Current Issue : April - June Volume : 2013 Issue Number : 2 Articles : 6 Articles
Background: There are scarce evidences that evaluated the impact of periodontal disease on oral health-related\r\nquality of life (OHRQoL) taking marginal gingival alterations into consideration. Thus, this study aimed to verify the\r\nassociation between OHRQoL and gingival enlargement and gingival bleeding in subjects under fixed orthodontic\r\ntreatment (FOT).\r\nMethods: 330 participants under FOT for at least 6 months were examined by a single, calibrated examiner for\r\nperiodontal variables and dental aesthetic index. Socio-economic background, body mass index, time with\r\northodontic appliances, and use of dental floss were assessed by oral interviews. OHRQoL was evaluated using the\r\noral health impact profile (OHIP-14) questionnaire. The assessment of associations used unadjusted and adjusted\r\nPoisson regression models.\r\nResults: Higher impacts on the OHIP-14 overall were observed in subjects who presented higher levels of anterior\r\ngingival enlargement (RR 2.83; 95% CI 2.60-3.09), were non-whites (RR 1.29; 95% CI 1.15-1.45), had household\r\nincome lower than five national minimum wages (RR 1.85; 95% CI 1.30-2.61), presented body mass index > 25\r\n(RR 1.14; 95% CI 1.01-1.29), and showed a dental aesthetic index > 30 (RR 1.32; 95% CI 1.20-1.46).\r\nConclusions: Anterior gingival enlargement seems to influence the OHRQoL in subjects receiving orthodontic\r\ntreatment....
Background: Occlusal surfaces of erupting and newly erupted permanent molars are particularly susceptible to\r\ncaries.\r\nThe objective of the study was to assess and compare the effect of a single application of 38% SDF with ART\r\nsealants and no treatment in preventing dentinal (D3) caries lesions on occlusal surfaces of permanent first molars\r\nof school children who participated in a daily school-based toothbrushing program with fluoride toothpaste.\r\nMethods: The prospective community clinical trial in the Philippines was conducted over a period of 18 months\r\nand included 704 six- to eight-year-old school children in eight public elementary schools with a daily school-based\r\nfluoride toothpaste brushing program. Children were randomly assigned for SDF application or ART sealant\r\ntreatment. Children from two of the eight schools did not receive SDF or ART sealant treatment and served as\r\ncontrols. SDF or ART sealant treatment was applied on sound occlusal surfaces of permanent first molars. Surfaces\r\nthat were originally defined as sound at baseline but which changed to dentinal (D3) caries lesions were defined as\r\nsurfaces with new caries (caries increment). Non-compliance to the daily toothbrushing program in three schools\r\noffered the opportunity to analyze the caries preventive effect of SDF and sealants separately in fluoride toothpaste\r\nbrushing and in non-toothbrushing children.\r\nResults: In the brushing group, caries increment in the SDF treatment group was comparable with the\r\nnon-treatment group but caries increment in the sealant group was lower than in the non-treatment group with a\r\nstatistically significant lower hazard ratio of 0.12 (0.02-0.61). In the non-brushing group, caries increment in the SDF\r\ntreatment group and the sealant group was lower than the non-treatment group but the hazard ratio was only\r\nstatistically significant for the sealant group (HR 0.33; 0.20-0.54). Caries increment was lower in toothbrushing\r\nchildren than in non-toothbrushing children. Hazard ratios reached statistical significance for the non-treated\r\nchildren (HR 0.43; 0.21-0.87) and the sealant-treated children (HR 0.15; 0.03-0.072).\r\nConclusions: A one-time application of 38% SDF on the occlusal surfaces of permanent first molars of six- to\r\neight-year-old children is not an effective method to prevent dentinal (D3) caries lesions. ART sealants significantly\r\nreduced the onset of caries over a period of 18 months...
