IN - Division of Paediatric Dentistry, College of Dentistry, King Saud University, Riyadh, Kingdom of Saudi Arabia. TI - Caries prediction model in pre-school children in Riyadh, Saudi Arabia. SO - International Journal of Paediatric Dentistry 1998 Jun;8(2):115-22 AB - OBJECTIVES: To evaluate the significance of variables such as oral hygiene, dietary habits, socio-economic status and medical history of a child in assessing the level of caries risk and to generate a caries prediction model for pre-school Saudi children. DESIGN: Cross-sectional study of pre-school children. SETTING: Clinics and schools in Riyadh, Saudi Arabia. SAMPLE AND METHODS: A sample of 446 Saudi pre-school children, 199 males and 247 females, with a mean age of 4.13 years, were selected at random from clinics and schools. Selection was limited to subjects who either had no caries (dmft = 0) or who had high caries experience (dmft > 8). Each child was examined for caries experience and oral hygiene status. Their mothers were interviewed through a standardized questionnaire for information about oral hygiene habits of the children, diet history, childhood illness and socio-economic status. RESULTS: There was a highly significant difference between the two groups in: debris index (P < 0.0001), aged child started tooth brushing, (P < 0.0001), age breastfeeding was stopped (P < 0.005), nocturnal bottle feeding with milk formula (P < 0.001), use of sweetened milk (P < 0.0001), frequency of use of soft drinks (P < 0.0005), frequency of consumption of sweets (P < 0.0001), and age at first dental visit (P < 0.0001). A caries prediction model developed through stepwise multivariate Logistic Regression (LR) analyses showed debris index, use of sweetened milk in bottle, frequency of consumption of soft drinks, frequency of intake of sweets and child's age at the first dental visit to be significant. Predictive probability of the model was 86.31% with a sensitivity of 90.1% and a specificity of 80.6%. CONCLUSIONS: Risk factors for dental caries have been identified and a caries prediction model has been developed for Saudi pre-school children. The prediction model, if verified, may provide with guidance in identifying high caries risk Saudi preschool children as targets for preventive programmes. <60> UI - 98383147 AU - Scopinaro N AU - Adami GF AU - Marinari GM AU - Gianetta E AU - Traverso E AU - Friedman D AU - Camerini G AU - Baschieri G AU - Simonelli A IN - Department of Surgery, University of Genoa School of Medicine, Italy. TI - Biliopancreatic diversion. SO - World Journal of Surgery 1998 Sep;22(9):936-46 AB - Biliopancreatic diversion (BPD) has made reacceptable the malabsorptive approach to the surgical treatment of obesity. The procedure, in a series of 2241 patients operated on during a 21-year period, caused a mean permanent reduction of about 75% of the initial excess weight. The indefinite weight maintenance appears to be due to the existence of a threshold absorption capacity for fat and starch, and thus energy, and the weight loss is partly due to increased resting energy expenditure. Beneficial effects other than those consequent to weight loss or reduced nutrient absorption included permanent normalization of serum glucose and cholesterol without any medication and on totally free diet in 100% of cases, both phenomena being due to a specific action of the operation. Operative mortality was less than 0.5%. Specific late complications included anemia, less than 5% with adequate iron or folate supplementation (or both); stomal ulcer, reduced to 3.2% by oral H2-blocker prophylaxis; bone demineralization, increasing up to the fourth year and tending to decrease thereafter, with need of calcium and vitamin D supplementation; neurologic complications, totally avoidable by prompt vitamin B administration to patients at risk; protein malnutrition, which was reduced to a minimum of 3% with 1.3% recurrence, in exchange with a smaller weight loss, by adapting the volume of the gastric remnant and the length of the alimentary limb to the patient's individual characteristics. It is concluded that the correct use of BPD, based on the knowledge of its mechanisms of action, can make the procedure an effective, safe one in all hands. <61> UI - 98280449 AU - Lopez Del Valle L AU - Velazquez-Quintana Y AU - Weinstein P AU - Domoto P AU - Leroux B IN - University of Puerto Rico. TI - Early childhood caries and risk factors in rural Puerto Rican children. SO - ASDC Journal of Dentistry for Children 1998 Mar-Apr;65(2):132-5 AB - A sample of 167 Puerto Rican children whose ages ranged from six months to forty-seven months (mean = 23 months) were studied. Children were examined for Early Childhood Caries with light and mirror and a structured interview was administered to parents and caretakers to identify risk factors. Results indicated that only 37.4 percent of the children were free of decalcification lesions or frank decay. While 53.9 percent of the children had lesions on maxillary incisors, 40.0 percent had molars affected by decalcification lesions and caries. Analysis of risk factors indicate that giving the baby a bottle when crying at night, number of adults and children in the family, use of fluoridated dentifrice, and age of the child were associated with the caries process in these children. Bottle and breast feeding, per se, were not risk factors. Disease patterns suggest other dietary risk