Antinociceptive effects of Trigonella foenum-graecum leaves extract

In 15 elderly residents of an old-age home, we measured the total number of bacteria and the numbers of streptococci and staphylococci in the pharynx over 5 months. Seven residents received professional oral health care from dentists and dental hygienists and eight practiced oral care by themselves or together with a helper. During the 5 months, the total number of bacteria and the numbers of streptococci and staphylococci decreased (p < 0.01) in those who received professional care. In contrast, the total number of bacteria and the numbers of streptococci and staphylococci neither did not change or increased in those who did not receive professional care. These findings show that professional oral health care by dentists and dental hygienists can decrease the total number of bacteria and the numbers of streptococci and staphylococci in the pharynx of elderly people, which might prevent aspiration pneumonia.     

Effects of a 12-month prophylactic programme on selected oral bacterial populations on root surfaces with active and inactive carious lesions

In 15 caries-active patients, with a total of 770 exposed root surfaces, the effect of fluoride therapy and professional tooth cleaning was studied during a 1-year period. Dental plaque from 92 of the root surfaces and whole saliva samples were analysed at baseline and after 12 months for the presence of specific bacteria. The results showed that the number of active carious lesions had decreased from 99 to 46, while the inactive lesions had increased from 69 to 124. Of the active lesions which had been converted into inactive lesions, most were on the buccal and fewest were located on the distal surfaces. Lower plaque scores were found on sound and inactive root surfaces compared to active surfaces. The salivary concentrations of mutans streptococci and lactobacilli remained constant during the 12-month observation period. There was a tendency for higher levels of Streptococcus mutans in plaque from active lesions compared with sound root surfaces, whereas an inverse relationship was noted for the Streptococcus oralis group. No significant differences in the Actinomyces naeslundii counts were detected. In conclusion, the 12-month prophylactic programme had an effect on the clinical surface characteristics of root caries, but the components of the oral microflora selected for study seemed to be relatively unaffected during the observation period.     

The efficacy and safety of dorzolamide as adjunctive therapy to timolol maleate gellan solution in patients with elevated intraocular pressure. Additivity Study Group

OBJECTIVES: To investigate the incidence of rehardening of caries lesions in children in Southern China taking part in a preventive programme. DESIGN: Longitudinal study. SAMPLE AND METHODS: A prevention programme was established for 168 3-6-year-old children in a kindergarten (KG1), which included regular oral health education sessions and a daily toothbrushing exercise using fluoridated toothpaste (1000 ppm F). A group of 121 children studying in two other kindergartens without a preventive programme formed the controls. Due to lack of resources and dental personnel, restorative and other curative treatments were not provided. RESULTS: Rehardening of dentine caries (arrested caries) was found in children in both test and control groups. At the third annual examination, 45% of the caries lesions on the proximal surfaces of primary anterior teeth in KG1 children found at the baseline and previous annual examinations had become arrested. A multiple linear regression analysis indicated that baseline ds score and its interactions with the prevention programme, gender and the child's oral hygiene all had significant effect on the number of tooth surfaces with arrested caries at the third annual examination. CONCLUSION: Results from this study support the use of simple prevention programmes to stabilize the caries situation in communities where intensive use of trained dental personnel is not feasible.     

Air pollution and asthma: molecular mechanisms

Three thousand children aged 18 months were screened for dental caries and ongoing breast-feeding at 46 child welfare centres in different parts of Sweden. Of these, 200 children were selected for a more comprehensive examination, involving investigation of dietary, toothbrushing and sucking habits, use of fluoride, and determination of salivary levels of mutans streptococci and lactobacilli. The children were divided into four groups: group 1: children with caries not being breast-fed; group 2: children with caries being breast-fed; group 3: caries-free children being breast-fed; group 4: caries-free gender- and age-matched reference children not being breast-fed. The results showed that 63 of the children (2.1%) had caries and 61 (2.0%) were still being breast-fed. Twelve (19.7%) of the 61 children still being breast-fed had caries compared with 51 (1.7%) of the 2939 children not being breast-fed; the difference was statistically significant. Children with caries and still being breast-fed had a mean defs of 5.3, and those with caries not being breast-fed 4.9; the difference was not statistically significant. Children with caries, irrespective of whether they were being breast-fed or not, had significantly higher numbers of cariogenic food intakes per day than caries-free children. Mutans streptococci were detected in 67% of the children and lactobacilli in 13%. Children with detectable mutans streptococci and lactobacilli had significantly more caries than those without. The results indicate that Swedish children with prolonged breast-feeding have a tendency to establish unsuitable dietary habits which constitutes a risk situation for developing caries at an early age.     

