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BACKGROUND: Hypohidrotic ectodermal dysplasia (HED) is a genetic disorder characterized by defective development of teeth, hair, nails and eccrine sweat glands. Both autosomal dominant and autosomal recessive forms of HED have previously been linked to mutations in the ectodysplasin 1 anhidrotic receptor (EDAR) protein that plays an important role during embryogenesis. METHODS: The coding DNA sequence of the EDAR gene was analyzed in two large Swedish three-generational families with autosomal dominant HED. RESULTS: A non-sense C to T mutation in exon 12 was identified in both families. This disease-specific mutation changes an arginine amino acid in position 358 of the EDAR protein into a stop codon (p.Arg358X), thereby truncating the protein. In addition to the causative mutation two polymorphisms, not associated with the HED disorder, were also found in the EDAR gene. CONCLUSION: The finding of the p.Arg358X mutation in the Swedish families is the first corroboration of a previously described observation in an American family. Thus, our study strengthens the role of this particular mutation in the aetiology of autosomal dominant HED and confirms the importance of EDAR for the development of HED.

The study consisted of two sets of experiments, one in saliva and one in dental plaque. The xylitol concentration in saliva was determined enzymatically in 12 children (mean age 11.5 years) after a standardised use of various xylitol products: (A) chewing gums (1.3 g xylitol), (B) sucking tablets (0.8 g xylitol), (C) candy tablets (1.1 g xylitol), (D) toothpaste (0.1 g xylitol), (E) rinse (1.0 g xylitol), and (F) a non-xylitol paraffin. Unstimulated saliva was sampled 1, 3, 8, 16 and 30 min after use. The concentration in dental plaque was determined after mouthrinses with contrasting amounts of xylitol (LX = 2.0 g, HX = 6.0 g, and control) and supragingival plaque was collected and pooled after 5, 15 and 30 min. The mean xylitol concentration in saliva at baseline was approximately 0.1 mg/ml. All xylitol-containing products resulted in significantly increased levels (p < 0.05) immediately after intake and remained elevated for 8-16 min in the different groups. The highest mean value in saliva was obtained immediately after use of chewing gums (33.7 +/- 16.4 mg/ml) and the lowest was demonstrated after using toothpaste (8.2 +/- 4.9 mg/ml). No significant differences were demonstrated between chewing gums (A), sucking tablets (B), candy (C) and rinses (E). In dental plaque, the mean values were 8.6 +/- 5.4 and 5.1 +/- 4.0 mg/ml 5 min after HX and LX rinses. Concerning the higher concentration, the values remained significantly elevated (p < 0.05) during the entire 30-min follow-up. In conclusion, commonly advocated xylitol-containing products gave elevated concentrations of xylitol in unstimulated whole saliva and dental plaque for at least 8 min after intake. Copyright 2006 S. Karger AG, Basel.

OBJECTIVES: To examine attitudes and experiences of parents whose children have complex congenital heart disease (CHD) with respect to dental health information and advice, dental care, and service and to compare the results with data from an age- and gender-matched control group without any medical problems. SETTING: Faculty of Medicine (Paediatric Cardiology and Paediatric Dentistry), Umea University, Umea, Sweden. SAMPLE AND METHOD: Each group comprised parents of 33 children; the children's mean age was 9.4 years. All the cases and the controls resided in the county of Vasterbotten, northern Sweden. Data were collected with a questionnaire with 20 joint questions to both groups and four additional questions to the CHD group. RESULTS: Of the 20 joint questions, significant differences were displayed in the following areas: the professional group that provided the parents with dental health information and advice (P < 0.01), attitudes to reception at the dental clinic, and experience of sedation before operative dental treatment (P < 0.05). Parents to 11 children with CHD who were patients at a specialist clinic for paediatric dentistry scored the reception at the dental clinic as excellent in nine cases and satisfactory in two, compared to excellent (3), satisfactory (11), decent (4), and poor (4) among those who were patients in general dental practice (P < 0.01). No statistically significant differences in educational level or in parental experience of dental health were noted between the two groups (P > 0.05). CONCLUSION: Children with CHD in northern Sweden mainly receive their dental health information from a physician or a dentist, and healthy children mainly receive information from a dental hygienist indicating that children with CHD are given priority in the dental care system. Parental attitudes to reception in the dental service differed, and parents of healthy children scored the reception at the dental clinic better than parents of childr

