Fluoride Intake and Salivary Fluoride Retention after Using High-Fluoride Toothpaste Followed by Post-Brushing Water Rinsing and Conventional (1400-1450 ppm) Fluoride Toothpastes Used without Rinsing.

This study aimed to compare the fluoride intake and salivary fluoride levels after brushing with conventional (1400-1450 ppm) fluoride toothpaste containing different fluoride agents: amine fluoride (AmF), sodium fluoride (NaF), sodium monofluorophosphate (SMFP), potassium fluoride (KF), and a high-fluoride (5000 ppm) toothpaste containing NaF. Fourteen volunteers took part in the study. They were instructed to brush and spit without rinsing after using conventional toothpaste or brush and rinse with water after using a high-fluoride toothpaste. Fluoride concentrations were determined using ion-selective fluoride (09-37 type) in the saliva samples before and after procedures. Fluoride intake was estimated based on fluoride recovered after brushing. Additionally, the amount of fluoride present in the oral fluids and lost during the rapid clearance phase after toothbrushing was calculated based on salivary fluoride levels and saliva flow immediately after brushing. Salivary fluoride after using high-fluoride toothpaste was significantly higher than those observed after conventional products. Two hours after brushing, salivary fluoride concentrations did not differ significantly from baseline values (p > 0.05) unless a high-fluoride product was used. Results indicate that by refraining from rinsing after brushing with conventional toothpaste, we cannot obtain fluoride retention in saliva as with high-fluoride toothpaste. Fluoride ingestion was higher after using a high-fluoride product.

Oral Care Recommendation for Cystic Fibrosis Patients-Recommendation for Dentists.

Cystic fibrosis (CF) is a genetic disease that is caused by a defect in the gene coding for the transmembrane cystic fibrosis transmembrane conductance regulator (CFTR). Research papers published so far point out that despite the numerous dental treatment needs of CF patients, there are no oral care guidelines for this group of patients. The aim of the article is to propose standards of dental prophylactic and therapeutic procedures for CF patients in different age groups. Regardless of the CF patient's age, dental check-ups should be scheduled at least every 6 months. However, taking into account the actual condition of the individual CF patients, therapeutic visits may be scheduled for earlier dates, to provide well-fitting treatment, considering the level of risk of oral diseases. The described management standards may be helpful and may improve the quality of dental care provided to CF patients.

Factors Affecting Dental Caries Experience in 12-Year-Olds, Based on Data from Two Polish Provinces.

(1) Background: Dental caries is a chronic disease that affects a child's dentition from the first stages of life. Several factors contribute to the development of the disease, including an improper diet. This cross-sectional study aimed to identify risk factors of dental caries in 12-year-old adolescents from Greater Poland and Lubusz Provinces (Poland). (2) Material and methods: The research was conducted in adolescents from five primary schools. A questionnaire consisted of close-ended questions on socioeconomic characteristics on family, diet, and oral hygiene habits. An assessment of the dentition was carried out in accordance with World Health Organization (WHO) recommendations. In addition to cavitated carious lesions, incipient caries lesions were noted according to the International Caries Detection and Assessment System, adapted for epidemiological studies (ICDASepiDMFt). (3) Results: The mean number of teeth with untreated caries; removed due to caries; and restored because of caries (DMFt) was 1.52 ± 1.90, while the ICDASepiDMFt index amounted to 2.64 ± 2.55, respectively. Children who did not brush every day had significantly higher odds of having ICDASepiDMFt > 0 than children brushing at least once daily (OR = 10.32, 95% CI = 1.36−78.32, p = 0.0240). Adolescents who drank sweet carbonated drinks every day had significantly higher ICDASepiDMTt than children who drank sweet carbonated drinks less frequently (p = 0.0477). (4) Conclusions: The research revealed that dental caries indices of 12-year-old adolescents from Greater Poland and Lubusz Provinces depend mainly on oral hygiene behaviors. The only significant nutritional factor that differentiated the caries intensity was the daily consumption of sweet carbonated drinks.

Clinical Consequences of Dental Caries, Parents' Perception of Child's Oral Health and Attitudes towards Dental Visits in a Population of 7-Year-Old Children.

