Search

Objective The aim was to evaluate the effect of a chlorhexidine-containing brush-on gel when used as supplement to oral hygiene instructions and mechanical debridement, on peri-implant mucositis in adults. Materials and methods The study group consisted of 38 adults (48-87 years.) with peri-implant mucositis that were consecutively enrolled in three private clinics after informed consent. The study employed a double-blind controlled design with two parallel arms. After baseline registrations, oral hygiene reinforcement and mechanical debridement, the patients were randomly allocated to either a test group with once daily tooth brushing with an oral care brush-on gel containing 0.2% chlorhexidine digluconate (Cervitec Gel) or a control gel group. The duration of the intervention was 12 weeks. The primary outcome was bleeding on probing ( BOP) and secondary endpoints were local plaque score ( LPS) and pocket probing depth ( PPD). Results The groups were balanced at baseline. The daily use of the chlorhexidine-containing gel resulted in reduced BOP after 4 and 12 weeks compared with the control group ( P < 0.05). The PPD was significantly reduced ( P < 0.05) after 12 weeks compared to baseline in the test group, but not in the control group. No side effects or adverse events were reported. Conclusion The present findings indicated moderate but significant improvements of clinical parameters when mechanical debridement was combined with a self-applied oral care brush-on gel for the management of peri-implant mucositis. [ABSTRACT FROM AUTHOR]

Objectives: To study preventive care provided to young adults in relation to their estimated risk category over a 3-year period. Methods: The amount and type of preventive treatment during 3 years was extracted from the digital dental records of 982 patients attending eight public dental clinics. The baseline caries risk assessment was carried out by the patient's regular team in four classes according to a predetermined model, and the team was responsible for all treatment decisions. Based on the variables 'oral health information', 'additional fluoride' and 'professional tooth cleaning', a cumulative score was constructed and dichotomized to 'basic prevention' and 'additional prevention'. Results: More additional preventive care was provided to the patients in the 'low-risk' and 'some risk' categories than to those classified as 'high' or 'very high' risk (OR = 2.0, 95% CI 1.4-3.0; P < 0.05). Professional tooth cleaning and additional fluorides were most frequently employed in the 'low-risk' and 'some risk' categories, respectively. Around 15% of the patients in the high-risk categories did not receive additional preventive measures over the 3-year period. There was an insignificant tendency that patients with additional prevention developed less caries than those that received basic prevention in all risk categories except for the 'very high-risk' group. Conclusion: The caries risk assessment process was not accompanied by a corresponding targeted individual preventive care in a cohort of young adults attending public dental service. Further research is needed how to reach those with the greatest need of primary and secondary prevention. [ABSTRACT FROM AUTHOR]

Introduction: Food supplemented with probiotic bacteria is a rapidly growing sector of the market. The aim of the present study was to evaluate and compare the acid production of selected probiotic strains available in commercial products. Methods: Six Lactobacillus strains ( Lactobacillus plantarum 299v and 931; Lactobacillus rhamnosus GG and LB21; Lactobacillus paracasei subsp. paracasei F19, and Lactobacillus reuteri PTA 5289) were cultivated at 37°C in an anaerobic atmosphere on Man, Rogosa, Shape (MRS) agar for 48 h or MRS broth for 16 h. After centrifugation, the cells were washed and resuspended in sterile phosphate-buffered saline and immediately subjected to a fermentation assay with 12 different carbohydrates (nine sugars and three sugar alcohols) in microtiter plates with a pH indicator. The plates were examined for color changes after 24, 48, and 72 h of incubation under aerobic and anaerobic conditions. Three scores were used: negative (pH > 6.8); weak (pH 5.2–6.8), and positive (pH < 5.2). The strains were characterized with the API 50 CH system to confirm their identity. Results: L. plantarum fermented all the sugars except for melibiose, raffinose, and xylitol. Both L. rhamnosus strains were generally less active although L. rhamnosus GG was slightly more active than strain LB21 in the 5% CO2 setting. The latter strain exhibited negative reactions for sucrose, maltose, arabinose, and sorbitol under anaerobic conditions. The assays with L. paracasei and L. reuteri had negative or weak reactions for all tested sugars under both aerobic and anaerobic conditions. Conclusion: The metabolic capacity to form acid from dietary sugars differed significantly between the various probiotic strains. [ABSTRACT FROM AUTHOR]