AIM: To evaluate the effect of xylitol-containing tablets on mutans streptococci colonisation and caries development in preschool children. STUDY DESIGN: Randomised single-blind prospective design. METHODS: The material consisted of 132 healthy 2-year-old children, 71 boys and 61 girls and they were assigned to a xylitol tablet (test) group or a non-intervention control group. The mean age was 2 years + 1 month in both groups. The drop-out rate was 10.6% during the 2-year trial. The test group was given 1-2 xylitol tablets (0.5-1g) per day during 1.5 years. Mutans streptococci (MS) enumeration was performed at baseline and semi-annually in the children and at baseline or shortly after in the mothers with a chair-side technique. Caries prevalence was scored at baseline and the age of 4 years. RESULTS: No statistically significant differences in MS colonisation were disclosed between the test and control groups at baseline or any of the designated follow-ups. A statistically significant positive relationship was found between the maternal salivary MS levels and the colonisation of the children in the control group at 2.5 years, 3 years and 3.5 years (r=0.39, r=0.35; r=0.30; p<0.01, p<0.01 and p<0.05) but not in the xylitol tablet group (p<0.05). The mean caries prevalence was lower in the test group compared with the control group at 4 years of age (dmfs 0.38 +/-1.05 vs. 0.80 +/-2.60) but the difference was not statistically significant. CONCLUSION: The findings do not support a low-dose xylitol tablet program for caries prevention in preschool children.

The aim was to investigate the effect of high and low amounts of xylitol on the interdental plaque-pH, directly and after sucrose challenge in schoolchildren with a habitual consumption. The study group consisted of 11 healthy children (10-15 years) with low caries risk and the experiment had a single-blind crossover (Latin square) design. After a 2-week run-in period with a daily 4.0 g xylitol intake, the children were subjected to single-dose exposures of chewing gums with i) paraffin (CTR; no xylitol), ii) low dose xylitol (LX; 2.0g xylitol), and iii) high dose xylitol (HX; 6.0g xylitol) in a randomised order separated by a wash-out period of one week. Samples of chewing-stimulated whole saliva were collected prior to and after the experimental period for determination of bacterial counts. The outcome measures were in situ plaque-pH (micro-touch method) and area under the curve (AUC) above pH 6.0. The AUC was significantly greater (p<0.05) in the HX group compared to the LX and control groups during the first 5 minutes after chewing. After a 10% sucrose rinse, the interdental plaque-pH dropped in all groups but the HX regimen displayed significantly less reduction 0-5 min after chewing (p<0.05). No significant alterations of the total viable counts or mutans streptococci levels in saliva were disclosed during the 4-week experimental period. The present results suggested that a high single dose of xylitol had a short and limited beneficial effect on interdental plaque-pH in habitual xylitol consumers while a low single dose, resembling a normal chewing gum use, did not differ from the control.

The aim was to assess how accurately some commonly used risk factors/risk markers (predictors) for caries development could identify children with and without approximal caries as judged from bitewing radiography. 267 consecutive 5-year-old children from two Swedish cities participated. Three experienced dentists examined the children. The predictors were the overall dmfs value (canines and molars), the number of occlusal dmfs, the frequency of intake of between meal sugary products, visible plaque on free smooth surfaces of second primary molars, toothbrushing habits, and (before bitewing examination) an overall judgement by the examining dentist. The mean dmfs without bitewing examination (BW) was 0.40 (SD = 1.22). Twelve percent of the children had at least one dentin lesion and 33 % at least one enamel lesion that were detected from BW only. The gain from adding BW to clinical examination amounted to a mean of 1.2 approximal enamel and/or dentin lesions. Results: The ability to correctly identify children with approximal caries from the predictors was limited; sensitivity ranged from 0.27 to 0.75 and specificity ranged from 0.41 to 0.93. The single best predictor was the dentist's overall judgement with an average precision of 73 %; average sensitivity for the presence of enamel and dentin lesions was 0.48 and for the presence of dentin lesions 0.66. The rest of the predictors added little to the predictive power. It is concluded that 33 % of the 5-year-olds, representing a low caries prevalence population, benefited from BW. The ability to identify these children from the predictors was, however, limited.

Background: The knowledge of oral health effects caused by long-term medication in medically compromised children is sparse. Besides the effects on salivary secretion, pharmacotherapy may also act directly on the dental hard tissues, with dental caries and/or erosive lesions as possible outcomes of their acid and fermentable sugar content. Methods: Thirteen pharmaceutical preparations commonly used on a long-term basis in paediatric cardiology were selected. The endogenous pH of water solutions of tablets, capsules, and liquid medicines were measured with a pH meter. The titratable acidity and the dissolution of calcium and phosphate after immersion of tooth specimens were quantified for preparations with an endogenous pH below 5.5. Results: The endogenous pH values varied between 3.03 and 9.02. Six of the 13 preparations (46%) had an endogenous pH below the critical value for enamel dissolution (pH 5.5). The captopril (12.5 mg) tablet water solution had the lowest pH while the propranolol hydrochloride mixture displayed the highest titratable acidity. The highest dissolved calcium and phosphate was displayed for captopril (12.5 mg) tablet water solution followed by acetylsalicylic acid (75 mg) tablet water solution. Conclusion: It is concluded that some pharmaceutical preparations that are commonly used on a long-term basis in paediatric cardiology may pose a hazardous threat to dental hard tissues due to their acidity.