This cross-sectional study aimed to assess the occurrence of the consequences of dental caries and factors affecting dental service utilization in a population of 7-year-old children. The research included oral examination of 7-year-old schoolchildren and socio-medical study of their parents/legal caregivers. It was carried out in five primary schools of two provinces, i.e., Greater Poland and Lubusz. Dental examination was performed in accordance with World Health Organization (WHO) recommendations. The socio-medical study consisted of questionnaires with close-ended questions concerning socioeconomic characteristics of the family, reasons and time of the last visit at the dental office, consequences of child's oral health problems, parents' attitude towards dental visits, and parental opinion about their child's teeth. Factors affecting utilization of dental services were statistically analyzed using univariate logistic regression assuming p < 0.05. The pufa index of examined children ranged from 0 to 7 (mean 0.80 ± 1.49), while the dmf index ranged from 0 to 14 (3.86 ± 3.32). Low financial burden of oral health expenditures and university education of at least one of the parents significantly increased the chance of visiting a dentist despite lack of pain (OR = 3.0 and 2.5, respectively). In spite of the availability of free dental care for children, socioeconomic factors still determine the utilization of dental services in Poland. Poor oral health status of examined population and negligence of regular dental check-ups emphasize a need to strengthen oral health literacy of parents and children, promoting proper attitudes towards dental care.

Prediction of Early Childhood Caries Based on Single Nucleotide Polymorphisms Using Neural Networks.

BACKGROUND: Several genes and single nucleotide polymorphisms (SNPs) have been associated with early childhood caries. However, they are highly age- and population-dependent and the majority of existing caries prediction models are based on environmental and behavioral factors only and are scarce in infants. METHODS: We examined 6 novel and previously analyzed 22 SNPs in the cohort of 95 Polish children (48 caries, 47 caries-free) aged 2-3 years. All polymorphisms were genotyped from DNA extracted from oral epithelium samples. We used Fisher's exact test, receiver operator characteristic (ROC) curve and uni-/multi-variable logistic regression to test the association of SNPs with the disease, followed by the neural network (NN) analysis. RESULTS: The logistic regression (LogReg) model showed 90% sensitivity and 96% specificity, overall accuracy of 93% (p < 0.0001), and the area under the curve (AUC) was 0.970 (95% CI: 0.912-0.994; p < 0.0001). We found 90.9-98.4% and 73.6-87.2% prediction accuracy in the test and validation predictions, respectively. The strongest predictors were: AMELX_rs17878486 and TUFT1_rs2337360 (in both LogReg and NN), MMP16_rs1042937 (in NN) and ENAM_rs12640848 (in LogReg). CONCLUSIONS: Neural network prediction model might be a substantial tool for screening/early preventive treatment of patients at high risk of caries development in the early childhood. The knowledge of potential risk status could allow early targeted training in oral hygiene and modifications of eating habits.

Diagnosis of Papillon-Lefèvre syndrome: review of the literature and a case report.

Papillon-Lefëvre syndrome (PLS), classified as ectodermal dysplasia, is an autosomal recessive condition related to the cathepsin C (CTSC) gene mutation. The first clinical symptoms, occurring most commonly between the ages of 1 and 4, are palmoplantar hyperkeratosis and also periodontitis resulting in the loss of most or all teeth in the same sequence in which they erupted. Most often the redness of palms and soles precede the occurrence of keratoderma. Moreover, excessive sweating, moderate mental retardation, the tendency to purulent skin and internal organs infection may occur. Lack of cathepsin seems to have a crucial role in the intensity of symptoms. In most of the patients, there can be observed impairment of phagocytosis and chemotaxis of neutrophils, granulocytes, leukocytes and cytotoxic lesion of fibroblasts and macrophages. Also, functional impairment of lymphocytes, neutrophils, and monocytes is observed. The study, using flow cytometry, showed a decreased percentage of T cells CD8+ and increased CD4:CD8 ratio.

Factors causing oral and skin pathological features in the hyperimmunoglobulin E syndrome patient including the environmental component: a review of the literature and own experience.

