Oral health assessment of an adult rural community

A pneumatic indentation system using a copper bellows has been developed for physiological studies where a controlled uniaxial compressive force is required to be applied to the surface of the skin. Such a system is useful for studies where the physiological response of the tissues is to be monitored following a known loading history. The indentation system is driven by a vacuum/compression pneumatic pump through solenoid valves under closed-loop computer control. A load cell placed between the indentor and bellows monitors the applied force providing a feedback signal to the computer. The signal from the computer activates the valves supplying air pressure to the bellows, and the applied force is controlled using a digital closed-loop protocol. This system can be used to provide a controlled loading sequence to the skin without utilizing gravitational forces, which allows the subject to keep a more natural position during the experiment.     

Oral and dental health in alcohol misusing patients

Dental and oral health and their relationship to nutritional status among a group of alcohol misusers (n = 107) from south London is reported. The Alcohol Use Disorders Identification Test (AUDIT) questionnaire was validated as an accurate and reliable screening questionnaire for use in alcohol misuse detection by a dentist. Half of the study population consumed >200 units of alcohol/week, and 80% were heavy smokers. A high incidence of tooth wear and trauma to the dentition was recorded. Eight subjects had oral mucosal lesions, including two previously treated carcinomas. The dental health in alcoholics overall was not compromised, but nutritional impairment (body mass index and reduced midarm muscle circumference) was associated with periodontal lesions. Oral mucosal health of alcoholics is of concern, particularly in heavy smokers. The interrelationships between dental-oral health and alcohol-tobacco usage have implications for preventative counseling in this patient group.     

Oral health of children undergoing allogeneic bone marrow transplantation

BACKGROUND: Mixed bone marrow chimerism reliably produces donor-specific transplantation tolerance for a variety of solid organ and cellular grafts. We used a rat heterotopic tracheal transplant model for chronic rejection to investigate whether mixed chimerism could successfully prevent obstructive airway disease. METHODS: Mixed allogeneic chimeras were prepared by reconstituting lethally irradiated Wistar-Furth (WF) recipients with a mixture of 5 x 10(6) T-cell-depleted syngeneic (WF) and 100 x 10(6) T-cell-depleted allogeneic (ACI) bone marrow cells (ACI + WF --> WF). Mixed chimerism was present in all animals 28 days after bone marrow transplantation. Donor-specific, syngeneic, or major histocompatibility complex (MHC)-disparate allogeneic tracheas were implanted in recipient's omentum and removed for histologic analysis 30 to 150 days after transplantation. RESULTS: At 30 days after implantation, median luminal obstruction grades (0=none, 4=complete) of syngeneic and allogeneic tracheas were 0 and 4, respectively. Donor-specific (ACI) tracheas implanted in chimeric (ACI + WF --> WF) recipients were remarkably free of obstruction (median luminal obstruction grade=0 at 150 days) and had excellent preservation of respiratory epithelium. Third-party F344 tracheas implanted in chimeric recipients developed progressive luminal obstruction (grade 2 at 30 days, grade 3 at 90 days). CONCLUSIONS: Mixed allogeneic chimerism induces donor-specific tolerance and prevents development of the characteristic fibroproliferative obstructive lesion of bronchiolitis obliterans in a rat heterotopic tracheal transplant model. Excellent preservation of tracheal structure and morphology was achieved across major and minor histocompatibility barriers.     

Oral health status of an industrial population in Romania

BACKGROUND: We investigated whether addition of bismuth subcitrate (BSC, 4 x 120 mg) to a two week therapy scheme of omeprazole (OME, 2 x 40 mg)/amoxicillin (AMO, 4 x 500 mg) increases Helicobacter pylori eradication. MATERIALS AND METHODS: Patients with dyspepsia underwent upper endoscopy. H. pylori positive patients were randomized to treatment A (OME/AMO, 83 patients) or treatment B (OME/AMO/BSC, 84 patients). RESULTS: In 65 patients of group A (78%) H. pylori was eradicated as determined from the histological assessment (Sydney classification) of antrum and corpus biopsies. In comparison, in 68 patients of group B (81%) H. pylori was eradicated (p = NS between groups). H. pylori eradication in both groups was associated similarly with a decrease of inflammation and activity whereas atrophy and intestinal metaplasia were not affected. A positive association was revealed between the decrease of H. pylori score and the decrease of both inflammation and activity scores for antrum as well as corpus biopsies. CONCLUSIONS: Addition of BSC to OME/AMO does not increase H. pylori eradication in patients with dyspepsia. Eradication of H. pylori is associated with disappearance of epithelial damage (inflammation and activity) in antral and corpus mucosa.     

