bluuebunny/crossref_metadata_2025 huggingface dataset:
Viability of cultured periodontal pocket epithelium cells and Porphyromonas gingivalis association
Authors: Dierickx K. , Pauwels M. , Van Eldere J. , Cassiman J. J. , Van Steenberghe D. , Quirynen M.
Published: March 2003

Objectives: Porphyromonas gingivalis, one of the key pathogens in the development of periodontitis, produces a number of virulence factors that might explain its pathogenicity. One of them is the ability to adhere and invade pocket epithelium. The aim of this study was to follow, over time, the association of P. gingivalis and consequent morphological changes of the pocket epithelium cells.

Material and Methods: The association capacity of four P. gingivalis serotypes [K1, K2, K4, K‐ (nonencapsulated)] with in vitro cultured mono‐layers from periodontal pocket epithelial cells of patients with periodontitis, was followed by fluorescence microscopy and bacterial culture. The contact time between bacteria and epithelium cells ranged from 45 min to 8 h. The microscopic evaluation allowed differentiation between dead and living cells (bacteria as well as epithelium) and description of the morphological changes after association.

Results: A highly significant difference in the number of associating bacteria was found between dead and living epithelium cells, and between non‐capsulated and capsulated strains. A significant increase in the proportion of dead pocket epithelium cells was found with prolonged association time. The morphological changes (rounding of the epithelial cell, detachment from the glass cover‐slip and loss of intercellular contact) occurred faster for mono‐layers inoculated with the non‐encapsulated P. gingivalis strain.

Conclusions: This study indicates that dead pocket epithelium cells harbor more P. gingivalis cells, and that a positive correlation exists between contact time and cell death. For the P. ginigvalis species, non‐encapsulated strains associate in higher number. As a result, the damage they cause to the host cell seems to occur faster than occurs in encapsulated strains. As such, cell death can be seen as the end‐result of bacterial association.
Safety and clinical effects of topical histatin gels in humans with experimental gingivitis
Authors: Paquette D. W. , Simpson D. M. , Friden P. , Braman V. , Williams R. C.
Published: March 2003

Background: Our research group has recently reported that exogenously applied histatins can inhibit plaque accumulation and gingival inflammation in a preclinical canine model (Paquette et al. 1997).

Objectives: The aims of the present double‐blinded, randomized, controlled clinical trial were to evaluate the safety and toxicity of three histatin (P‐113) concentrations in gel formulations, and to assess potential clinical benefit on the development of gingivitis (partial mouth design).

Material and methods: One hundred and six healthy subjects were recruited and brought to optimal gingival health (GI < 0.5) prior to treatment initiation. At baseline, eligible subjects were randomized for one of the following treatments: (1) placebo; (2) 0.0625% P‐113; (3) 0.125% P‐113; and (4) 0.375% P‐113. Patients self‐applied gels twice daily for 29 days to the maxillary right quadrant with the use of customized stents. In addition, patients deferred all oral hygiene procedures within this quadrant for the duration of the treatment period. Safety was assessed in terms of physical and oral examinations, clinical laboratory testing and recording of adverse events. Clinical indices were measured weekly and included gingival index (GI), plaque index (PI) and %BOP.

Results:  All study formulations were well tolerated by patients, and no differences in adverse event occurrences were noted among treatment groups, including taste alteration or staining. For the intent‐to‐treat population, significantly smaller %BOP changes were noted in subjects treated with 0.0625, 0.125 and 0.375% P‐113 gels (17.4, 18.18 and 17.9%, respectively) versus placebo (28.0%) (p < 0.05) at day 29. When groups were compared in terms of per cent responders (change in %BOP < 15 or < 20%), P‐113 treatment groups exhibited a higher frequency of response, especially for the 0.0625 and 0.125% P‐113 formulations (p < 0.05). Although no statistically significant intergroup differences were noted for changes in GI or PI among all subjects (intent‐to‐treat population), significantly smaller changes in PI at day 22 were observed among compliant individuals (defined as subjects using > 60% of the target gel mass) administering P‐113 gels as compared with compliant placebo subjects (p < 0.05).

Conclusions: These data indicate safety and tolerance of P‐113 gels for topical oral use in human subjects. These data also suggest that P‐113 gels administered twice daily may reduce experimental gingivitis as measured with bleeding on probing in humans.
The effect of a SCN–/H2O2 toothpaste compared to a commercially available triclosan‐containing toothpaste on oral hygiene and gingival health – a 6‐month home‐use study
Authors: Rosin Michael , Kramer Axel , Bradtke Detlef , Richter Gerrit , Kocher Thomas
Published: March 2003

Objectives: The aim of the study was to compare the gingival health benefits of a thiocyanate/carbamide peroxide toothpaste to that of a triclosan toothpaste in home use.