The hyperimmunoglobulin E syndrome (HIES) is a rare multi-system disease with non-immunological as well as immunological abnormalities. The syndrome is characterized by a triad of the most distinctive symptoms, such as pneumonia with pneumatocele formation, recurring staphylococcal skin abscesses and a high serum concentration of IgE. Central mediators of immune responses such as STAT1 and STAT3 affect immune responses and contribute to changes of the skin microbiome which subsequently can amplify the defective immune response against microbial and fungal pathogens. Reactions related to an environmental factor, such as sun-induced skin changes, in individuals during long-term medication therapy have also been reported. The dermatological symptoms, oral status and other health problems of a hyperimmunoglobulin E syndrome paediatric patient are presented. HIES is of great importance to different professionals because sufferers require special preventive and therapeutic management from early infancy in order to avoid complications which can even prove to be life-saving for such patients.

Limited Mandibular Movements as a Consequence of Unilateral or Asymmetrical Temporomandibular Joint Involvement in Juvenile Idiopathic Arthritis Patients.

This study aimed to assess the asymmetry of the lower face and motor dysfunction of the masticatory system resulting from unilateral or asymmetrical bilateral temporomandibular joint (TMJ) involvement in juvenile idiopathic arthritis (JIA) patients. The study consisted of clinical examination and cone beam computed tomography (CBCT) of TMJs. Statistical analysis showed correlations between several factors: facial asymmetry and mandibular lateral deviation; the direction of mandibular deviation and the degree of radiological deformities in TMJs; the child's age at the time of the onset and the range of lateral movement towards the healthy or less destructed joint. In addition, there was a significant difference in ranges of lateral movements; a significantly smaller range was observed for the joint with fewer condylar abnormalities compared to the range in the opposite direction. In JIA children, among the clinical markers of unilateral or asymmetrical TMJ involvement, the asymmetry of the lower face, deviation of the mandible on opening, and an uneven range of mandibular lateral movements deserve attention. The obtained results do not show a relationship between the degree of condylar changes and the asymmetry of the lower face and the presence and degree of mandibular motor dysfunction.

Periodontal condition and periodontal risk assessment in adult patients with cystic fibrosis.

INTRODUCTION: The presence of chronic inflammation in the mouth, such as infectious disease of the periodontal tissues, may be the reservoir of microorganisms that are not usually present, including Pseudomonas aeruginosa. OBJECTIVE: The purpose of the study was to create a profile of periodontal conditions and periodontal risk assessment in adult patients with cystic fibrosis. MATERIAL AND METHODS: The study involved 22 patients with cystic fibrosis (CF) aged 29.43 years. The following parameters were included in the clinical study: number and cause of permanent teeth loss (excluding third molars), the presence of plaque (PCR), bleeding on probing (BOP), probing pocket depth (PPD), clinical attachment level (CAL). On the basis of obtained clinical data, the periodontal status and the periodontal risk were determined. RESULTS: The study showed healthy periodontal tissues in 9 people (41%), gingivitis in 5 (23%), and mild periodontitis in 8 (36.36%). The periodontal risk in the vast majority of patients (90.91%) was at a low level - only 2 people, on average. CONCLUSIONS: The poor oral hygiene in CF patients indicates the need to develop standards of dental care for this group aimed at education and elimination of risk factors for oral diseases. The obtained results of clinical trials do not rule out the likelihood of auto-infections of the respiratory system originating from periodontal tissues, which, in CF patients, may adversely affect the general state of health and conducted therapy.

A Study of Enamel Defects and Dental Caries of Permanent Dentition in School Children with Intellectual Disability.

Data concerning the prevalence of developmental enamel defects and their association with dental caries in individuals with intellectual disability are scarce. This paper aims to evaluate the prevalence and distribution of developmental enamel defects and dental caries in the permanent dentition of special-care school children from Poznan (Poland). Out of 1091 students attending all special-care schools in the city, the study covered 268 subjects with intellectual disability (mild, moderate, severe, and profound) with permanent dentition, aged 10-20. One calibrated dentist performed dental examinations. The Statistica Software v10 was used for statistical analysis, assuming the level of statistical significance p ≤ 0.05. Among the subjects of the study, 19.40% presented developmental enamel defects. The number of teeth with changes ranged from 1 to 28, with maxillary incisors most frequently affected. Students without developmental enamel defects had more teeth observed with active caries compared to those with such changes (10.92% vs. 7.82%, p < 0.01). The highest number of students with developmental defects of enamel was observed in the group of individuals with mild intellectual disabilities. The present study revealed that in special-care students from Poznan, enamel defects and dental caries were frequently observed. However, individuals with developmental enamel defects did not show higher dental caries indices.