The aims of the present study were to describe eating, toothbrushing and smoking habits in a cohort of Swedish female adolescents, and to relate the findings to dental caries increment.The research took the form of a longitudinal study.The study sample consisted of a cohort of 162 girls under regular dental care, aged 12 years at baseline, who were followed for 3 years, from the sixth to the ninth grade. Eating, oral cleaning and smoking habits were self-reported three times per year through a questionnaire, and caries data at baseline and after 3 years were collected from dental records.The results showed significantly (P<0·05) impaired eating habits during the study period and that adherence to regular main meals diminished. In the eighth grade, one-third of the girls skipped breakfast before school and only 50% had their free school lunch daily. The omission of breakfast and irregular main meals, as well as smoking were significantly associated with caries (decayed, missed and filled surfaces) increment in the eighth grade (odds ratio = 4·1–4·9,P<0·05). Snacks, light meals, soft drinks and sweets were already frequently consumed at baseline and continued to be so over the years. Although> 95% of subjects reported that they brushed their teeth at least once a day, approximately 20% did not do it every evening, and this figure remained stable over the study period. However, snacks, soft drinks and sweets, and toothbrushing habits had no significant influence on caries development.Dietary advice for caries prevention in adolescent girls should focus on the importance of retaining regular main meals, and especially, not skipping breakfast. [ABSTRACT FROM AUTHOR]

To investigate the relationship between caries risk and glucosylated haemoglobin and to evaluate the use of a computerized caries risk assessment program as a predictor of metabolic control in schoolchildren with Type 1 diabetes mellitus.The material consisted of 64 young Type 1 diabetes mellitus patients (8–16 years) attending an outpatient paediatric clinic. Within 2 weeks after the onset of diabetes, a caries risk assessment was carried out with the aid of a computer-based program (Cariogram) and data on the level of metabolic control were collected from the medical records at the 3-year check-up. Caries increment was registered at recall clinical examinations.A statistically significant positive relationship between caries risk and metabolic control was found (r = 0.51;P < 0.01), with a sevenfold increased risk of impaired metabolic control after 3 years in those assessed with high caries risk at onset (OR 7.3;P < 0.01). When the Cariogram was used as a predictor for the metabolic state of the disease, the sensitivity and specificity was 75% and 71%, respectively. The negative predictive value was 91%.Our data suggested that a caries risk assessment at the diagnosis of diabetes mellitus in children may be a good indicator of overall health care that can provide useful prognostic information on the level of metabolic control after 3 years.Diabet. Med. 22, 312–315 (2005) [ABSTRACT FROM AUTHOR]

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

Summary. Objectives. To examine the effect of operative and restorative treatment of dental caries on the levels of caries associated microorganisms in saliva and to relate alterations to the type and extent of treatment. Design. Longitudinal. Setting. Paediatric Dentistry Department at a central hospital in Sweden. Subjects and methods. One hundred and eight pre-school children with severe dental caries scheduled for treatment under general anaesthesia. Chair-side tests were used to estimate the levels of salivary mutans streptococci, lactobacilli and buffer capacity before the surgery and at recall appointments 1 and 6 months after treatment. Caries were assessed according to WHO guidelines and the number of extracted teeth and filled surfaces during surgery were recorded. Results. The results demonstrate that the post-treatment levels of mutans streptococci and lactobacilli were significantly reduced (P < 0·001) compared to pretreatment levels. Lactobacilli levels were more dramatically reduced than mutans streptococci. The reduction of mutans streptococci was positively correlated to the number of extracted teeth (P < 0·01), but not to the number of restored or ground surfaces. Lactobacilli reduction was not significantly related to the type of treatment. Conclusion. The findings suggest that extensive operative and restorative dental care effectively reduces the levels of caries associated with microorganisms during a period of at least 6 months. [ABSTRACT FROM AUTHOR]