Materials and methods: The study was a two‐centre, randomised, double‐blind, parallel‐group clinical trial, and consisted of a 2‐week pre‐experimental phase, followed by an experimental period of 6 months. A total of 140 healthy male and female volunteers (70 per group) who had at least 20 natural teeth with no probing depths greater than 5 mm and a mean gingival index (GI) of 1 or more at screening were admitted to the study. The two products were the test toothpaste (RCP) containing 0.5% SCN– (rhodanide), carbamide peroxide (equivalent 0.1% H2O2), and 1450 p.p.m. fluoride, and a control toothpaste (Colgate Total®) containing 0.3% triclosan, 2.0% polyvinyl methyl ether maleic acid (PVM/MA), and 1450 p.p.m. fluoride (Triclosan). In the pre‐experimental phase, all subjects used a fluoride toothpaste. Plaque (Turesky et al. 1970) and gingivitis (Löe & Silness 1963) were scored prior to beginning the pre‐experimental phase, at baseline, and after 6 weeks and 3 and 6 months.

Results: In both the RCP and the Triclosan group, gingival health improved significantly between baseline and the following examinations. Plaque scores decreased significantly between baseline and 6 months in both groups. There were, however, no significant differences between the groups for either gingival index or plaque index.

Conclusion: To conclude, this study seems to verify that in normal home use, a toothpaste containing a combination of thiocyanate and carbamide peroxide is as effective in reducing gingival inflammation and supragingival plaque formation as a benchmark control product.
Tooth loss and pocket probing depths in compliant periodontally treated patients: a retrospective analysis
Authors: König Jörgen , Plagmann Hans‐Christian , Rühling Andreas , Kocher Thomas
Published: March 2003

Background/aims: This retrospective study determined the treatment outcomes of 142 compliant periodontal patients observed for at least 10 years at the University of Kiel. All patients had been treated for moderate to advanced periodontitis and regularly received supportive periodontal therapy (SPT).

Methods: Patient‐ and tooth‐related variables [tooth loss and pocket probing depth (PPD)] were analysed.

Results: Of a total of 3353 teeth, 167 were extracted during active treatment and 99 during SPT, mainly for periodontal reasons. Forty‐five per cent of the patients did not lose any teeth during 11.7 years of observation. Thirty‐seven per cent underwent extractions during active treatment or SPT, 18% both during active periodontal therapy and SPT. Mean tooth loss per patient was 0.07 teeth/year during SPT. Mobility, furcation involvement, smoking, and prescription antibiotics had a negative impact on prognosis. Intraindividual differences in PPD were significant between single‐ and multirooted teeth with initial PPD ≥ 4 mm at baseline, following active treatment and at the end of SPT, and between firm and mobile teeth at baseline. Interindividual differences in mean PPD were only significant between smokers and non‐smokers at the end of the observation period.

Conclusions: Long‐term maintenance of our patients was effective. Periodontal disease represented the major cause of tooth loss in a minority of the population.
Effects of enamel matrix protein application on the viability, proliferation, and attachment of human periodontal ligament fibroblasts to diseased root surfaces in vitro
Authors: Davenport D. R. , Mailhot J. M. , Wataha J. C. , Billman M. A. , Sharawy M. M. , Shrout M. K.
Published: March 2003

Objectives: The purpose of this research was to examine the influence of enamel matrix proteins (EMP) on the viability, proliferation, and attachment of periodontal ligament fibroblasts (PDLF) to diseased root surfaces.

Materials and Methods: Primary cell cultures of PDFL were obtained from clinically healthy third molars or premolar teeth. Viability and proliferation rates were carried out over a 10‐day period. A total of 80,000 cells were plated in 24‐well plates followed by EMEM with 10% FBS (positive control) and EMEM plus EMP at 25, 50, 75, and 100 μg/ml. Cells were harvested on days 1, 3, 5, 7, and 10 and viability was performed utilizing an MTS assay. PDLF proliferation rates were assessed by a CyQUANT GR dye assay. SEM analysis was used to examine the qualitative effects of cellular attachment to diseased root surfaces following EMP compared to nontreated controls.

Results: The results indicated that viability was negatively affected for higher doses over time while lower doses displayed viability effects similar to control. Proliferation, however, appeared to be ameliorated following exposure to EMP. The SEM analysis suggests that cellular attachment to diseased dentin was enhanced following EMP application.

Conclusion: These in vitro studies support the concept that EMP may act as a suitable matrix for PDLF.
The effects of cigarette smoking on the periodontal condition of young Jordanian adults
Authors: Al‐Wahadni Ahed , Linden Gerard J.
Published: March 2003

Background: Several studies have reported an association between smoking and periodontal destruction in young adults.

Aims: To investigate the effects of cigarette smoking on the periodontal condition of young Jordanian adults.

Methods: A case‐control study of young adults between the ages of 20 and 35 years who were attending a dental hospital in Jordan for routine dental treatment. A group of 100 subjects who had smoked for at least 2 years were compared with 100 age‐ and sex‐matched never smokers. Clinical measurements of plaque, bleeding on probing and probing depth were recorded and interproximal bone levels related to molar teeth were assessed from bitewing radiographs.

Results: The smokers had higher levels of plaque, more sites which bled in response to probing and a greater mean probing depth than never smokers. The unadjusted odds ratio for smoking to be associated with the presence of more than 10 pockets which were ≥4 mm was 3.08 (95% confidence interval 1.58–6.03). The proportion of measurable surfaces in smokers (22.7%) which had bone levels ≥3 mm below the cementoenamel junction was significantly higher (P<0.0001) than in never smokers (7.4%). Independent predictors of reduced bone levels in multivariate analysis were infrequent interdental cleaning (P=0.03), age of 30 or older (P=0.03) and smoking (P<0.0001). Within the multivariate analysis the adjusted odds ratio for smoking to be associated with reduced molar bone levels was 4.95 (confidence interval 2.48–9.88).