Oral health assessment in dogs: study design and results

The authors have conducted a large number of canine dental studies during the past six years. Study methodologies have been driven by the need for statistical validation of results, requiring the participation of large numbers of animals in each study. For plaque, stain, and calculus evaluations, a "clean tooth" model was used, in which formation of these substrates was assessed days to weeks after an initial coronal cleaning. A primary goal of the studies described was to validate the study designs used--that is, to use accepted plaque-, calculus-, and stain-controlling agents to test whether the study methods could detect differences between treated and untreated groups. The results of clinical studies show that the methods described can be used to identify plaque, calculus, and stain control attributable to chemical agents, oral hygiene aids, and consumable products.     

Oral health profile of schoolchildren, mothers and schoolteachers in Zanzibar

The piped water of Kuopio, Finland, was fluoridated in 1959. Owing to strong opposition by different civic groups, water fluoridation was stopped at the end of 1992. OBJECTIVES: The aim of this study was to examine the consequences of the discontinuation on dental health. METHODS: In 1992 and 1995, independent random samples of all children aged 6, 9, 12 and 15 years were drawn from Kuopio and Jyv?skyl?, a nearby low fluoride town whose distribution of demographic and socio-economic characteristics was fairly similar to Kuopio's. The total number of subjects examined was 550 in 1992 and 1198 in 1995. Caries was registered clinically and radiographically by the same two calibrated dentists in both towns. RESULTS: In 1992, the mean DMFS values were lower in the fluoridated town for the two older age groups, the percentage differences for 12- and 15-year-olds being 37% and 29%, respectively. For the two younger age groups no meaningful differences could be found. In 1995, the only difference with possible clinical significance was found in the 15-year-olds in favor of the fluoridated town (18%). In 1995, a decline in caries was seen in the two older age groups in the nonfluoridated town. In spite of discontinued water fluoridation, no indication of an increasing trend of caries could be found in Kuopio. The mean numbers of fluoride varnish and sealant applications decreased sharply in both towns between 1992 and 1995. In spite of that caries declined. CONCLUSIONS: These findings suggest that the decline of caries has little to do with professional preventive measures performed in dental clinics.     

Oral disease in Africa: a challenge to change oral health priorities

The relationship between subjective work noise exposure and the risk of myocardial infarction (MI) was assessed in a population based case-control study. 395 MI patients (31-65 years) were compared to 2148 controls from a random population sample with the same agelsex distribution. The relative risk (RR) for MI-adjusted for control variables (smoking, age, social status, etc.)-was found to increase significantly and steadily with noise category. Subjective work noise exposure was the second greatest risk factor for MI after smoking. Possible bias due to overreporting of subjective noise exposure is discussed. Interdisciplinary studies on the relationship between cardiovascular diseases and work-related stressors including subjective and objective noise assessment are needed to quantify the risk of MI due to work noise.     

Oral health of persons with and without dementia attending a geriatric clinic

Results of a 20 month split-udder trial on the effect of discontinuation of postmilking teat disinfection on intramammary infections (IMI) with major and minor pathogens in seven dairy herds with a low somatic cell count are described. The incidence of Escherichia coli IMI was found to be significantly lower, whereas the incidence of IMI with Staphylococcus aureus and minor pathogens was significantly higher in quarters for which postmilking teat disinfection was discontinued than in disinfected quarters. It was concluded that discontinuation of postmilking teat disinfection decreased the incidence of E. coli IMI, accompanied by a, from a practical point of view, acceptable rise in somatic cell count. However, the possible increase in the incidence of S. aureus IMI calls for careful monitoring of the dynamics of IMI with contagious pathogens, when postmilking teat disinfection is discontinued in an attempt to reduce E. coli mastitis.     

Oral health in Europe with changing socioeconomic structures as seen by the epidemiologist

During the 20th century in Europe remarkable results were obtained in health and social care systems which positively influenced general and oral health. Among others this was favoured by the WHO-initiated multinational movement "Health for all by the year 2000". Political changes in Eastern Europe levelled the way for constructive collaboration also in the field of health promotion. In contrast to this, economic deprivation in all European countries limits the financing of continually increasing costs of dental care. Oral health improved during the last decades, although differences in the health level between socioeconomic classes increased. In Eastern Europe the transformation process towards a new dental care system is quite difficult and is still going on. The establishment of new health-structures depends on socioeconomic resources and has so far attained different levels in various countries. The epidemiological situation also varies greatly. In general, caries prevalence is higher than in Western Europe.     