Summary. The purpose of this study was to evaluate the use of a chair-side test involving a count of salivary mutans streptococci (the Strip mutans test) in the assessment of caries risk in a group of preschool children living in an area with a low caries prevalence. A group of 528 4-year-old children were randomly allocated to a study or a control group. In the study group, the baseline microbial data, together with clinical findings of past caries experience, were used for caries risk assessment and for planning subsequent preventive treatment. All children were examined at baseline and after 2 years. Caries experience was assessed according to WHO criteria. There was no difference in caries experience between the study group and the control group at baseline. Within the study group, caries increment was positively correlated ( P<0·01) with the number of mutans streptococci in saliva at baseline, and children assessed 'at risk' at baseline (Strip mutans score > 2 and/or > 1 dmfs) developed more new lesions than those considered as 'low risk' (mean dmfs 2.6 v 0·9; P<0·05). The sensitivity and specificity of this combined clinical and microbial caries risk selection were 67% and 75%, respectively, disease being defined as an increment of at least one carious lesion over the 2-year period. In both groups, 50% of the children remained caries inactive during the study. The mean caries increment was, however, lower in the study group than in the control group (mean dmfs 1·7 v 2·1) but the difference was not statistically significant. The results indicate that the Strip mutans test, as a supplement to clinical examination, may be useful in the assessment of caries risk in preschool children and therefore in the planning of preventive measures. Résumé. Cette étude porte sur un test de comptage au fauteuil du streptocoque salivaire mutans (le test Strept mutans) pour évaluer le risque carieux dans une population d'enfants d'âge préscolaire vivant dans une zone à prévalence carieuse faible. Les 528 enfants out été répartis au hasard dans le groupe de contrôle et le groupe d'étude. Dans le groupe d'étude, les donněes microbiennes ainsi que cliniques de l'étude de départ ont été utilisées pour prévoir le risque carieux et pour planifier un programme de prévention. Tous les enfants ont ensuite été examinés deux ans après. l'expérience carieuse a été notée à l'aide des critères de l'OMS. Lors de l'étude de départ, il n'y avait pas de différence entre les deux groupes en ce qui concerne les caries. Dans le groupe d'étude, l'augmentation du nombre de caries était corrélée de façon positive au nombre de streptocoques mutans ( P<0.01) dans la salive et les enfants à risque (strep mutans > 2 et/ou > 1 cao) ont par la suite eu plus de nouvelles caries que les enfants à risque faible (indice cao moyan 2.6 vs 0.9; P<0.05) La sensibilité et la spécificité de ce test clinique et microbien étaient respectivement de 67% et 75%, la maladie carieuse étant définie par l'apparition d'au moins une lésion carieuse pendant la période de deux ans. Dans les deux groupes, 50% des enfants n'ont pas eu d'autres caries pendant la durée de l'étude. l'augmentation moyenne du nombre de caries était plus bas dans le groupe d'études que dans le groupe de contrôle) (indice moyan cao 1.7 vs 2.1). Les résultats montrent que le test Strep mutans, en complément de l'étude clinique, peut être utile pour prévoir le risque carieux chez les enfants d'âge préscolaire, donc pour prévoir un programme de prévention. Zusammenfassung. Der Zweck dieser Studie