Conclusions: It is concluded that cigarette smoking was a major environmental factor associated with accelerated periodontal destruction in the young adult Jordanians investigated.
Determinants of patients' treatment preferences in a clinical trial
Authors: Awad Manal A. , Shapiro Stanley H. , Lund James P. , Feine Jocelyne S.
Published: March 2003

Abstract – Several researchers have suggested that patients' preferences for a particular form of treatment should be taken into account in clinical trials. Preferences may influence the outcome of treatment, especially in trials when patients cannot be blinded to the type of treatment received and the outcome is based on patients' evaluations of therapy. Participants in this study were 136 edentulous patients who took part in a randomised controlled clinical trial comparing two types of treatments for edentulism: conventional dentures and implant‐supported prostheses. Prior to receiving treatment, subjects were required to complete a questionnaire regarding their satisfaction with their present prostheses. In addition, they were asked to indicate which treatment they would prefer if given a choice. The objective of this study was to determine whether there are important differences among study participants between patients who have a treatment preference and those who do not. The effects of satisfaction with pre‐treatment prostheses, age, gender and level of education on preferences were examined. Level of satisfaction with the original dentures and level of education were significant predictors of preference. Compared to subjects who rated their satisfaction with their current condition as ‘low’, the odds ratios associated with having a preference for implant treatment were 0.31 (95% CI: 0.09 to 0.96) for subjects who rated their prostheses in the ‘medium’ range and 0.11 (95% CI: 0.03 to 0.41) for those who rated in the ‘high’ range. In addition, subjects with high levels of education were significantly less likely to have a preference for either conventional or implant treatments (OR=0.18, 95% CI: 0.02 to 0.77 and OR=0.20, 95% CI: 0.05 to 0.76, respectively) compared to those with low education. Neither age nor gender was a significant predictor of preference. We suggest that study designs which incorporate patients' preferences must take into account possible differences between preference groups that might confound the relationship between preference and the outcome of interest.
Oral hygiene knowledge of high‐risk Grade One children: an evaluation of two methods of dental health education
Authors: Hawkins Robert J. , Zanetti Debra L. , Main Patricia A. , Jokovic Aleksandra , Dwyer John J. M. , Otchere Daniel F. , Locker David
Published: March 2003

Abstract – The effectiveness of two methods of dental health education (DHE) for improving oral hygiene knowledge among high‐risk Grade One students was evaluated. Fifty elementary schools in the former City of North York, Canada were assigned to one of two groups. In one group, students received a classroom‐based DHE lesson which was reinforced by two small‐group sessions (n=243). In the other group, students received only a single classroom‐based DHE lesson (n=206). After DHE interventions, students in both groups displayed improved knowledge for most oral hygiene questions (e.g., when should you throw your toothbrush away?). However, for several questions, a significantly higher proportion of “classroom plus small‐group sessions” students displayed improved knowledge compared to students receiving only a classroom lesson. These items included: awareness that cavity prevention and removal of germs are two purposes of oral hygiene; and knowledge that teeth help people to eat and talk. Results suggest a classroom‐based lesson combined with small‐group sessions is a more effective method of improving oral hygiene knowledge among high‐risk Grade One students compared to a single classroom‐based lesson.
Salivary alterations in type 2 (non‐insulin‐dependent) diabetes mellitus and hypertension
Authors: Dodds Michael W. J. , Yeh Chih‐Ko , Johnson Dorthea A.
Published: March 2003

Abstract – Objectives: The aim of this study was to determine whether saliva output and composition are altered in type 2 diabetes mellitus by comparison with a healthy, non‐medicated control group, and also a group of hypertensives. Methods: From a community‐dwelling cohort of Mexican American and European American subjects enrolled in the OH:SALSA oral aging study, we identified 233 subjects with type 2 diabetes mellitus, 227 with hypertension, and 240 healthy control subjects. We collected unstimulated whole (UW) and submandibular/sublingual (US) saliva, as well as stimulated parotid (SP) and submandibular/sublingual (SS) saliva. Flow rates were determined, yeast carriage was assayed in UW saliva, and SP and SS saliva samples were analyzed for protein composition. ELISA was used to determine concentrations of an array of specific protein components, with both antimicrobial and other activities. Results: Both diabetic and hypertensive subjects had reduced output of both stimulated and unstimulated submandibular/sublingual saliva. 30% of the diabetic subjects had high oral yeast counts (≥1000 cfu/mL) compared with 17% of the healthy subjects and 20% of the hypertensives. Significant increases in the concentrations of a number of the protein components were found in the diabetic subjects, specifically, SP lactoferrin, myeloperoxidase (MPO), and salivary peroxidase (SPO), as well as SS total protein, albumin, lactoferrin and secretory IgA. Conclusions: The pattern of decreased flow rates and increased protein concentrations were similar, but consistently greater in diabetics than hypertensives, suggesting that disease‐specific mechanisms may be responsible. Diabetics may be more prone to oral dryness and infections than non‐diabetics.
Dental neglect and dental health among 26‐year‐olds in the Dunedin Multidisciplinary Health and Development Study
Authors: Thomson W. Murray , Locker David
Published: March 2003