Oral hygiene following traumatic brain injury: a programme to promote dental health

In spontaneously beating sinus venosus of the frog Caudiverbera caudiverbera the effects of bekanamycin and dibekacin, two aminoglycoside antibiotics, on action potentials of cardiac primary pacemaker cells were studied by intracellular recording. Bekanamycin and dibekacin induced a concentration-dependent decrease of the amplitude, overshoot and the rate of rise of the action potential. Both also flattened the slow diastolic depolarization leading to a marked decrease in beat rate. At the highest concentration used (1 x 10(-3) M), the aminoglycosides produced a complete inhibition of primary cells action potentials. It was preceded by the appearance of subthreshold oscillations of the membrane potential which were observed for a few minutes until the electrical activity of pacemaker cell ceased. During absence of impulse initiation a stable membrane potential about -40 mV was observed. Aminoglycoside effects, excepting those on SCL, were completely suppressed when external calcium was increased to 3.6 mM. The results support the conclusion that bekanamycin and dibekacin depress the electrical activity of pacemaker cells. It is suggested that this effect is induced by aminoglycosides blockade of the slow calcium current involved in both upstroke and slow diastolic depolarization and through modification of potassium outward current. Bekanamycin at a lower concentration than that needed to induce electrophysiological effects potentiated verapamil 1 x 10(-8) effects on cardiac pacemaker cells.     

Diary of a week in practice

Spontaneous cavernositis is a distinctly uncommon entity. Corporeal infection and abscess formation have been described in association with priapism, cavernosography, intracavernous injection therapy, trauma and penile prostheses. We report a case of acute necrotizing cavernositis in a diabetic patient, which presumably originated with hematogenous seeding from a periodontal abscess. Isolation of typical oral pathogens from corporeal cultures provides bacteriological evidence of a dental source for the corporeal infection.     

Oral disease epidemiologic illness indices and oral health measures--traditional concepts are supplemented by new socio-dental indicators

The approach to patients with chronic cough has been well defined and evaluated in the literature through a number of prospective studies. Meticulous attention to detail of the afferent loop of the cough reflex has helped identify the cause of cough in most patients. The most common causes appear to be similar in both children and adults and include asthma, postnasal drip syndromes, gastroesophageal reflux diseases, and aspiration. In children, recurrent viral infections and infections with atypical organisms also are very prevalent. Specific therapy directed at the cause alleviates the cough in most patients. In some patients, there may be more than one cause of cough. Invasive testing (eg, bronchoscopy and esophageal pH probing) is rarely necessary. In patients in whom a specific cause cannot be identified or in whom cough modifiers are necessary while specific therapy is taking hold, antitussives of both the narcotic and nonnarcotic variety are helpful.     

Preventive oral health behaviors in a multi-cultural population: the North York Oral Health Promotion Survey

To examine the preventive oral health behavior levels of randomly-selected dentate and edentulous adults, age 18 and over, a mail survey was conducted in North York, Ontario, a multicultural suburb of Metropolitan Toronto (n = 1,050). High optimal levels of at least daily tooth brushing were reported by the majority of the dentate (96 per cent). Lower rates were evident for yearly preventive visiting (69 per cent), daily flossing (22 per cent), daily use of an interdental device (25 per cent), not snacking between meals (12 per cent) and eating one or no cariogenic foods on the previous day (36 per cent). Logistic regression results indicated higher levels on an additive index of oral preventive behaviors for females, those having a higher education and non-Italian respondents. Edentulous respondents reported high daily denture cleaning rates (87 per cent), but less frequent night removal (51 per cent), checking for oral lesions (68 per cent) and preventive visiting (12 per cent). Oral disease is one of the most common and costly chronic disorders affecting modern populations. However, unlike most other chronic diseases, it is largely preventable. These data indicate a clear need for determined oral health promotion efforts to inform and encourage increased levels of preventive behaviors in addition to tooth and denture brushing, particularly among specific sociodemographic and ethnic groups.     

Oral health of the child population. I. Situation in Hungary based on the epidemiologic study conducted for the WHO Oral Data Bank in 1996

It is strongly suggested by WHO to undertake regular 5-yearly epidemiological surveys, to monitor changes in oral health. In Hungary the first national baseline examinations were carried out in 1985, followed by data collections in 1991 and 1996 according to the WHO basic criteria, using the pathfinder methodology. The aim of the present paper is to give up to date information on the oral disease status, trends, and treatment needs in children based on the recent survey. A total of 1800 children were examined at 17 sample sites. Age groups were: 5-6 years and 12 years. The basic findings were: The ratio of caries free 5-6 year old children was 27% The DMFT mean level was 3.8 at 12 years, i.e. the caries level has decreased in this age group. The parodontal situation did not show any improvement in 12 year old. More than two third (72.0%) of the children had gingivitis, need oral hygiene instruction and a third of them (32.3%) had dental calculus.     

Uniting the past and the future in public health nursing: the Michigan Oral History Project

In 1987 a group of Michigan public health nurses recognized the need to capture the richness of the lives of renowned public health leaders by collecting and preserving their oral histories. With the assistance of the Bentley Collection at the University of Michigan, the Michigan Oral History Project found a home. In this paper, the process of designing and implementing the oral history project is described within the framework of McBride's Orchestrating the Stages of a Career, adapted from the Dalton/Thompson/Price career development model. The steps in selecting interviewers and leaders, conducting the interviews, and keeping track of the completed work are outlined. Finally, the early results and potential uses for the collected data are discussed. This project has special significance in this year for the celebration of the centennial of public health nursing.