war, die Beurteilung der Anwendung des Strep-mutans Testes bei der Abschätzung des Kariesrisikos einer Vorschulaltersgruppe, in einer Gegend mit niedrigen Kariesbefall 528 vier Jahre alter Kinder wurde aufgeteilt in 2 Teile, einer Studiengruppe und einer Kontrollgruppe. Bei der Studiengruppe wurden die mikrobiellen Data am Anfang, und die bisherigen Kariesrisiko zu bestimmen, um anhand dieser Befunde die Vorbeugungsmassnahmen zu planen. Alle Kinder wurden am Anfang und nach 2 Jahren beurteilt. Die Karies wurde anhand der WHO Kriteniengemessen. Am Anfang der Studie wurden keinerlei Unterschiede zwischen der Studiengruppe und der Kontrollgruppe bezüglich der Karies festgestellt. In der Studiengruppe, die Korrelation zwischen der Kariesanfälligkeitund der Anzahl der Streptococci nuntan im Speichel war posoitiv ( P<0.01). Kinder welche am Anfang mit hohem Kariesrisiko eingestuft wurden (Strep mutans test,>2 oder>1 dmfs) entwickelten mehr neue Kariöse Läsicnen als die Kinder welche mit niedrigem Risiko (dmfs 2.6). Die Empfindlichkeit und die Spezifität dieses kombinierten klinischen und mikrobiellen Risikotestes waren 67% resp. 75% wenn sich wenigstens 1 neue Kariesläsion während 2 Jahre entwickelt. In beiden Gruppen 50% der Kinder blieben Karies inaktif während der Studie. Der durchschnittliche Karieszuwachs war niedriger in der Studiengruppe als in der Kontrollgruppe (dmfs 1.7 gegenüber 2.1) aber dieser Unterschied war nicht statistisch Signifikant. Die Resultate zeigen den Nutzen des Strep mutans Testes zusätzlich zum Klinischen Untersuch. Resumen. El próposito de este estudio fue evaluar el uso de un test diseñado para ser utilizado en la consulta odontológica para determinar el numero de estreptococos mutans salival (Strep Mutans test). El estudio fue realizado en niños prescolares sin caries que residín en un área con baja prevalencia de caries. Un grupo de 528 niños de 4 años de edad fueron distribuídos en un grupo control y uno experimental. En la grupo experimental, los valores microbiológicos iniciales y los hallazgos clinicos de la experimencia de caries pasada fueron utilizados para determinar el riesgo de caries y para planificar el tratamiento preventivo subsecuente. Todos los niños fueron examinados al inicio del estudio y a los 2 años. La prevalencia de caries fue determinada basado en los criterios de la OMS. No hubo diferencia en la prevalencia de caries entre los dos grupos al inicio del estudio. Dento del grupo experimental, el incremento de caries fue positivamente correlacionado ( P<0.01) al numero de estreptococos mutans salival al inicio del estudio y os niños consideragos 'en riesgo' al inicio del estudio (valor del estreptococo mutans > 2 y/o cpos > 1) desarrollaron más lesiones que los niños considerdos en 'bajo riesgo' (media cpos 2.6 vs 0.9, P<0.05). La sensitividad y especificidad de esta selección combinada clínica y microbiológica para determinar el riesgo de caries fue de 67% y 75%, respectivamente, considerando a la lesión como el incremento de por lo menos una lesion cariosa durante los 2 años. En ambos grupos, el 50% de los niños no desarrolló caries. El incremento promedio de caries fue, sin embargo, más bajo en el grupo experimental que en el control (media cpos 1.7 vs 2.1), pero la diferencia no fue estadísticamente significativa. Los resultados indican que el test Strep mutans, como suplemento a la evaluación clínica, puede ser útil para determinar el riesgo de caries en niños prescolares y por lo tanto el el desarrolló de programas preventivos. [ABSTRACT FROM AUTHOR]