Abstract – Objectives: To test a modification of a previously‐reported six‐item dental neglect scale and examine its association with dental health and service‐use among young adults. Methods: Of the 980 26‐year‐old participants in the Dunedin Multidisciplinary Health and Development Study, 973 completed the scale and 930 underwent dental examination. Sociodemographic and dental service‐use data were collected using a self‐report questionnaire. Results: Factor analysis showed that five of the original six items loaded on the scale, and responses to those items were summed to give a dental neglect scale score for each participant. Scale scores were normally distributed (mean=13.0; SD=3.6; range 5 to 25), and a median split created higher and lower dental neglect groups. A higher proportion of the higher neglect group group: (i) were male; (ii) rated their dental health and dental appearance as below average; (iii) brushed their teeth infrequently; (iv) had extensive plaque deposits; (v) used dental services only when they had a problem; (vi) had not recently seen a dentist; (vii) had lost at least one permanent tooth because of caries, and (viii) had a greater number of decayed tooth surfaces. Conclusions: Although further examination of its validity and reliability is indicated, the dental neglect scale appears to hold promise for use in dental health promotion, not only in highlighting population groups or individuals who would benefit from intensive health promotion efforts, but also in the evaluation of health promotion interventions.
Oral hygiene and sugar consumption among urban and rural adolescents in Ghana
Authors: Blay Daniel , Åstrøm Anne Nordrehaug , Haugejorden Ola
Published: March 2003

Abstract – Objectives: The purpose of this study was to compare categories of self‐reported oral health behavior among adolescents raised in urban and rural areas of Ghana. Methods: Second year students (n=583) aged 14–18 years were selected from the five secondary schools in the Awutu‐Effutu Senya district, using a stratified random sampling procedure. A total of 504 (86%) students completed questionnaires under supervision at school. Results: Cross‐tabulation analyses revealed that most urban and rural residents (97% and 96%) reported daily tooth brushing, whereas small and moderate proportions reported use of toothpicks and intake of sugared snacks, respectively. Multiple logistic regression analyses, controlling for gender and parents' education, showed that the socio‐regional context (urban/rural) was significantly related to intake of cakes/biscuits (odds ratio (OR)=2.6, 95% CI 1.7–4.4), chocolate/sweets (OR=3.5, 95% CI 2.0–6.0) and use of toothpicks (OR=2.6, 95% CI 1.3–5.5), indicating true differences between urban and rural residents. Conclusion: As predicted, urban residents were more likely than their rural counterparts to use toothpicks and to consume sugared snacks. Among both urban and rural residents, males and those having less educated parents reported oral hygiene and sugar intake less frequently than did females and the highly educated. Whereas the gender difference with respect to intake of sugared snacks was larger among urban than rural residents, the socio‐economic disparity with respect to use of toothpicks was most pronounced among rural residents. The results appear to imply that in addition to targeting specific oral health behaviors, both individual characteristics and the wider socio‐regional context should be addressed when planning oral health intervention among Ghanaian adolescents.
Application of the high‐risk strategy to control dental caries
Authors: Hausen Hannu , Kärkkäinen Sakari , Seppä Liisa
Published: March 2003

Abstract – Objective: The aim of this prospective study was to determine whether a child population with low overall caries frequency benefits when prevention is targeted to high‐risk individuals. Methods: Data from clinical examinations and salivary tests were used to assess caries risk in 12‐year‐olds (n=1465). Children who were regarded as being at high risk of developing caries were randomized into two groups. Half (HRI group) were offered intensive prevention (counseling, F‐varnish applications, F‐lozenges, sealants, chlorhexidine), and the other half (HRB group) were provided the same basic prevention given to low‐risk children (counseling, one F‐varnish application/year). A random sample of the low‐risk children (LRB) was followed up for the same 3‐year period as the high‐risk children. The number of children completing the study was 216 in the LRB group, 199 in the HRI group and 174 in the HRB group. Results: The mean (SD) 3‐year DMFS increment was 2.0 (2.4), 4.4 (4.7) and 5.1 (5.0) in the LRB, HRI and HRB groups, respectively. Comparison between the LRB and HRB groups revealed that risk assessment was fairly successful in terms of mean DMFS increment. However, 63% of the children in the LRB group developed at least one new lesion (max. 12). Conclusions: The negligible difference between the HRI and HRB groups implies that intensifying prevention produced practically no additional benefit. By offering all children only basic prevention, virtually the same preventive effect could have been obtained with substantially less effort and lower costs.
Qualitative techniques to investigate how patients evaluate dentists: a pilot study
Authors: Newsome Philip R. H. , Wright Gillian H.
Published: March 2003