factors, such as frequent snacking on food/drinks with sugar. <62> UI - 98326573 AU - Scheie AA AU - Fejerskov O AU - Danielsen B IN - Department of Oral Biology, Faculty of Dentistry, University of Oslo, Norway. TI - The effects of xylitol-containing chewing gums on dental plaque and acidogenic potential. SO - Journal of Dental Research 1998 Jul;77(7):1547-52 AB - The aim of this study was to test the hypothesis that the chewing of xylitol- or xylitol/sorbitol-containing chewing gum reduces plaque formation and the acidogenic potential of dental plaque. Thirty healthy volunteers aged from 19 to 28 yrs were randomly allocated to one of three test groups, chewing either xylitol-, xylitol/sorbitol-, or sucrose-sweetened gums. A three-day plaque accumulation period of no oral hygiene was instituted prior to and at the termination of the chewing gum program, which lasted 33 days. Plaque quantity was assessed on the basis of protein content of individual plaque samples collected by a standardized technique. Acidogenic potential of individual baseline and test plaque samples was assessed by the quantity of various organic acids formed from D-(U-14C)glucose. Identification of extracellular and intracellular metabolites was performed by HPLC. Statistical evaluation of data was performed according to paired comparisons of individual baseline and post-chewing data. Plaque formation, acidogenic potential, and glycolytic profiles were similar at baseline and after the gum-chewing periods. Also, there was no intracellular accumulation of glycolytic metabolites within the plaque bacteria to indicate the inhibition of glycolysis. The study thus leads to the conclusion that, in young adults with low caries experience, exposure of the oral cavity to acceptable doses of xylitol or xylitol and sorbitol has no effect on the microbial deposits on the teeth. <63> UI - 98271373 AU - Moon H AU - Paik D AU - Horowitz AM AU - Kim J IN - National Institute of Dental Research, National Institutes of Health, Bethesda, MD 20892-6401, USA. TI - National survey of Korean dentists' knowledge and opinions: dental caries etiology and prevention. SO - Journal of Public Health Dentistry 1998 Winter;58(1):51-6 AB - OBJECTIVE: Dentists have the potential to influence what their patients know and do regarding dental caries prevention. The practices of dentists and what they tell their patients are influenced, in part, by their own knowledge and opinions. The purposes of this study were to determine the level of knowledge and opinions about caries etiology and prevention among Korean dentists and to describe related factors. METHODS: A pretested, 27-item questionnaire was mailed to 2,047 dentists, selected by a stratified random sampling allocated proportionately. A postcard reminder was sent to all dentists after one week. Nonrespondents were sent additional complete mailings after three, seven, and nine weeks. The response rate was 83 percent (n = 1,700 dentists). RESULTS: Analysis of six factors thought to be related to knowledge about caries etiology and prevention showed that recent graduates and dentists who worked in public health centers were likely to be more knowledgeable about caries etiology and prevention than their counterparts (P < .05). In regression analysis of perceived effectiveness of caries-preventive procedures for children, recent graduates, males, and dentists who worked in public health centers tended to rate caries-preventive procedures more effective than other dentists (P < .05). Dentists who had experience with school-based preventive programs and dentists in rural areas were likely to rate caries-preventive procedures for adults more effective than other dentists (P < .05). CONCLUSIONS: Overall, results of this study suggest that the majority of dentists do not know current information concerning etiology and prevention of dental caries, mechanisms of action of fluoride, and effectiveness of preventive procedures for children and adults. Efforts to enhance the level of knowledge and practices of Korean dentists about caries prevention should focus on strategies to educate older graduates and female dentists, especially those in private practice. <64> UI - 98307312 AU - Arnadottir IB AU - Rozier RG AU - Saemundsson SR AU - Sigurjons H AU - Holbrook WP IN - University of Iceland Faculty of Odontology, Reykjavik. TI - Approximal caries and sugar consumption in Icelandic teenagers. SO - Community Dentistry & Oral Epidemiology 1998 Apr;26(2):115-21 AB - The aim of this study, conducted in 1994, was to examine the association between approximal caries and sugar consumption in teenagers residing in three fluoride-deficient areas in Iceland while controlling for a number of behavioral, residential and microbiological factors. One hundred and fifty subjects (mean age 14 years) selected from the Icelandic Nutritional Survey (INS) were examined radiographically and they completed questionnaires about sugar consumption frequency. Total grams of sugar intake were obtained from the INS for each subject. Caries experience on approximal surfaces, diagnosed from radiographs, was used as the dependent variable in the analyses. Altogether 45.2% of subjects were caries free on approximal surfaces. The overall sample was found to have a mean DFS on approximal surfaces of 2.73 (s=4.36) per subject. Average daily total sugar intake was 170 g per subject and the mean number of sugar-eating