Dental Health Status and Oral Health Care in Nursery School-Aged Children and their Parents Living in Poznan (Poland).

OBJECTIVES: The aim of this study was to evaluate the dental health status of nursery age children and parents. The use of dental services was assessed. SUBJECTS AND METHODS: The study was performed in nursery schools located in Poznan, Western Poland. Clinical examination was carried out in 157 children (48.41% males and 51.59% females), aged 10-42 months. Dental health status (the number of teeth with caries, fillings and extracted) of their parents was determined on the basis of data obtained from a questionnaire. The questions also concerned information on child's and parents' dental check-ups and opinion on their predisposition to dental caries. RESULTS: Clinical examination revealed that 21.05% of boys and 18.51% of girls had dental caries. Most mothers had from 1 to 5 either carious and/or filled teeth (47.13%) or extracted teeth due to carious process (61.15%); the fathers' values were similar at 46.50 and 66.24%, respectively. More mothers (84.71%) than fathers (72.62%) had regular dental check-ups (p = 0.02). The analysis of mother-father-child triads showed that when both parents visited the dentist regularly, more children were free of caries (56.68%) in comparison to those with the disease (13.38%; p < 0.001). CONCLUSIONS: This study showed that the dental health status, as well as oral care of nursery school children and their parents, is unsatisfactory. Therefore, there is a need to introduce an intensive dental educational program focusing on dental prophylaxis for nursery age children and their parents or caregivers.

Salivary Biomarkers and Oral Microbial Load in Relation to the Dental Status of Adults with Cystic Fibrosis.

The mutation of cystic fibrosis transmembrane conductance regulator (CFTR) can modify the physical and chemical properties of saliva, which in turn can affect the oral microflora and oral health in patients with cystic fibrosis (CF). The aim of the study was to examine oral health status, salivary properties, and total oral bacteria count in CF adults. Dental status was assessed using the decayed missing filled surfaces (DMF-S) index, and oral clearness using the approximal plaque index (API). The Saliva-Check BUFFER test was used to assess saliva, and real-time polymerase chain reaction (PCR) test to determine the total oral bacteria count. CF patients in comparison to healthy controls showed a higher level of examined clinical indices, higher total oral bacteria count, lower salivary flow rate, lower salivary pH, and increased viscosity. Conclusions: In CF patients, saliva properties, accompanied by insufficient dental care, might be an essential dental caries risk factor. In CF patients, among the etiological factors for dental caries, the bacterial agent seems to be less significant. The frequent and long-term infectious pharmacotherapy can probably explain that. A great deal of the information collected on the oral environment in CF patients, which has helped us understand the etiological conditions for inflammation and infection in this area of the body, indicates that proper dental care can mostly counteract these pathologies.

Periodontal Status and Subgingival Biofilms in Cystic Fibrosis Adults.