Abstract – Objectives: Most previous studies have portrayed patient satisfaction as a rather simple outcome based solely on patient perceptions. The goal of this pilot study was to determine if evidence could be found to support the view that patient evaluation is a more complex process better explained by drawing on the theories of ‘disconfirmation of expectations’ and ‘attribution’. Methods: A qualitative methodological approach was chosen with data collection being achieved by means of four focus group interviews comprising a total of 25 participants (16 women and 9 men, mean age 43.8 years, standard deviation of 14.45) representing a wider population of adults (over the age of 18) who had attended for dental treatment within the previous 12 months. Results: Analysis suggests that patient perceptions of dental practice alone do not fully account for the way patients evaluate dentists. Disconfirmation of expectations does take place during the evaluation process. Equally, patients appear to apply the attributional concepts of ‘duty’ and ‘culpability’ to determine either satisfaction or dissatisfaction. Conclusions: A better understanding of patient satisfaction, and the evaluation process that leads to satisfaction, can only be achieved if, in addition to patient perceptions, other antecedent factors such as patient expectations and desires are considered. Disconfirmation and attribution theory do appear to play an important role in this process and warrant further investigation.
Prevalence of impacts of dental and oral disorders and their effects on eating among older people; a national survey in Great Britain
Authors: Sheiham Aubrey , Steele Jimmy G. , Marcenes Wagner , Tsakos Georgios , Finch Stephen , Walls Angus W. G.
Published: March 2003

Abstract – Objective: The objective was to assess the prevalence, in a British population aged 65 years and older, of oral health related impacts and the effects they had on the quality of daily life and in particular on eating. Methods: 753 free living and 202 institutionalised subjects aged 65 years and over, participating in the oral health survey of the British National Diet and Nutrition Survey (NDNS), had a dental examination and interview. Data on the impact of dental and oral disorders on the activities of daily living based upon the modified Oral Impacts on Daily Performance (OIDP) indicator were collected. Results: 17% of the free living edentate participants reported that their mouth affected their pattern of daily living on a regular basis. Oral impacts levels were lowest in dentate subjects with the greatest number of teeth. For the dentate, the most common oral impacts were on eating and speaking. Impacts relating to emotional stability, sleeping, relaxing, carrying out physical activity and social contact were very infrequent, but were severe when they did occur. Among those with an impact on eating, 25% said it was severe and 42% had the impact nearly every day or in a spell of 3 or more months. Oral impacts were more prevalent among the institution sample, particularly the dentate. The impacts were associated with the inability or difficulty to eat a range of 16 common foods. Conclusion: This survey has shown that the oral status of older people fairly frequently affects the quality of life of older people, and in particular, the ability to eat several common types of foods.
Recurrent oral ulcerations associated with recurrent herpes labialis – two distinct entities?
Authors: Katz Joseph , Chaushu Gavriel , Peretz Benjamin
Published: March 2003

Abstract – We investigated the prevalence of recurrent aphthous ulcerations (RAU) and recurrent herpes labialis (RHL) in a young adult population. The study group consisted of 20 689 soldiers (aged 18–21 years, mean 19.8±1 years). There were 14 991 men and 5698 women. Every patient was asked to complete a self‐report health questionnaire which requested information about the occurrence of either RAU or RHL. Data were analyzed using the chi‐square test, and the odds ratio was also determined. The prevalence of RAU and RHL was 6.2% and 5.4%, respectively. The prevalence among women was significantly higher (P<0.001), than among men for both RAU (7.1% and 5.8%, respectively) and RHL (6.8% and 4.9%, respectively). Among women, the chance of having RAU for those who were RHL positive was 6.88 greater than for those RHL negative. Among men, the chance of having RAU for those who were RHL positive was 12.37 greater than for those RHL negative. In women, the chance of having RHL for those who were RAU positive was 6.88 greater than for those who were RAU negative. In men, the chance of having RHL for those who were RAU positive was 12.37 greater than for those who were RAU negative. It is concluded that a similar underlying pathological process or unknown cofactor may be involved in both RAU and RHL.
Primary tooth fluorosis and fluoride intake during the first year of life
Authors: Levy Steven M. , Hillis Stephen L. , Warren John J. , Broffitt Barbara A. , Mahbubul Islam A. K. M. , Wefel James S. , Kanellis Michael J.
Published: March 2003

Abstract –

Objectives: Few studies in North America have assessed dental fluorosis of the primary dentition and few, if any, anywhere have assessed the relative importance in fluorosis etiology of fluoride intake during different time periods or from multiple sources. The purpose of this paper is to report on analyses relating estimated prenatal fluoride intake and fluoride intake during different parts of the first year of life to primary tooth fluorosis.

Methods: As part of The Iowa Fluoride Study, subjects were recruited at birth and studied longitudinally. Trained examiners assessed dental fluorosis for children aged 4–7 years using the Tooth Surface Index of Fluorosis (TSIF) adapted for the primary dentition. Detailed parent questionnaires at childbirth were used to estimate prenatal fluoride intake and questionnaires sent at 6 weeks and 3, 6, 9, and 12 months were used to estimate fluoride intake during the first year of life (combined fluoride intake from water, food and beverage, supplements, and dentifrice). There were 504 children with prenatal and at least four of the five postnatal responses with complete data.

Results: Fluorosis prevalence was 12.1%, occurring primarily on the second primary molars. Receiver operating characteristic (ROC) curves and logistic regression were used to assess the importance of different time periods' fluoride intake. In bivariate analyses, fluoride intake during each time interval was individually significantly related to fluorosis occurrence. For multivariate analyses, the period from 6 to 9 months was most important individually (P = 0.0001), and no other period was jointly statistically significant.