The relationship of dental calculus to caries, gingivitis, and selected salivary factors in 11- to 13-year-old children in Chiang Mai, Thailand

Thai children have been shown to accumulate large amounts of dental calculus. The purpose of this study was to examine the relationship of calculus to caries and gingivitis, and salivary conditions which may contribute to calculus accumulation. Four-hundred and thirty-nine (439) children from 18 schools in Chiang Mai were selected for this study. The children were given oral examinations to determine calculus index (CI); decayed, missing, and filled surfaces (DMFS); decayed, missing, and filled teeth (DMFT); gingival index (GI); and plaque index (PI). Children with mean CI scores > or =1 (206) were assigned to the calculus group; the 233 children with mean CI scores of <1 to the noncalculus group. Saliva was collected from 60 randomly-selected children in each group. Unstimulated and stimulated whole saliva and stimulated parotid saliva were assessed for flow rate, pH, and buffer capacity using 2 methods. Results showed that calculus status was not significantly associated with caries, but that there was a high association between gingivitis and plaque status with calculus accumulation (P < 0.001). There were no significant differences in saliva flow rate, pH, or buffer capacity between calculus and noncalculus groups. The lack of association between calculus status and caries indicated these 2 conditions have different etiologies and suggests the importance of plaque and calculus prevention programs, in addition to caries control efforts, to maintain oral health of Thai children.     

Oral hygiene in relation to caries development and immigrant status in infants and toddlers

The purpose of this study was to describe oral hygiene factors in infants and toddlers living in Sweden with special reference to caries prevalence at 2 and 3 yr of age and to immigrant status. The study was designed as a prospective, longitudinal study starting with 671 children aged 1 yr. At 3 yr, all the children were invited to a further examination. A total of 298 children, randomly selected from the original group, were also examined at 2 yr. The accompanying parent was interviewed about the child's oral health habits. Children who were free of caries at 3 yr had had their teeth brushed more frequently at 1 and 2 yr of age, had used fluoride (F)-toothpaste more often at 2 yr of age, and had a lower prevalence of visible plaque at 1 and 2 yr of age than children with caries. Immigrant children had had their teeth brushed less frequently, had used less F-toothpaste, and had a higher prevalence of visible plaque at 1 yr of age than nonimmigrant children. Early establishment of good oral hygiene habits and regular use of F-toothpaste seem to be important for achieving good oral health in pre-schoolchildren.     

Night-to-night variability in CPAP use over the first three months of treatment

Caries of the pits and fissures of permanent teeth continues to be a problem for children, newly erupted permanent molars being particularly at risk. Oral hygiene measures have been shown to be able to reduce the incidence of caries. The aim of this study was to compare the caries-preventive effects on newly erupted first permanent molars of a professional tooth cleaning and oral health education program (test) with a standard preventive program (control), comprising selective fissure sealing and application of topical fluorides. School Dental Service clinics of the Health Department of Western Australia, in Perth, were assigned to four test or four control clinics. Schoolchildren, mean age 6.3 +/- 0.3 (s) years with sound, newly erupted first permanent molars were included in the study (207 test, 197 control). After 12 months, 186 test and 163 control children were examined by an examiner who was 'blind' to the test or control status of the children. Caries of the first permanent molars developed in 34 test and 35 control children; the estimated risk ratio was 0.86 (95% CI 0.56, 1.30). Children in the test group had an average DFT score of 0.26 +/- 0.62 compared with 0.29 +/- 0.64 DFT in the control group (t-test, P = 0.67). The 12-month results suggest that there was no statistically significant difference between the caries-preventive effects of a professional tooth cleaning and oral health education program and a program based on selective fissure sealing and application of topical fluorides.     

Dental care for the handicapped: general problems

In contrast to an increased oral health level in the Western countries, this improvement is not the case in age matched handicapped. The dental mutilation is generally related to periodontal problems (plaque, gingivitis, periodontitis, calculus), dental caries, traumatic injuries and self-injuring behaviour. Via a questionnaire, data from 88 institutions in Flanders were obtained. It became clear that there is a striking lack of oral health care and follow-up within institutions. There is a strong need for mouth hygiene instructions programmes for educators, parents, as well as for dentists involved in the special care of these patients.     