occasions between meals was 5.32 (s=6.29) per subject. The regression model indicated that the frequency of between-meal sugar consumption was associated with approximal caries, with frequency of candy consumption being the most important of the sugar variables. In multivariate analysis, no relationship was found between dental caries and total daily intake of sugar, although a significant relationship between total sugar consumption and presence of caries was seen in bivariate analysis. Between-meal consumption of sugar remains a risk factor for the occurrence of dental caries, especially in populations with moderate-to-high levels of dental caries experience. <65> UI - 98224952 AU - Axelsson P AU - Paulander J AU - Lindhe J IN - Department of Periodontology, Faculty of Odontology, Goteborg University, Sweden. TI - Relationship between smoking and dental status in 35-, 50-, 65-, and 75-year-old individuals. SO - Journal of Clinical Periodontology 1998 Apr;25(4):297-305 AB - The aim of the present study was to examine the dental status and smoking habits in randomized samples of 35-, 50-, 65-, and 75-year-old subjects (n = 1093), recruited for a cross-sectional epidemiological study in the County of Varmland, Sweden. The following clinical variables were recorded by 4 well-calibrated dentists: number of edentuolous subjects, number of missing teeth, probing attachment level, furcation involvement, CPITN scores, DMF surfaces, plaque and stimulated salivary secretion rate (SSSR). In addition, the subjects reported in a questionnaire their tobacco habits, oral hygiene habits, dietary habits etc. The percentage of smokers in 35-, 50-, 65-, and 75-year-olds was 35%, 35%, 24% and 12%, respectively. In 75-year-olds, 41% of the smokers were edentulous compared to 35% of non-smokers. The difference in number of missing teeth between smokers and non-smokers was 0.6 (p=0.15), 1.5 (p=0.013), 3.5 (p=0.0007) and 5.8 (p=0.005) in the 4 age groups. Smokers had the largest mean probing attachment loss in all age groups. The differences between smokers and non-smokers in mean attachment level were 0.37 (p=0.001), 0.88 (p=0.001), 0.85 (p=0.001) and 1.33 mm (p=0.002) in the 35-, 50-, 65-, and 75-year-olds, respectively. Treatment need assessed by CPITN was in all age groups greatest among smokers. The number of intact tooth surfaces was fewer in 35-, 50-, and 75-year-old smokers than in non-smokers. The number of missing surfaces (MS) was higher in 50-, 65-, and 75-year-old smokers than in non-smokers. In addition, 35-year-old smokers exhibited a significantly larger number of decayed and filled tooth surfaces (DFS) than non-smokers. Male smokers had significantly higher SSSR than non-smoking males (p=0.012). Plaque index and oral hygiene were similar in smokers and non-smokers. Smokers reported a more frequent intake of sugar containing soft drinks (p=0.000) and snacks (p=0.003) than non-smokers. The opposite was reported for consumption of fruit (p=0.003). It was concluded that smoking is a significant risk indicator for tooth loss, probing attachment loss and dental caries. <66> UI - 98204418 AU - Makinen KK AU - Hujoel PP AU - Bennett CA AU - Isokangas P AU - Isotupa K AU - Pape HR Jr AU - Makinen PL IN - Department of Biologic and Materials Sciences, The University of Michigan, Ann Arbor, USA. TI - A descriptive report of the effects of a 16-month xylitol chewing-gum programme subsequent to a 40-month sucrose gum programme. SO - Caries Research 1998;32(2):107-12 AB - A previous caries trial (Belize studies) involved the usage of sucrose chewing-gum for a period of 40 months in one group of initially 10-year-old subjects in an environment of high sugar consumption, high caries activity, and limited access to restorative care. After the termination of the 40-month supervised sucrose gum usage, the 109 subjects of the original sucrose group retrieved at the endpoint of the original trial were invited to participate in a xylitol chewing-gum programme (involving the usage of the '100% pellet-shaped formular') for 16 months. The average daily consumption level of xylitol was up to 14 g per subject, normally used in seven daily chewing episodes. Although most subjects used chewing-gum at schools and received their gum portions from a school official, gum chewing during these 16 months was mostly unsupervised. After 16 months, 83 subjects (76%; mean age 14.9 years) were retrieved. The caries status of these subjects was examined by the same calibrated, blinded examiners as in the original trial. To mask the examiners, 141 similar non-participating subjects were recruited from the same school classes and were examined in a random order with the gum-using subjects, according to the same standard routine. The intensified xylitol gum usage for 16 months was associated with a reduction of the mean DMFS score from 10.9 (at 40 months) to 9.3 (at 56 months, p = 0.0013) and a reduction in caries rate from 20.1 caries onsets per 1,000 surface-years (40-month period average rate) to 10.2 caries onsets per 1,000 surface-years. The reduction in DMFS score resulted mostly from the change in the D component of the index and possibly reflected a stabilisation of the caries process and rehardening of some caries lesions to a non-progressive carious state. <67> UI - 98170785 AU - Mohan A AU - Morse DE AU - O'Sullivan DM AU - Tinanoff N IN - Department of Pediatric Dentistry, School of Dental Med