Conclusions: Results suggest that the middle of the first year of life is most important in fluorosis etiology for the primary dentition in this setting.
Caries experience of some countries and areas expressed by the Significant Caries Index
Authors: Nishi Makiko , Stjernswärd Jayanthi , Carlsson Peter , Bratthall Douglas
Published: March 2003

Abstract –

Objectives: To calculate and present the caries prevalence for some countries/states among 12‐year‐olds, expressed as Significant Caries Index (SiC Index) and to analyse the relationship between the mean DMFT and the SiC Index for these countries. SiC Index is the mean DMFT of the one‐third of a population with the highest caries values.

Methods:  An Excel® application for calculating SiC was developed (http://www.whocollab.od.mah.se/expl/siccalculation.xls) and indices were calculated from the data collected for 14 countries and one state from the Country/Area Profile Programme (http://www.whocollab.od.mah.se/index.html). To investigate the provinces of a country that had already reached the proposed SiC Index goal of 3 DMFT among the 12‐year‐olds, data for 17 counties and a city from Sweden were collected and the respective mean DMFT and SiC Indices calculated.

Results:  The mean DMFT varied from 1.0 to 8.5 and the SiC Index varied from 2.8 to 13.7 in the national data. Jamaica, Senegal and Sweden were the only three countries that showed SiC Indices that were less than 3 DMFT. The mean DMFT varied from 0.5 to 1.4 and the SiC Index varied from 1.4 to 3.6 in the Swedish county/city data examined. A strong linear relationship between the mean DMFT and the SiC Index was found for the populations presented in this study.

Conclusion:  The SiC Index is an indicator that reflects the situation among the most caries‐exposed individuals and could be included in future population‐based oral health surveys together with the mean DMFT.
Tooth loss in the very old: 13–15‐year incidence among elderly Iowans
Authors: Warren John Joseph , Watkins Catherine Ann , Cowen Howard Jeffry , Hand Jed Stephen , Levy Steven Marc , Kuthy Raymond Andrew
Published: March 2003

Objectives: Very few studies have reported tooth loss incidence over a period of 10 years or more, and fewer have reported tooth loss occurrence in subjects aged 80 and older, so that the long‐term pattern of tooth loss in the very old is largely unknown. This study assessed 13–15‐year tooth loss incidence among a cohort of Iowans, aged 65 and older at baseline. Methods: Oral examinations were conducted on 520 subjects beginning in 1983, and periodically until 1988, with another round of examinations conducted on surviving members of the initial cohort during 1996–98. Results: Of the 73 remaining subjects, 45 subjects lost a total of 153 teeth during the period (mean=2.1 teeth lost), with a maximum of 17 teeth lost. Molars were the most commonly lost teeth, while canines and maxillary incisors were the least commonly lost. Bivariate analyses found that tooth loss was associated with untreated decay at baseline and level of periodontal attachment loss at earlier examinations. Logistic regression identified only greater severity of attachment loss as a significant risk factor for tooth loss (Adjusted odds ratio=2.4, P=0.006). The impact of tooth loss on subjects' lives was assessed using OHIP and other questions. The occurrence of tooth loss over the study period had little impact, but the number of remaining teeth significantly impacted subjects' ability to eat or chew food, swallow, or their willingness to smile. Conclusions: These results suggest that tooth loss continues in the very old, that periodontal attachment loss is associated with tooth loss in this age group, and that loss of teeth over one's lifetime does affect certain quality‐of‐life measures.
Tobacco use and oral hygiene as risk indicators for periodontitis
Authors: Amarasena Najith , Ekanayaka Asoka N. I. , Herath Lilani , Miyazaki Hideo
Published: March 2003

Objective: To detect the periodontal status of male smokers and betel chewers in a rural community in Sri Lanka and compare it with that of male non‐tobacco users of the same community. Methods: A cross‐sectional community based study was carried out in a sample of 2277 rural adult males aged 20–60 years, adopting multistage cluster sampling technique. The present analysis was confined to 2178 subjects who were mutually exclusive smokers, betel chewers or non‐tobacco users. The periodontal status was assessed by clinical measurement of levels of bacterial plaque (PLI), gingival inflammation (GI) and loss of epithelial attachment (LA). All measurements were carried out on four sites of all teeth present except third molars and the mean values for periodontal parameters were calculated. Results: Bivariate analysis revealed that the overall periodontitis levels were significantly higher in betel chewers and smokers than in non‐tobacco users. Multiple linear regression analysis showed that there were no significant effects of smoking and betel chewing per se on LA, independent of age, socioeconomic status (SES) and whether or not controlled for PLI. The effect of the quantified tobacco use on LA was statistically significant regardless of age, PLI or SES. However, the effect of the quantified tobacco use was considered limited when compared to that of oral hygiene. Conclusions: The findings highlighted the importance of oral hygiene in the aetiology of periodontitis while confirming the statistical significance of the quantified tobacco use on LA. Oral hygiene and the quantified tobacco use may be considered as risk indicators for periodontitis.
Impact of traumatic injuries to the permanent teeth on the oral health‐related quality of life in 12–14‐year‐old children
Authors: Ilma de Souza Cortes Maria , Marcenes Wagner , Sheiham Aubrey
Published: March 2003

Background/Aim:  There are no data on the impacts on daily living of traumatic injuries to the permanent teeth. The aim of the present study was to assess the socio‐dental impacts of untreated fractured anterior teeth in Brazilian schoolchildren.