Aim: The aim was to examine the association between moderate to late preterm birth and the prevalence of early childhood caries., Methods: We searched the PubMed, Scopus, Cochrane Trials Register databases up to February 28, 2020. Two independent reviewers screened the papers for relevance, extracted data and assessed the risk of bias. A random-effects meta-analysis was performed to pool the prevalence of early childhood caries by gestational age., Results: The authors identified 14 studies covering 210,691 children. They were published from 2007-2020 and included birth cohorts, cross-sectional, register-based and case-control studies. We assessed eight of them as having low or moderate risk of bias. The median caries prevalence was 48.8% among children born moderate to late preterm compared to 20.5% for those born full term. The pooled overall odds ratio was 1.48 (95% confidence interval 1.16-1.89; P < .001). The certainty of this finding was low due to heterogeneity and inconsistencies across the studies., Conclusion: This systematic review and meta-analysis displayed a significantly higher prevalence of early childhood caries in children born moderate to late preterm compared to full term children. The finding suggests that the gestational age should be collected as a risk factor in the paediatric dental records., (© 2020 The Authors. Acta Paediatrica published by John Wiley & Sons Ltd on behalf of Foundation Acta Paediatrica.)

Aim: To study the relationship between early childhood caries and perinatal and metabolic risk factors in a cohort of preschool children., Methods: The study population consisted of 208 children followed from birth to 6.5 years. We extracted the perinatal factors from medical records and questionnaires and assessed the occurrence of caries at the age of 5 years. Indicators of the metabolic syndrome (waist circumference, blood pressure, fasting insulin, glucose and dyslipidaemia) were recorded at 6.5 years of age., Results: Infants born moderately to late preterm and infants born small for gestational age were more likely to have early childhood caries at 5 years of age (relative risk 4.2 and 2.3, respectively; P < .05). The presence of metabolic risk factors according to the IDEFICS monitoring levels did not differ between children with or without caries but a statistically significant correlation was found between the fasting glucose values and the number of decayed or filled teeth (r = 0.18; P < .05)., Conclusion: Being born preterm or small for gestational age increased the risk of early childhood caries. Preschool children with caries had higher fasting glucose levels but no other signs of the metabolic syndrome., (© 2020 The Authors. Acta Paediatrica published by John Wiley & Sons Ltd on behalf of Foundation Acta Paediatrica.)

Today, dental caries is regarded as a preventable non-communicable disease (NCD) that affects a majority of the population across their lifespan. As such, it shares a number of behavioural, socio-economic, and lifestyle factors with other NCDs, such as overweight and diabetes, and should be subjected to a similar model of chronic disease management. Caries prevention has traditionally relied on fluoride exposure, diet control, thorough oral hygiene, and antibacterial measures. Prevention of caries as an NCD does certainly not disqualify these methods, but brings them into a new context. This conference paper provides a brief review on how common preventive measures can interfere with the drivers of dysbiosis and promote the growth of health-associated clusters in the oral microbiome. Besides the established routines of regular toothbrushing with fluoride products, there is an opportunity for additional technologies, based on ecological principles, to address and modify the oral biofilm. Methods to reduce dietary sugar intake, slow down plaque metabolism, and support saliva functions should be further developed and investigated in terms of efficacy, compliance, and cost-effectiveness. Furthermore, biofilm engineering through pre- and probiotics early in life to support microbial diversity seem promising in order to obtain a sustained caries-preventive effect., (© 2018 Eur J Oral Sci.)

Periodontal diseases and dental caries are the most common diseases of humans and the main cause of tooth loss. Both diseases can lead to nutritional compromise and negative impacts upon self-esteem and quality of life. As complex chronic diseases, they share common risk factors, such as a requirement for a pathogenic plaque biofilm, yet they exhibit distinct pathophysiologies. Multiple exposures contribute to their causal pathways, and susceptibility involves risk factors that are inherited (e.g. genetic variants), and those that are acquired (e.g. socio-economic factors, biofilm load or composition, smoking, carbohydrate intake). Identification of these factors is crucial in the prevention of both diseases as well as in their management., Aim: To systematically appraise the scientific literature to identify potential risk factors for caries and periodontal diseases., Methods: One systematic review (genetic risk factors), one narrative review (role of diet and nutrition) and reference documentation for modifiable acquired risk factors common to both disease groups, formed the basis of the report., Results & Conclusions: There is moderately strong evidence for a genetic contribution to periodontal diseases and caries susceptibility, with an attributable risk estimated to be up to 50%. The genetics literature for periodontal disease is more substantial than for caries and genes associated with chronic periodontitis are the vitamin D receptor (VDR), Fc gamma receptor IIA (Fc-γRIIA) and Interleukin 10 (IL10) genes. For caries, genes involved in enamel formation (AMELX, AMBN, ENAM, TUFT, MMP20, and KLK4), salivary characteristics (AQP5), immune regulation and dietary preferences had the largest impact. No common genetic variants were found. Fermentable carbohydrates (sugars and starches) were the most relevant common dietary risk factor for both diseases, but associated mechanisms differed. In caries, the fermentation process leads to acid production and the generation of biofilm components such as Glucans. In periodontitis, glycaemia drives oxidative stress and advanced glycation end-products may also trigger a hyper inflammatory state. Micronutrient deficiencies, such as for vitamin C, vitamin D or vitamin B12, may be related to the onset and progression of both diseases. Functional foods or probiotics could be helpful in caries prevention and periodontal disease management, although evidence is limited and biological mechanisms not fully elucidated. Hyposalivation, rheumatoid arthritis, smoking/tobacco use, undiagnosed or sub-optimally controlled diabetes and obesity are common acquired risk factors for both caries and periodontal diseases., (© 2017 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.)