Oral disease and physical disability in community-dwelling older persons

OBJECTIVE: The aim of this epidemiologic investigation was to determine whether poor oral health in older persons was associated with physical disability. DESIGN: The study was a cross-sectional survey involving in-home interviews and dental examinations of older persons. SETTING: A random sample of 68 cities and towns was selected from the six New England states, with stratification according to population size. PARTICIPANTS: The study sample consisted of 1,156 community-dwelling (non-institutionalized) individuals aged 70 and over, randomly selected from the Medicare beneficiary lists for each city and town. MEASUREMENTS: Oral health was assessed by three dichotomous indices: edentulism (no teeth); current caries, including either coronal or root decay; and periodontal disease, as measured by gingival pocket depth. Physical disability was indicated by the subject's self-report of difficulty in the areas of personal care (eating, bathing, dressing, and using the toilet) and mobility (walking, bed transfer, getting outside). Additional independent variables included age, sex, number of teeth, education, living alone, oral hygiene practices, and time since last dental visit. RESULTS: We found a direct association between specific areas of physical disability and current caries and edentulism. The risk of poor oral health did not increase with advancing age once the related risk factors were controlled for. Those subjects with mobility disabilities were at increased risk of tooth loss; those with personal care limitations were at increased risk of current caries. CONCLUSIONS: Physical disability should be added to the list of known risk factors for oral disease among the older population. Our findings call attention to the need for health care providers to screen for oral health problems among disabled older persons. Further gerontologic research is needed to identify the mechanisms linking physical disability with oral disease in older persons.     

HLA-markers and diabetic retinopathy in the Senegalese population]

Twelve dentulous patients, age 65 or older, with no medical or pharmacologic predisposition to gingival hyperplasia were enrolled in a controlled clinical trial to evaluate the effect of the unaided use of an ultrasonic toothbrush on supragingival plaque and gingival bleeding. Subjects used the ultrasonic toothbrush in lieu of their conventional toothbrushes for a 30-day period. Clinical measurements of the plaque index and bleeding index were made at baseline and at 15 and 30 days. At the end of the 30-day test period, the use of the ultrasonic toothbrush resulted in significant reductions in plaque score, proportion of high plaque surfaces, and bleeding index. The reduction of the bleeding index indicates significant improvement in oral health. In this study, the use of an ultrasonic toothbrush effectively improved oral hygiene and health in a population that often exhibits decreased manual dexterity. Strategies for oral health care assessment and education for guidance of effective interventions are included in checklist form; level of care classification, cost in both time involved and equipment, and purchase instructions also are discussed. Further study is warranted to evaluate this instrument for cognitively impaired elders, who often rely on caregivers for oral hygiene procedures.     

Psychiatrists' and internists' knowledge and attitudes about delivery of clinical preventive medical services

OBJECTIVE: Changes in the health care environment have placed a greater responsibility on psychiatrists to deliver basic primary care services. The study assessed baseline knowledge and attitudes about clinical preventive medical services among psychiatric faculty and psychiatric residents at a tertiary care medical center. METHODS: Residents and faculty in psychiatry and general internal medicine completed a structured questionnaire, including 20 case scenarios, that assessed their baseline knowledge of clinical preventive medical services, their attitudes concerning delivery of those services, and their beliefs about the effectiveness of those services in changing patients' behavior. The case scenarios and knowledge questions were based on the clinical preventive medical services recommendations outlined by the U. S. Preventive Services Task Force. RESULTS: Psychiatrists reported more frequent assessment of and counseling about the use of illicit drugs and weapons, and internists were more likely to query about measures related to physical health such as cancer screening and immunizations. The two groups reported similar attitudes toward the need for and the efficacy of preventive medical services. Commonly cited barriers to the delivery of preventive care included lack of time and education. Psychiatrists scored reasonably well on baseline knowledge about guidelines for preventive medical services, particularly given their recent lack of specific education in these matters. CONCLUSIONS: Psychiatrists believe clinical preventive services are important and express interest in their delivery. Additional educational interventions are needed to train psychiatrists in clinical preventive services to avoid missed clinical opportunities for intervention in psychiatric populations that may have poor access to other medical care.     

A six-month clinical evaluation of the Dentrust toothbrush

Clinical study guidelines have been established by the American Dental Association for assessing plaque and gingivitis reductions with chemotherapeutic agents. Two six-month studies are required. While the toothbrush is also instrumental in plaque and gingivitis reduction, there are currently no study requirements by the ADA for manual brush efficacy. It was thought to apply the long-term efficacy requirements for chemotherapeutic agents to two manual toothbrushes to assess their efficacy for comparative purposes. Forty-eight subjects using the Dentrust toothbrush and forty-five subjects using the Oral-B toothbrush completed a six-month study to assess safety, plaque removal and gingivitis reduction. The subjects were randomly assigned to use either the newly designed (three sided) Dentrust toothbrush or the traditional flat-headed toothbrush. The subjects took their respective toothbrushes home following a baseline evaluation, and were subsequently assessed at three and six months by the same examiners with the same indices in this single-blind trial. There were no significant differences between the two groups on plaque removal during the study. At six months, the Dentrust group removed a significant amount of both buccal and lingual plaque and the flat-headed toothbrush removed a significant amount of buccal plaque only. On gingivitis the groups had no significant differences at baseline; however, by six months the Dentrust group was significantly better than the flat-headed toothbrush on gingivitis reduction. Long-term use of the Dentrust toothbrush can be said to significantly contribute to gingival health overall, and especially in the hard to reach lingual areas compared to long-term use of a traditional flat-head toothbrush.     