Methods:  A population‐based matched case‐control study was used and a 2 : 1 control‐to‐case ratio was adopted. The cases were 68 children 12–14 years old, having non‐restored teeth, with fracture involving dentine. The controls were 136 children without any traumatic dental injury. They were matched by age, sex and socio‐economic status. The Oral Impact on Daily Performances (OIDP) index was used to measure the impacts.

Results: The response rate was 100%. Results of conditional logistic regression showed that children with fractured teeth were 20 times (95% CI = 2.2–45.6) more likely to report any impact on their daily living than children with no traumatic dental injury. These results remained statistically significant for the items of the OIDP separately, ‘smiling’ (P < 0.001), ‘maintaining emotional state’ (P < 0.001), ‘eating’ (P < 0.01), ‘enjoying contact with people’ (P < 0.01) and the overall OIDP (P < 0.001), after adjusting for confounding variables such as the Aesthetic Component of the Index of Orthodontic Treatment Need and DMFT index in a multiple conditional logistic regression.

Conclusions:  Children with untreated dental fracture of permanent teeth had more impacts on their daily living than children without any traumatic injury.
Emerging theories into the social determinants of health: implications for oral health promotion
Authors: Watt Richard Geddie
Published: March 2003

In recent years public health research has increasingly focused upon exploring the social determinants of health. This interest has partly arisen through an acknowledgement of the limitations of educational preventive approaches in improving population health and reducing health inequalities. Many health education interventions have been influenced by health behaviour research based upon psychological theories and models. These theories focus at an individual level and seek to explore cognitive and affective processes determining behaviour and lifestyle. Current psychological theories have only a limited value in the development of public health action on altering the underlying social determinants of health. New theoretical approaches have however, emerged which explore the relationship between the social environment and health. This paper aims to review and highlight the potential value to oral health promotion of three important public health theoretical approaches: life course analysis, salutogenic model and social capital. It is important that an informed debate takes place over the theoretical basis of oral health promotion. As the field of oral health promotion develops it is essential that it is guided by contemporary and appropriate theoretical frameworks to ensure that more effective action is implemented in the future.
Patch testing with corticosteroid mixes in Europe
Authors: Isaksson M. , Andersen K. E. , Brandão F. M. , Bruynzeel D. P. , Bruze M. , Camarasa J. G. , Diepgen T. , Ducombs G. , Frosch P. J. , Goossens A. , Lahti A. , Menné T. , Rycroft R. J. G. , Seidenari S. , Shaw S. , Tosti A. , Wahlberg J. , White I. R. , Wilkinson J. D.
Published: March 2003

This study investigated whether a corticosteroid mix containing tixocortol pivalate, budesonide, and hydrocortisone‐17‐butyrate could detect contact allergy to corticosteroids. 2 corticosteroid mixes, 1 with a high (mix I) and 1 with a low (mix II) concentration and the 3 individual constituents, each at 2 concentrations, were inserted into the standard series of 16 participating clinics. Tests were read on day (D) 3 or 4. 5432 patients were tested, and 110 (2.0%) had positive reactions to at least 1 of the 8 test preparations. Of the 8 preparations, mix I identified most allergic patients, followed by mix II, budesonide 0.10%, budesonide 0.002%, and tixocortol pivalate, both concentrations (1.0 and 0.10%) tracing the same number. With the mixes, 53.2–59.6% of tixocortol pivalate allergy was missed. 47 patients were allergic to either concentration of tixocortol pivalate, 25% of these only to 1.0% and another 25% only to 0.10%. Testing with mix I and tixocortol pivalate 0.10% picked up 98/110, testing with tixocortol pivalate 1.0% and 0.10% and budesonide 0.10% picked up 105/110. 3379 patients were read on both D3 or D4 as well as on D7. Without a late reading (D7), up to 30% of contact allergy to corticosteroid markers was missed.
Iontophoresis of nickel elicits a delayed cutaneous response in sensitized individuals that is similar to an allergic patch test reaction
Authors: Brasch Jochen , Hüttemann Martin , Proksch Ehrhardt
Published: March 2003

Wearing of patch test chambers for 1–2 days is uncomfortable for patients. Allergen application by iontophoresis avoids this, but it is unknown so far whether iontophoresis itself interferes with the delayed immune response. We compared the effects occurring 48 h after iontophoresis with distilled water, 0.9% NaCl, and 0.01 M NiSO4 in normal volunteers and in nickel‐sensitized patients (total n=36). Visual assessment was performed and transepidermal water loss (TEWL), stratum corneum hydration, cutaneous blood flow, and immunohistopathology were determined. After iontophoresis with nickel sulfate, only individuals sensitized to nickel reacted with a positive clinical response, increase in cutaneous blood flow, decline in epidermal CD‐1a‐positive cells, increase in epidermal proliferation (Ki‐67‐positive cells), pronounced infiltration of cells positive for CD4, CD11, or CLA, and cellular activation (expression of ICAM1, HLA‐DR). Iontophoresis with distilled water or saline did not result in such reactions in volunteers with or without nickel sensitization, and the latter also tolerated nickel iontophoresis without significant skin reactions. We conclude that the delayed cutaneous response to nickel induced via iontophoresis is specific and similar to a positive patch test reaction. Iontophoresis may therefore be considered as an alternative to patch testing.
Effect of an antioxidant (quercetin) on sodium‐lauryl‐sulfate‐induced skin irritation
Authors: Katsarou A. , Davoy E. , Xenos K. , Armenaka M. , Theoharides T. C.
Published: March 2003