Background: Over 90% of adults aged 20 years or older with permanent teeth have suffered from dental caries\r\nleading to pain, infection, or even tooth loss. Although caries prevalence has decreased over the past decade, there\r\nare still about 23% of dentate adults who have untreated carious lesions in the US. Dental caries is a complex\r\ndisorder affected by both individual susceptibility and environmental factors. Approximately 35-55% of caries\r\nphenotypic variation in the permanent dentition is attributable to genes, though few specific caries genes have\r\nbeen identified. Therefore, we conducted the first genome-wide association study (GWAS) to identify genes\r\naffecting susceptibility to caries in adults.\r\nMethods: Five independent cohorts were included in this study, totaling more than 7000 participants. For each\r\nparticipant, dental caries was assessed and genetic markers (single nucleotide polymorphisms, SNPs) were\r\ngenotyped or imputed across the entire genome. Due to the heterogeneity among the five cohorts regarding age,\r\ngenotyping platform, quality of dental caries assessment, and study design, we first conducted genome-wide\r\nassociation (GWA) analyses on each of the five independent cohorts separately. We then performed three\r\nmeta-analyses to combine results for: (i) the comparatively younger, Appalachian cohorts (N = 1483) with\r\nwell-assessed caries phenotype, (ii) the comparatively older, non-Appalachian cohorts (N = 5960) with inferior caries\r\nphenotypes, and (iii) all five cohorts (N = 7443). Top ranking genetic loci within and across meta-analyses were\r\nscrutinized for biologically plausible roles on caries.\r\nResults: Different sets of genes were nominated across the three meta-analyses, especially between the younger\r\nand older age cohorts. In general, we identified several suggestive loci (P-value = 10E-05) within or near genes with\r\nplausible biological roles for dental caries, including RPS6KA2 and PTK2B, involved in p38-depenedent MAPK\r\nsignaling, and RHOU and FZD1, involved in the Wnt signaling cascade. Both of these pathways have been\r\nimplicated in dental caries. ADMTS3 and ISL1 are involved in tooth development, and TLR2 is involved in immune\r\nresponse to oral pathogens.\r\nConclusions: As the first GWAS for dental caries in adults, this study nominated several novel caries genes for\r\nfuture study, which may lead to better understanding of cariogenesis, and ultimately, to improved disease\r\npredictions, prevention, and/or treatment...
Background: Oral cancer is increasing in incidence in the UK and indeed worldwide. Delay in diagnosis is\r\ncommon; up to half of patients are diagnosed with advanced lesions. Thus it is essential to develop methods to aid\r\nearly detection. This study aimed to assess dental patientsââ?¬â?¢ experiences and awareness of oral cancer and screening\r\nwithin general dental practice.\r\nMethods: A cross-sectional questionnaire survey of 184 English-speaking adults, with no previous history of oral\r\ncancer was conducted. The questionnaire collected data on participantââ?¬â?¢s knowledge of oral cancer, experience of\r\nââ?¬Ë?screeningââ?¬â?¢, attitudes and feelings towards having a screening, anticipated help-seeking behaviours, health-related\r\nbehaviours (particularly risk factors) and sociodemographics.\r\nResults: Twenty percent of respondents had never heard of oral cancer; 77% knew little or nothing about it and\r\n72% did not know that their Dentist routinely screens for oral cancer. Overall, attitudes to screening were positive.\r\nNinety two percent of respondents would like their Dentist to tell them if they were being screened for signs of\r\noral cancer and 97% would like help from their Dentists to reduce their risk.\r\nConclusion: Patients seem generally unaware of oral cancer screening by their dentist but are happy to take part\r\nin screening, would like to be informed, and welcome the support of their Dentist to reduce their risk of\r\ndeveloping oral cancer....