Common pediatric dental problems

Physicians who provide primary care for children have a unique position to provide diagnostic, triage, educational, and preventive dental care for patients. Several papers have been published regarding primary pediatricians' participation in the preventive dental health care of their patients. One publication, a survey of physicians in Alabama focusing on physicians' overall awareness of dental issues, concluded that most physicians believe they have a role in the oral health of their patients, yet most were not aware of the American Academy of Pediatric Dentistry's recommendations. Most physicians report that they routinely perform oral examinations during physical examinations of children and deliver preventive, oral information by the age of 6 months or earlier; however, most recommend that infants' first visit should be at 3 years of age, not at the time of first-tooth eruption as the authors recommend. Furthermore, many primary care physicians do not talk about oral health during prenatal counseling. Many physicians understand the preventive advantages of fluoride, yet most do not prescribe vitamin combinations that contain fluoride. If an understanding of the aforementioned issues of dental care, as well as aspects of preventive care in infants and children, become more uniform among primary care physicians, the prevention-based practice of pediatric dentistry will become much more successful, and children and adults will enjoy better dental health.     

The conversion game: high stakes, few rules

The aim of this project was to determine the severity of nursing caries, and to examine contributing behavioral factors, in a group of Vietnamese families in British Columbia, Canada. The data collected became the basis for a community-based oral health promotion program. Information on feeding, dental health practices, and dental caries were collected for 60 mother/child pairs. For children > or = 18 mos, prevalence of nursing caries was 64 percent. Sixty-five percent of all children had a naptime bottle, and 85 percent > or = 18 mos had a "comfort" bottle that was carried around, and drunk from during the day. Milk was the most common beverage. A "comfort" bottle was significantly related to the presence of nursing caries, P = 0.02; a naptime bottle had a less significant association, P = 0.07. Dental knowledge questions revealed that all mothers knew that a child who had a "comfort" bottle could get tooth decay, but 63 percent thought that cavities were not a problem in baby teeth.     

Galactose oxidase-glucan binding domain fusion proteins as targeting inhibitors of dental plaque bacteria

In order to inhibit the growth of bacteria present in the human oral cavity, a novel system which targets antimicrobial agents to dental plaque has been developed. This system involves a hybrid protein consisting of a peptide expressing the bactericidal properties of galactose oxidase (GAO) fused to the glucan binding domain (GBD) of the Streptococcus mutans glucosyltransferase-S enzyme. A gene encoding GAO from the fungus Fusarium sp. has been inserted into an Escherichia coli expression vector and fused to sequences encoding the GBD, which binds to the glucans synthesized by oral streptococci. Bacterial extracts expressing the hybrid protein were tested for their ability to target the GAO activity to an in vitro plaque model consisting of streptococcal cells bound to microtiter plate wells. The binding of the hybrid protein to the streptococcal cells through its GBD and the dependence of binding on the production of glucans by bacteria were demonstrated. Furthermore, killing of three different species of oral streptococci by bound hybrid protein in conjunction with the galactose-lactoperoxidase-iodide cytotoxic system has been demonstrated. These results suggest a novel strategy for controlling dental plaque formation as well as dental caries in humans.     

The use of a triclosan/copolymer dentifrice may retard the progression of periodontitis