Quercetin is a bioflavonoid with antioxidant and anti‐inflammatory activity. The purpose of this study was to examine the effect of quercetin on acute skin irritation, with special interest in the skin barrier function recovery. Acute irritant contact dermatitis was induced in 15 patients by 24‐h occlusion of 2% sodium lauryl sulfate (SLS) (day (D) 1). The influence of application on SLS‐irritated skin of topical quercetin for 5 consecutive Ds, compared to vehicle and controls, was studied. Parameters measured were transepidermal water loss (TEWL) and erythema index. Final measurements were taken on D 7 after a 1‐D rest period. TEWL and the erythema index continued to rise 2 D after application of SLS and 1 D after treatment with quercetin, vehicle or controls. Both TEWL and erythema values at D 7 did not return to values before the SLS barrier disruption at all the test sites. Therefore, quercetin topically applied after induction of irritant contact dermatitis does not appear to increase the recovery of barrier function and erythema caused by SLS.
Dental gold alloys and contact hypersensitivity
Authors: Vamnes Jan S. , Morken Tore , Helland Svein , Gjerdet Nils R.
Published: March 2003

A total of 172 patients referred to the Norwegian National Adverse Reaction Group were patch‐tested with a dental series. Of these, 25% showed a positive reaction to gold sodium thiosulfate or potassium dicyanoaurate. There was a statistically significant correlation (p=0.0019) between the presence of dental gold and a positive patch test to gold. There was a statistically significant correlation between ear piercing and a positive patch test to gold (p=0.04). In most cases, we did not find clinical correlates to positive patch tests to gold. 2 patients with objective and subjective oral/perioral and general symptoms are described as case reports. Their symptoms disappeared when gold restorations were removed. We conclude that there is an overrepresentation of gold allergies among those with dental restorations containing gold.
Textile dye allergic contact dermatitis prevalence
Authors: Hatch Kathryn L. , Maibach Howard I.
Published: March 2003

This article summarizes textile dye prevalence studies and makes recommendations for advancing knowledge about textile‐dye sensitization. Prevalence data is provided by study and by dye. Dermatology teams are encouraged to conduct textile‐dye prevalence studies in countries other than Italy, include dyes for which the least prevalence data has been collected, to standardize method of application and reading, and to verify purity and identity of dyes used for patch testing. Testing with pure dyes and other chemicals in dye formulations should provide insights in choosing dye systems that will decrease sensitization.
Effect of dark test‐substance pigmentation on skin perfusion assessments and effect of test technique on balsam of Peru patch‐test results
Authors: Bjarnason Bolli , Flosadóttir Ellen , Fischer Torkel
Published: March 2003

13 balsam of Peru (Myroxylon Pereirae) patch‐test‐positive subjects are re‐tested with 25% balsam of Peru in petrolatum and with serial doses printed on polyester squares. All substances are applied with tape strips for 3, 6, 24 (1 day [D]), 48 (2D), 72 (3D) and 96 h (4D) on each subject and for 96 h (4D) with plastic foils. Tests are followed visually and with perfusion assessments from 3 h to 9 days. Results show that pigment remnants following detachment of patches affect perfusion assessments. Such effect due to pigment is supported by readings of patch tests through the petrolatum test substance while applied with transparent foils. For most reactions, good agreement is observed between the assessment techniques when peak assessment values of reactions are compared. There is inter‐individual variation in perfusion with identical tests. With the petrolatum test substance, increased visible reactivity was observed when the application time was extended up to 24 h (1D), while extension of application time increased perfusion in most cases except for an extension from 24 (2D) to 48 h (4D) where decreased perfusion resulted in most cases. Dose and application time did not affect the timing of highest reactivity of reactions in most cases.
Survey of patch testing in Scotland
Authors: Bong J. L. , Fleming C. J. , Forsyth A.
Published: March 2003

We have surveyed Scottish dermatologists to establish the extent of patch testing, to assess the reasons for referral and to document resources and methods used by dermatologists. 104 questionnaires were sent to members of the Scottish Dermatological Society. 82 questionnaires (79%) were returned. 50% of respondents were consultants, 27% were trainees and 23% held staff grade or clinical assistant positions. The mean waiting time for a patch test appointment was 4.5 months. The most frequent reasons for patch testing were localized eczema, eczema not responding to conventional treatment, occupational eczema, history of contact sensitivity and eczema of uncertain cause. 17 of 82 respondents (21%) were the principal clinicians supervising patch testing in their hospitals. 11 of 17 read reactions at 2 and 4 days. Mean time spent on advising patients was 13 min per patients. 7 of 17 were dissatisfied with resources available for patient education and 16 of 17 felt they would benefit from a central source for patient information. Only 4 of 17 centres recorded patch test results on a database and 3 centres regularly reviewed their patch test results. In conclusion, we have identified areas of patch testing that require further improvement.