Background: The knowledge of oral health effects caused by long-term medication in medically compromised children is sparse. Besides the effects on salivary secretion, pharmacotherapy may also act directly on the dental hard tissues, with dental caries and/or erosive lesions as possible outcomes of their acid and fermentable sugar content. Methods: Thirteen pharmaceutical preparations commonly used on a long-term basis in paediatric cardiology were selected. The endogenous pH of water solutions of tablets, capsules, and liquid medicines were measured with a pH meter. The titratable acidity and the dissolution of calcium and phosphate after immersion of tooth specimens were quantified for preparations with an endogenous pH below 5.5. Results: The endogenous pH values varied between 3.03 and 9.02. Six of the 13 preparations (46%) had an endogenous pH below the critical value for enamel dissolution (pH 5.5). The captopril (12.5 mg) tablet water solution had the lowest pH while the propranolol hydrochloride mixture displayed the highest titratable acidity. The highest dissolved calcium and phosphate was displayed for captopril (12.5 mg) tablet water solution followed by acetylsalicylic acid (75 mg) tablet water solution. Conclusion: It is concluded that some pharmaceutical preparations that are commonly used on a long-term basis in paediatric cardiology may pose a hazardous threat to dental hard tissues due to their acidity.

Background: The knowledge of oral health effects caused by long-term medication in medically compromised children is sparse. Besides the effects on salivary secretion, pharmacotherapy may also act directly on the dental hard tissues, with dental caries and/or erosive lesions as possible outcomes of their acid and fermentable sugar content. Methods: Thirteen pharmaceutical preparations commonly used on a long-term basis in paediatric cardiology were selected. The endogenous pH of water solutions of tablets, capsules, and liquid medicines were measured with a pH meter. The titratable acidity and the dissolution of calcium and phosphate after immersion of tooth specimens were quantified for preparations with an endogenous pH below 5.5. Results: The endogenous pH values varied between 3.03 and 9.02. Six of the 13 preparations (46%) had an endogenous pH below the critical value for enamel dissolution (pH 5.5). The captopril (12.5 mg) tablet water solution had the lowest pH while the propranolol hydrochloride mixture displayed the highest titratable acidity. The highest dissolved calcium and phosphate was displayed for captopril (12.5 mg) tablet water solution followed by acetylsalicylic acid (75 mg) tablet water solution. Conclusion: It is concluded that some pharmaceutical preparations that are commonly used on a long-term basis in paediatric cardiology may pose a hazardous threat to dental hard tissues due to their acidity.

Background: The knowledge of oral health effects caused by long-term medication in medically compromised children is sparse. Besides the effects on salivary secretion, pharmacotherapy may also act directly on the dental hard tissues, with dental caries and/or erosive lesions as possible outcomes of their acid and fermentable sugar content. Methods: Thirteen pharmaceutical preparations commonly used on a long-term basis in paediatric cardiology were selected. The endogenous pH of water solutions of tablets, capsules, and liquid medicines were measured with a pH meter. The titratable acidity and the dissolution of calcium and phosphate after immersion of tooth specimens were quantified for preparations with an endogenous pH below 5.5. Results: The endogenous pH values varied between 3.03 and 9.02. Six of the 13 preparations (46%) had an endogenous pH below the critical value for enamel dissolution (pH 5.5). The captopril (12.5 mg) tablet water solution had the lowest pH while the propranolol hydrochloride mixture displayed the highest titratable acidity. The highest dissolved calcium and phosphate was displayed for captopril (12.5 mg) tablet water solution followed by acetylsalicylic acid (75 mg) tablet water solution. Conclusion: It is concluded that some pharmaceutical preparations that are commonly used on a long-term basis in paediatric cardiology may pose a hazardous threat to dental hard tissues due to their acidity.

Background: The knowledge of oral health effects caused by long-term medication in medically compromised children is sparse. Besides the effects on salivary secretion, pharmacotherapy may also act directly on the dental hard tissues, with dental caries and/or erosive lesions as possible outcomes of their acid and fermentable sugar content. Methods: Thirteen pharmaceutical preparations commonly used on a long-term basis in paediatric cardiology were selected. The endogenous pH of water solutions of tablets, capsules, and liquid medicines were measured with a pH meter. The titratable acidity and the dissolution of calcium and phosphate after immersion of tooth specimens were quantified for preparations with an endogenous pH below 5.5. Results: The endogenous pH values varied between 3.03 and 9.02. Six of the 13 preparations (46%) had an endogenous pH below the critical value for enamel dissolution (pH 5.5). The captopril (12.5 mg) tablet water solution had the lowest pH while the propranolol hydrochloride mixture displayed the highest titratable acidity. The highest dissolved calcium and phosphate was displayed for captopril (12.5 mg) tablet water solution followed by acetylsalicylic acid (75 mg) tablet water solution. Conclusion: It is concluded that some pharmaceutical preparations that are commonly used on a long-term basis in paediatric cardiology may pose a hazardous threat to dental hard tissues due to their acidity.