Background: Dental caries remains a significant public health problem, prevalence being linked to social and\r\neconomic deprivation. Occlusal surfaces of first permanent molars are the most susceptible site in the developing\r\npermanent dentition. Cochrane reviews have shown pit and fissure sealants (PFS) and fluoride varnish (FV) to be\r\neffective over no intervention in preventing caries. However, the comparative cost and effectiveness of these\r\ntreatments is uncertain. The primary aim of the trial described in this protocol is to compare the clinical\r\neffectiveness of PFS and FV in preventing dental caries in first permanent molars in 6-7 year-olds. Secondary aims\r\ninclude: establishing the costs and the relative cost-effectiveness of PFS and FV delivered in a community/school\r\nsetting; examining the impact of PFS and FV on children and their parents/carers in terms of quality of life/\r\ntreatment acceptability measures; and examining the implementation of treatment in a community setting.\r\nMethods/design: The trial design comprises a randomised, assessor-blinded, two-arm, parallel group trial in 6ââ?¬â??7\r\nyear old schoolchildren. Clinical procedures and assessments will be performed at 66 primary schools, in deprived\r\nareas in South Wales. Treatments will be delivered via a mobile dental clinic. In total, 920 children will be recruited\r\n(460 per trial arm). At baseline and annually for 36 months dental caries will be recorded using the International\r\nCaries Detection and Assessment System (ICDAS) by trained and calibrated dentists. PFS and FV will be applied by\r\ntrained dental hygienists. The FV will be applied at baseline, 6, 12, 18, 24 and 30 months. The PFS will be applied at\r\nbaseline and re-examined at 6, 12, 18, 24, and 30 months, and will be re-applied if the existing sealant has become\r\ndetached/is insufficient. The economic analysis will estimate the costs of providing the PFS versus FV. The process\r\nevaluation will assess implementation and acceptability through acceptability scales, a schools questionnaire and\r\ninterviews with children, parents, dentists, dental nurses and school staff. The primary outcome measure will be the\r\nproportion of children developing new caries on any one of up to four treated first permanent molars.\r\n(Continued on next page) Discussion: The objectives of this study have been identified by the National Institute for Health Research as one\r\nof importance to the National Health Service in the UK. The results of this trial will provide guidance on which of\r\nthese technologies should be adopted for the prevention of dental decay in the most susceptible tooth-surface in\r\nthe most at risk children....
Background: Oral health education (OHE) in schools has largely been imparted by dental professionals.\r\nConsidering the substantial cost of this expert-led approach, the strategies relying on teachers, peer-leaders and\r\nlearners themselves have also been utilized. However the evidence for comparative effectiveness of these strategies\r\nis lacking in the dental literature. The present study was conducted to compare the effectiveness of dentist-led,\r\nteacher-led, peer-led and self-learning strategies of oral health education.\r\nMethods: A two-year cluster randomized controlled trial following a parallel design was conducted. It involved five\r\ngroups of adolescents aged 10-11 years at the start of the study. The trial involved process as well as four outcome\r\nevaluations. The present paper discusses the findings of the study pertaining to the baseline and final outcome\r\nevaluation, both comprising of a self-administered questionnaire, a structured interview and clinical oral\r\nexamination. The data were analyzed using Generalized Estimating Equations.\r\nResults: All the three educator-led strategies of OHE had statistically higher mean oral health knowledge (OHK),\r\noral health behavior (OHB), oral hygiene status (OHS) and combined knowledge, behavior and oral hygiene status\r\n(KBS) scores than the self-learning and control groups (p<0.001). The mean OHK, OHS and KBS scores of the three\r\neducator-led strategies did not differ significantly. The peer-led strategy was, however, found to have a significantly\r\nbetter OHB score than the respective score of the teacher-led strategy (p<0.05). The self-learning group had\r\nsignificantly higher OHB score than the control group (p<0.05) but the OHK, OHS and KBS scores of the two groups\r\nwere not significantly different.\r\nConclusions: The dentist-led, teacher-led and peer-led strategies of oral health education are equally effective in\r\nimproving the oral health knowledge and oral hygiene status of adolescents. The peer-led strategy, however, is\r\nalmost as effective as the dentist-led strategy and comparatively more effective than the teacher-led and\r\nself-learning strategies in improving their oral health behavior....
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