The present investigation was performed to examine if triclosan and a copolymer, incorporated in a dentifrice and used by periodontitis-susceptible subjects could influence clinical symptoms characteristic of recurrent periodontitis. 60 subjects, 34 to 67 years of age, were recruited for the study. They were randomly selected from a group of patients previously treated for advanced periodontal disease. This treatment had included oral hygiene instruction, subgingival debridement, but no surgical therapy. The patients had, during a 3-5 year period following active therapy, been enrolled in a maintenance care program but had, at various intervals, exhibited signs of recurrent periodontitis. The patients were stratified into 2 balanced groups with respect to mean probing pocket depth. The test group, included 30 individuals who used a dentifrice containing triclosan/copolymer/fluoride, i.e. 0.3% triclosan, 2% copolymer and 1100 ppm F from 0.243% sodium fluoride (Colgate Total). The control group also included 30 subjects who used a dentifrice identical to the one used in the test group but without the triclosan/copolymer content. Following the baseline examination, including clinical and radiographical assessments, all volunteers received detailed information on how to brush their teeth in a proper way. This information was repeated on an individual need basis during the course of the subsequent 36 months. No professional subgingival therapy was delivered between the baseline and the 36-month examinations, but the subjects were recalled every 3 months. Re-examinations were performed after 6, 12, 24, and 36 months of the trial. A 2nd set of radiographs was obtained at the final examination, i.e., at 36 months. The results demonstrated that in subjects susceptible to periodontal disease, meticulous, self-performed, supragingival plaque control maintained over a 3-year period failed to prevent recurrent periodontitis. In a similar group of subjects and plaque control program, however, the daily use of a triclosan-containing dentifrice reduced (i) the frequency of deep periodontal pockets, and (ii) the number of sites that exhibited additional probing attachment and bone loss.     

Impact of a children's health insurance program on newly enrolled children

CONTEXT: Although there is considerable interest in decreasing the number of US children who do not have health insurance, there is little information on the effect that health insurance has on children and their families. OBJECTIVE: To determine the impact of children's health insurance programs on access to health care and on other aspects of the lives of the children and their families. DESIGN: A before-after design with a control group. The families of newly enrolled children were interviewed by telephone using an identical survey instrument at baseline, at 6 months, and at 12 months after enrollment into the program. A second group of families of newly enrolled children were interviewed 12 months after the initial interviews to form a comparison sample. SETTING: The 29 counties of western Pennsylvania, an area with a population of 4.1 million people. SUBJECTS: A total of 887 families of newly enrolled children were randomly selected to be interviewed; 88.3% agreed to participate. Of these, 659 (84%) responded to all 3 interviews. The study population consists of 1031 newly enrolled children. The children were further classified into those who were continuously enrolled in the programs. The 330 comparison families had 460 newly enrolled children. MAIN OUTCOME MEASURES: The following access measures were examined: whether the child had a usual source of medical or dental care; the number of physician visits, emergency department visits, and dentist visits; and whether the child had experienced unmet need, delayed care, or both for 6 types of care. Other indicators were restrictions on the child's usual activities and the impact of being insured or uninsured on the families. RESULTS: Access to health care services after enrollment in the program improved: at 12 months after enrollment, 99% of the children had a regular source of medical care, and 85% had a regular dentist, up from 89% and 60%, respectively, at baseline. The proportion of children reporting any unmet need or delayed care in the past 6 months decreased from 57% at baseline to 16% at 12 months. The proportion of children seeing a physician increased from 59% to 64%, while the proportion visiting an emergency department decreased from 22% to 17%. Since the comparison children were similar to the newly enrolled children at enrollment into the insurance programs, these findings can be attributed to the program. Restrictions on childhood activities because of lack of health insurance were eliminated. Parents reported that having health insurance reduced the amount of family stress, enabled children to get the care they needed, and eased family burdens. CONCLUSIONS: Extending health insurance to uninsured children had a major positive impact on children and their families. In western Pennsylvania, health insurance did not lead to excessive utilization but to more appropriate utilization.     

Preventive services in a Medicare managed care environment

The results of a four year demonstration project of preventive services for Medicare managed care enrollees suggest that health promotion programs can impact health behaviors and outcomes. The study provided selected preventive services to 1,800 Medicare enrollees in a managed care environment. Participants were randomly assigned to control and experimental groups with the experimental group receiving an intervention service package and the control group usual care. The results included enhanced health behavior practices, lower depression, and higher immunization rates among those individuals in the experimental group. This study suggests that selected preventive services can be provided in a managed care environment to Medicare enrollees with likely positive health status and utilization outcomes.     

A randomized trial of a self-help smoking cessation intervention in a nonvolunteer female population: Testing the limits of the public health model.

2,786 smokers among 15,004 female members of a health maintenance organization who completed a routine needs assessment were invited into a preventive health behavior study, consisting of 5 telephone interviews over 2 yrs assessing health practices. 1,396 participants were randomized into experimental or control conditions of an unsolicited, mailed, self-help smoking cessation program. Ss were not alerted to the link between the program and the health study. Smoking status was assessed at 1, 6, 12, and 18 mo. Although quit rates were higher than in the general population and were comparable to volunteer samples in self-help smoking cessation trials, there was no differential effect of the targeted intervention on the experimental group compared with the control group. Data indicate that mass mailing of cessation materials is not a useful form of cessation intervention. (PsycINFO Database Record (c) 2010 APA, all rights reserved)