The aim of this study was to assess the periodontal status of cystic fibrosis (CF) adult patients and to evaluate whether there is a correlation between the bacterial population of the subgingival biofilm and the health status of the periodontal tissues in this group of adults. The study involved 22 cystic fibrosis adult patients. The periodontal condition was assessed using Plaque Index (PLI), Gingival Index (GI), and Probing Pocket Depth (PPD). The gingival sulcus samples were analyzed by the Real-Time PCR assay (RT-PCR). Majority of patients showed moderate or severe bacterial dental plaque accumulation, but none of them had clinical symptoms of periodontal diseases. RT-PCR showed the presence of periopathogens in 50% of patients. Red complex microorganisms were detected in 9.09%, orange complex in 27.27%, and green complex in 31.82% of the samples analyzed. In cystic fibrosis patients colonized by periopathogens, the periodontal markers were significantly higher in comparison to not colonized by periopathogens patients. Despite the widespread presence of bacterial dental deposits in the cystic fibrosis adult patients examined, none of them has clinical symptoms of periodontal disease; however, the presence of periodontal pathogens in subgingival biofilm may represent a possible risk factor of this disease in the future. An unsatisfactory level of oral hygiene in any patient with cystic fibrosis indicates a need to focus on standards of dental care for such patients.The aim of this study was to assess the periodontal status of cystic fibrosis (CF) adult patients and to evaluate whether there is a correlation between the bacterial population of the subgingival biofilm and the health status of the periodontal tissues in this group of adults. The study involved 22 cystic fibrosis adult patients. The periodontal condition was assessed using Plaque Index (PLI), Gingival Index (GI), and Probing Pocket Depth (PPD). The gingival sulcus samples were analyzed by the Real-Time PCR assay (RT-PCR). Majority of patients showed moderate or severe bacterial dental plaque accumulation, but none of them had clinical symptoms of periodontal diseases. RT-PCR showed the presence of periopathogens in 50% of patients. Red complex microorganisms were detected in 9.09%, orange complex in 27.27%, and green complex in 31.82% of the samples analyzed. In cystic fibrosis patients colonized by periopathogens, the periodontal markers were significantly higher in comparison to not colonized by periopathogens patients. Despite the widespread presence of bacterial dental deposits in the cystic fibrosis adult patients examined, none of them has clinical symptoms of periodontal disease; however, the presence of periodontal pathogens in subgingival biofilm may represent a possible risk factor of this disease in the future. An unsatisfactory level of oral hygiene in any patient with cystic fibrosis indicates a need to focus on standards of dental care for such patients.

Self-Evaluation of Anxiety in Dental Students.

AIM: The aim of the study was to analyze anxiety in female and male dental students related to their first procedure performed on a pediatric patient as part of their study curriculum. MATERIALS AND METHODS: The study was carried out in eighty-four 3rd year dental students (75.00% females and 25.00% males), aged 22-28 years. The participation in the research was anonymous and voluntary. The study was performed during clinical classes in pediatric dentistry where the students were supposed to perform simple prophylactic or therapeutic procedures on pediatric patients. To assess anxiety, a State-Trait Anxiety Inventory was used prepared by Spielberger et al. based on the American STAI questionnaire of 1970 that is composed of two-parts scales: the X-1 scale to assess anxiety as a state and the X-2 scale to assess anxiety as a trait. For statistical analysis, the Wilcoxon signed-rank test, Pearson's chi-squared test, and Mann-Whitney test as well as Statistica 10 programme were used. RESULTS: The results obtained from the first and second part of the questionnaire concerning anxiety as a state and as a trait showed high level of anxiety as a state in 51.19% of the students and as a trait in 32.14% and low level in 19.05% and 41.67%, respectively. The obtained results showed minimal and maximal values to be 24 and 71, respectively, for the STAI-1 scale (mean = 40.55), and 24 and 57, respectively, for the STAI-2 scale (mean = 41.75). CONCLUSIONS: The results show that the anxiety level during clinical classes is relatively high in the studied population of students. Preparing the students to cope with stress resulting from treating the patients seems to be of importance. Such programmes should be implemented before the start of practical clinical classes. The acquired knowledge will be useful in further professional career.

Dental and periodontal manifestations in patients with cystic fibrosis - A systematic review.

BACKGROUND: The oral cavity is an important reservoir of microorganisms and can be a potential source of infection of the respiratory tract in CF patients. The literature on the oral health does not explicitly determine dental problems in these patients. The aim of the study was to systematically review the studies relating to oral status in CF patients. METHODS: A systematic review of papers published from 1997 to 2018 regarding oral status in CF children and adults, carried out in accordance with the Cochrane Collaboration guidelines. RESULTS: The search resulted in 143 studies. Thirteen publications were included in the systematic review.

Early Childhood Caries Among a Population of Nursery-school Children from an Area with Suboptimal Fluoride Levels in Drinking Water.