This article describes the construction and characterization of a mariner-based transposon vector designed for use in oral streptococci, but with a potential use in other Gram-positive bacteria. The new transposon vector, termed pMN100, contains the temperature-sensitive origin of replication repATs-pWV01, a selectable kanamycin resistance gene, a Himar1 transposase gene regulated by a xylose-inducible promoter, and an erythromycin resistance gene flanked by himar inverted repeats. The pMN100 plasmid was transformed into Streptococcus mutans UA159 and transposon mutagenesis was performed via a protocol established to perform high numbers of separate transpositions despite a low frequency of transposition. The distribution of transposon inserts in 30 randomly picked mutants suggested that mariner transposon mutagenesis is unbiased in S. mutans. A generated transposon mutant library containing 5000 mutants was used in a screen to identify genes involved in the production of sucrose-dependent extracellular matrix components. Mutants with transposon inserts in genes encoding glycosyltransferases and the competence-related secretory locus were predominantly found in this screen., (© 2014 The Authors. MicrobiologyOpen published by John Wiley & Sons Ltd.)

Aim: Periodontitis is a multifactorial disease in which subgingival bacteria play an important role in the pathogenesis of the disease. The objective of this study was to determine if periodontitis is associated with a characteristic salivary bacterial profile. This was accomplished by comparing the bacterial profile of saliva from subjects with chronic periodontitis with that of saliva from a control cohort., Materials and Methods: Stimulated saliva samples from 139 chronic periodontitis patients and 447 samples from a control cohort were analysed using the Human Oral Microbe Identification Microarray (HOMIM). Frequency and levels (mean HOMIM-value) of around 300 bacterial taxa/clusters in samples were used as parameters for investigation. Differences at taxon/cluster values between groups were analysed using Mann-Whitney U-test with Benjamini-Hochberg correction for multiple comparisons. Principal component analysis was used to visualize bacterial community profiles obtained by the HOMIM., Results: Eight bacterial taxa, including putative periodontal pathogens as Parvimonas micra and Filifactor alocis, and four bacterial clusters were identified statistically more frequently and at higher levels in samples from periodontitis patients than in samples from the control cohort. These differences were independent of the individuals' smoking status., Conclusions: Periodontitis is associated with a characteristic bacterial profile of saliva different from that of a control cohort., (© 2013 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.)

This study aimed to investigate two dose regimens of xylitol-containing tablets on the ecology of dental plaque and saliva during treatment with fixed orthodontic appliances. The study group comprised 56 healthy patients (mean age 15.8 yr) randomly assigned into the following groups: A, (n = 23) two xylitol tablets two times a day (1.7 g xylitol d(-1)) for 18 wk; B, (n = 23) two tablets four times per day (3.4 g xylitol d(-1)) for 18 wk; and C, (n = 10) no tablets. The levels of mutans streptococci (ms) were enumerated in plaque and saliva and the proportion of xylitol-sensitive (X(S)) strains in saliva was determined by autoradiography with [(14)C]-xylitol at baseline and at 6, 12, and 18 wk. The lactic acid formation rate was assessed enzymatically in sucrose-challenged plaque suspensions. A drop in salivary ms levels was found in Group A after 6 wk but not after 12 or 18 wk. The proportion of X(S) ms was decreased after 6 wk in groups A and B and remained so during the experimental period. The lactic acid formation rates decreased slightly ( approximately 10%) in the two xylitol groups compared with baseline. In conclusion, our results showed that although an alteration of ms strains was demonstrated following a regular daily low-dose intake of xylitol, the long-term total ms counts in plaque and saliva as well as plaque acidogenicity remained unchanged.

The aim of this study was to apply the quantitative light-induced fluorescence (QLF) method in a randomised controlled study, comparing treatment with fluoride varnish and professional tooth cleaning for remineralisation of white spot lesions in caries-active adolescents. In the fluoride varnish group (n = 13; 32 lesions), professional tooth-cleaning was followed by application of fluoride varnish at the beginning of the study, after 1 wk, and then once every 6 wk for 6 months. The other group (n = 18; 30 lesions) underwent professional tooth-cleaning once every 6 wk for 6 months. Enamel fluorescence was measured at baseline and at each visit. In the fluoride varnish group there was a significant change over time (baseline: 6 months) for both lesion area: and average change in fluorescence (decreased lesion area and increased fluorescence radiance). The corresponding changes in the professional tooth-cleaning group were not significant. There was a significant difference in average change in fluorescence between the two test groups. For lesion area, there was no significant difference, but a tendency towards a difference between the test groups. It was concluded that (a) the QLF method is a sensitive method, suitable for longitudinal quantification of incipient caries lesions on smooth surfaces; and (b) that repeated fluoride applications had a favourable effect on the remineralisation of white spot lesions as measured after 6 months.