PURPOSE: To evaluate caries among nursery-school children. MATERIALS AND METHODS: Clinical examination was carried out in 1123 children (568 girls and 555 boys), aged 6-47 months, who attended 33 nursery schools located in a large city (Poznan, Poland). The research was done by experienced dentists in accordance with the criteria set by the World Health Organization for epidemiological studies. The obtained data determined the frequency of caries and the number and surfaces of teeth with carious lesions. In Poznan, drinking water is not artificially fluoridated. RESULTS: The prevalence of caries in the general population was 7.21%. The mean number of teeth affected by caries in the whole population was 0.26 (0.24 for girls and 0.28 for boys), whereas the mean number of tooth surfaces affected by caries was 0.37 (0.32 and 0.41, respectively). In the maxilla, most of the carious lesions were located in the incisors; in contrast, in the mandible, they were in the molars. Only 3 of the examined children had prior fillings. CONCLUSIONS: Currently, preventive and curative dental care for nursery-school-age children is unsatisfactory. The results obtained indicate the need for monitoring the oral health of young children.

Enamel defects and dental caries among children attending primary schools in Poznan, Poland.

BACKGROUND: Both positive and negative associations between developmental enamel defects (DED) and dental caries have been reported in the literature. OBJECTIVES: The aim of this study was to assess the prevalence of DED of permanent dentition and its association with dental caries in schoolchildren living in Poznan (Wielkopolskie Voivodeship, Poland). MATERIAL AND METHODS: A total of 2,522 6th grade children and 3,112 1st grade children were examined. Developmental enamel defects were described using the modified Developmental Defects of Enamel Index. Dental caries experience was assessed in accordance with the number of decayed, missing and filled teeth (DMFT). RESULTS: The study revealed 475 children (9.6%) to have at least 1 enamel defect of permanent dentition. In 6th-graders, statistical analysis confirmed significant differences between DMFT, DT (decayed teeth) and FT (filled teeth) numbers of various DED groups with subjects affected by diffuse opacities having generally the lowest caries indices and subjects with enamel hypoplasia and/or demarcated opacities having the highest caries indices. In both age groups, dental caries prevalence was statistically significantly higher in subjects with hypoplasia and/or demarcated opacities as compared to subjects without DED or with diffuse opacities (p < 0.05). CONCLUSIONS: The prevalence of DED in the examined population was low and comparable to those reported in regions without fluoridated water. The study confirmed that children affected by diffuse enamel opacities were less susceptible to dental caries, while demarcated opacities and hypoplasia should be considered important dental caries risk factors.

The relationship between oral hygiene level and gingivitis in children.

BACKGROUND: The condition of the teeth, periodontium and oral mucosa determines directly and indirectly the general health of the organism and, therefore, requires to be monitored. Childhood, especially the first years of life, is the time when proper health-promoting behaviors are formed, allowing the future prevention of such diseases as dental decay and gingivitis. Studies concerning the gingival status and bleeding in children are scarce, although such knowledge can be useful in planning preventive programs. OBJECTIVES: The aim of the study was to determine the relationship between oral hygiene level and the likelihood of gingival bleeding. MATERIAL AND METHODS: The examined group comprised 2,856 children aged 7 years, living in an urban area in western Poland. The hygiene status was evaluated according to the simplified Debris Index (DI-S) criteria and the periodontal status was evaluated according to the Community Periodontal Index (CPI) criteria. Logistic regression analysis was used to determine the predictors of gingival bleeding. RESULTS: The average value of DI-S was 0.91; it was not significantly different between girls and boys. In more than a half of the studied subjects (59.10%), oral hygiene was fair, in 12.46% - poor. Clinically healthy periodontium was observed in 91.32% of cases, bleeding on probing was present in 7.46% of cases. Calculus was detected in 1.22% of the children. Logistic regression analysis of the predictors of gingival bleeding showed that children with fair and poor oral hygiene were respectively 6 and 25 times more likely to show bleeding on probing compared to the children with very good oral hygiene. CONCLUSIONS: In the studied group, it was noted that there is a need to promote oral hygiene, as it contributes to the fall in gingivitis prevalence among school children.

Child sexual abuse as an etiological factor of overweight and eating disorders - considerations for primary health care providers.

Despite the recognition of the clinical importance of child sexual abuse, primary health care providers are often not ad-equately prepared to perform medical evaluations and diagnose child sexual maltreatment. Paper presents basic symptoms and signs of CSA, which may suggest the need for further patient's diagnosis and referral. Since the great majority of sexually abused children do not have any abnormal physical findings, special attention is paid to the silent warning signs of CSA, such as changes in attitude towards own body and eating habits. Numerous studies suggest that victims of CSA may develop obesity or eating disorders of various forms and intensities.