The prevalence and number of salivary lactobacilli was determined in all schoolchildren starting the 7th grade (12-13 yr; n = 1,578) in comprehensive school located in Kumla, Sweden between 1987 and 1998. Whole saliva samples were collected and transferred to dip-slides (Dentocult-LB) and incubated in room temperature for 7 d. Caries data were collected from the dental records and from bitewing radiographs. Both the number of lactobacilli and the prevalence of manifest caries and restorations exhibited a decreasing tendency and were significantly lower in 1998 than in 1987. The mean caries prevalence (DFS) declined from 5.2 to 1.8. In 1987, 45% of the children harboured high or very high lactobacilli counts ( > or =10(5) CFU/ml) in their saliva compared to approximately 10-15% at the later examinations. The proportion of children with no detectable counts varied between 4-29% during the study period, while children with low counts (10(3)-10(4) CFU/ml saliva) constituted a clear majority at the recent samplings. With such low levels in the population, the use of lactobacilli counts as a didactic tool in dietary counselling must be called into question.

Development and progression of approximal caries is still difficult to prevent and control even in societies with declining caries prevalence. In this study, a test group of 115 12-yr old children were treated semi-annually with a mixture (1:1) of a varnish containing 0.1% F (Fluor Protector) and 1.0% chlorhexidine (Cervitec). A reference group of 104 children received fluoride varnish treatment (Fluor Protector) semi-annually. Approximal caries was recorded from bitewing radiographs at baseline and after 3 yr. At baseline, total decayed and filled surfaces (DFS) including enamel caries were 1.79+/-2.36 in the reference group and 2.0+/-2.77 in the test group. After 3 yr, the mean approximal caries incidence including enamel caries was 3.01+/-3.74 and 3.78+/-4.32, respectively. The differences at baseline as well as after 3 yr were not statistically significant. The results showed that both groups had a comparatively low incidence of approximal caries during the experimental period, and suggest that a mixture of fluoride and antibacterial varnish had no additional preventive effect on approximal caries incidence compared with fluoride varnish treatments alone.

The aim was to study the effect of a chlorhexidine/thymol-containing varnish (Cervitec) on the levels of prostaglandin E2 (PGE2) in gingival crevicular fluid (GCF). The material consisted of 25 adolescents and young adults with fixed orthodontic appliances exhibiting gingival inflammation. Four buccal sites, adjacent to bands and brackets, were selected on each patient and randomly treated with either a varnish containing chlorhexidine diacetate (1% w/w) and thymol (1% w/w) or a placebo varnish without active ingredients. After baseline registration, the varnishes were applied twice within 3 d. Follow-up examinations were performed after 3, 8 and 30 d. The gingival inflammation was assessed by bleeding on probing, volume of GCF with a Periotron 8000 and PGE2 level in GCF by using a radioimmuno assay. Compared with baseline, a statistically significant reduction in the volume of GCF was recorded at the chlorhexidine/thymol treated sites in contrast to the placebo. The mean PGE2 levels were significantly reduced after the test varnish treatment compared with baseline and differed significantly from placebo after 8 d. The findings suggest that treatments with the antibacterial varnish result in reduced gingival inflammation and may thus be beneficial for patients with fixed orthodontic appliances.

The aim of the present study was to evaluate the salivary secretion rate and composition in a group of 16 children and young adults (6-27 years) with Papillon-Lefèvre Syndrome (PLS), and to compare the findings with a group (n = 16) of healthy controls. Unstimulated and stimulated whole saliva was collected at least 2 h after meals and the secretion rate determined. The stimulated saliva was assessed for buffer capacity, total protein, peroxidase and hexosamine, while the unstimulated samples were evaluated for total protein, lysozyme, thiocyanate, lactoferrin and salivary IgA. Both the unstimulated (p < 0.01) and stimulated (p < 0.05) saliva secretion rates were significantly lower among the PLS patients compared with the controls. Furthermore salivary buffer capacity was significantly (p < 0.01) lower in the PLS patients. The total protein content in saliva was comparatively high in the study group, while the concentrations of immunoglobulins and non-immunoglobulins were within normal ranges. When calculating the output of the assessed antimicrobial factors, the mean peroxidase level in stimulated whole saliva was found to be significantly (p < 0.01) lower in the PLS patients than in the healthy controls. In conclusion, the present study indicates an impaired water secretion and a somewhat altered saliva gland function in children and young adults with PLS.

The levels of salivary mutans streptococci and caries experience were used as predictors for caries incidence in 3 groups of pre-school children from areas with different levels of natural and topical fluoride exposure. Altogether 1022 children, 4-5 years of age at baseline, were examined according to the WHO-criteria and followed for 2 years. The low fluoride group (n = 374) had a low fluoride level in the piped water and no topical fluoride applications; the F-varnish group (n = 442) had low water fluoride but semiannual topical applications of a fluoride varnish; the optimal fluoride group (n = 206) had an optimal level of fluoride in the drinking water and semiannual F-varnish applications. The number of salivary mutans streptococci was estimated and scored at baseline with the Strip mutans chair-side method. The sampling procedure was repeated in 337 children of the low fluoride group 3 weeks after baseline. In comparison with the low fluoride group, caries incidence was 30% and 60% lower in the F-varnish and the optimal fluoride group respectively. The caries predictive ability decreased with increasing fluoride exposure. The sum of sensitivity and specificity decreased from 151% (65% + 86%) in the low fluoride group to 131% (40% + 91%) in the optimal fluoride group. The positive predictive value was highest (62%) in the low fluoride group. Repeated salivary samplings at baseline did not improve the caries predictive power. The results suggest that the overall fluoride exposure should be taken into account when caries risk assessment strategies for preschool children are developed and implemented.

Periodontal health in relation to systemic retinoid medication was evaluated retrospectively in patients with Papillon-Lefèvre Syndrome (PLS). The material consisted of 18 children/young adults ranging from 8 to 28 years of age, all with a confirmed diagnosis of PLS. 9 participants, comprising a medication group, had been on long-term (range 1.5-9 years) retinoid medication for their cutaneous lesions. The remaining 9 served as controls. Regardless of whether or not retinoid medication was received, every patient experienced an early and devastating periodontitis, with atypical edematous and erythematous gingiva, suppuration from deep gingival pockets and premature loss of teeth. No correlation could be found between the severity of skin involvement and the severity of periodontal involvement. An improvement with age could be seen for the cutaneous lesions but not for the periodontal condition. Systemic medication with retinoids had a favorable therapeutic effect on cutaneous lesions, and no severe complication/side effect could be seen after several years of continuous use. However, from the results of this study it can be concluded that, at least in a situation with poor compliance of daily oral home-care, no positive effect on the periodontal health in patients with PLS could be seen by the retinoid medication.

The effects of the antihypertensive drug captopril on salivary secretion rate and composition was evaluated in 24 healthy adults (18-46 yr) according to a double-blind, cross-over design. Unstimulated and paraffin-chewing stimulated whole saliva and 3% citric acid stimulated parotid and submandibular-sublingual (SM-SL) secretion were collected at 10.30 a.m. (about 2h after intake of breakfast) on day 0 (baseline values), day 1 (experimental acute values) and day 7 (experimental chronic values) in each treatment period. In 8 of the subjects, also morning samples were collected at 7.30 a.m., with the test subjects in a fasting condition. Whole saliva was assessed for flow rate and for concentrations of sodium, potassium, chloride, calcium and phosphate. In addition, parotid and SM-SL secretion were assessed for concentrations of total protein, hexosamine, sialic acid, lactoferrin and salivary IgA and for activities of amylase, lysozyme and salivary peroxidase. During treatment with the angiotensin converting enzyme inhibitor captopril, the secretion rates tended to increase for unstimulated and paraffin-chewing stimulated whole saliva and for parotid secretion. For salivary composition, no alterations were observed in any of the collected secretions.