Tooth-surface distribution of caries in Greek schoolchildren, using ICDAS-II index. A national pathfinder survey.

AIM: The objective of this cross-sectional nationwide study was to assess the caries status of Greek children, in regard to the severity and the distribution pattern of the lesions in the primary and permanent dentition at a tooth-surface level, based on ICDAS-II criteria. METHODS: Study Design: A national survey was conducted in 15 urban and 9 rural sites and about 50 subjects were examined at each location across the country. Caries data, based on ICDAS-II index, were recorded on 4,410 children aged 5, 12, and 15-years by 10 calibrated dentists. The rankings of the most affected tooth-surfaces, the most vulnerable teeth found cavitated, the right-left symmetry of caries stages and its pattern of distribution shown per jaw or dentition were determined by using descriptive statistics (SPSS v.20). CONCLUSION: Caries lesions were quite frequent in this school aged child population and the most common code of ICDAS-II observed was that of incipient enamel caries, mainly on the occlusal surfaces, indicative of the need for fissure sealant application. For those surfaces with ICDAS-II=3-6, dental care and intensive prevention programmes, both at home and office based, are needed.

Caries prevalence of 11.5 year-olds between 1989 and 2001 in a province of North-Eastern Greece.

OBJECTIVE & DESIGN: To compare cross-sectional caries prevalence data of 11.5 year old children over a 13 year period (1989-2001) and to evaluate the maximum effect of the applied preventive programme (sealants to 1st molars and 6-year health education) on DMFT values during the last five years. PARTICIPANTS: Using the records of a Public Health Centre (PHC) in NE Greece, a number (153-250) of children aged 11.5-years were selected from each calendar year, constituting 11 study groups (totalling 2,217 children), stratified by area of residency. METHOD: Annual oral health education sessions provided in 1990, a year after the PHC was established. Light-cured fissure sealants were systematically mass introduced in 1996. The same dentist completed all DMFT records in the dental clinic during the children's routine visits. DMFT was analysed using two Poisson and two Binomial models for both data from all years, and for the last five years. The models had as factors: "Time" (year of examination of the study group), "Residency" (semi urban, rural lowland, rural highland), number of "Sealed 1st molars" and "Sealed posterior teeth". RESULTS: All the factors were highly statistically significant (p<0.001). Dental health was found to be good (DMFT=0), improving progressively year by year (range 12-50%). The mean DMFT decreased steadily from 4.5 (in 1989) to 1.81 (in 2001). The Significant Caries index was almost halved (from 8.08 to 4.23). CONCLUSION: An important improvement in the caries status of 11.5 year-olds since 1989 has been demonstrated, irrespective of the residency. The systematic application of fissure sealants to all 1st molars, parallel to the cumulative effect of the 6-year health education programme per child, played a significant role in reducing disparities in disease prevalence, despite the difficulty of improving rates of decline when the caries levels are relatively low.

Transient oral microflora in Greeks attending day centres for the elderly and residents in homes for the elderly.

OBJECTIVE: To examine the isolation frequency and the carriage of yeasts, Enterobacteriaceae, Staphylococcus and Enterococcus species in oral samples from elderly Greeks living alone or in institutions. BACKGROUND: Ageing may promote changes in the oral ecosystem, which lead to colonisation of the mouth by microbes found less commonly or only transiently in younger subjects. Previous studies indicate a geographical variation in the isolation frequency of such bacteria in elderly populations. MATERIALS AND METHODS: Medical and dental records were obtained from 66 attenders at elderly people's day centres (EPDC), and 82 residents of elderly people's homes (EPH), 66-95 years old. Mucosa smear samples were cultured on appropriate media for enumeration of the above species. Microbial identification was performed by conventional microbiological tests. The results were analysed using the Multiple Correspondence Analysis (MCA), ANOVA and other traditional statistical tests. RESULTS: No statistically significant association was found between the place of residence and the wearing of dentures. The isolation frequencies of Staphylococcus aureus, Enterococcus and Enterobacteriaceae species were 21.6, 20.3 and 7.4% respectively. MCA, and further statistical analysis, revealed that the place of residence affected the isolation frequency of years (54.9% in EPH vs. 37.9% in EPDC). Moreover, ANOVA showed that living in EPH increased the carriage of yeasts. CONCLUSIONS: Elderly Greeks exhibit a moderate to high oral carriage of transient bacteria compared with other elderly populations. Living in EPH seems to increase both the isolation frequency and carriage of yeasts.

Caries prevalence in 6-, 11- and 14-year-old children in the Cyclades Islands, Greece.

Following the World Health Organization criteria, a total of 1,604 out of 3,225 children aged 6, 11 and 14 years living on the 20 islands of the Cyclades complex were examined. Recordings showed that in the 6-year-old children, the mean dmft index was 2.21 (SD=3.00) with 46% caries free. In the 11-year-old children, the DMFT averaged 1.39 (SD=1.78) with 46% caries free. In the 14-year-old children, the mean DMFT was 2.62 (SD=2.83) with 32% caries free. Statistically significant differences were found in the DMFT of the 11- and 14-year-old subjects living in naturally water fluoridated and non-fluoridated areas. According to these data, it appears that the first two WHO targets for the year 2000 are almost fulfilled.

Cariogenicity of isomaltulose (palatinose), sucrose and mixture of these sugars in rats infected with Streptococcus mutans E-49.

Each of three groups of Wistar rats, 19-20 animals per group, was fed an experimental diet containing either (1) isomaltulose 56%, (2) sucrose 56%, or (3) a mixture of isomaltulose and sucrose (17.5% + 38.5%). The animals were infected with Streptococcus mutans E-49 and one half of the animals was kept on the diet for 8 weeks and the other half for 14 weeks. Only sulcal caries was found in the isomaltulose animals after 8 weeks and 14 weeks. the group fed sucrose had high numbers of carious bucco-lingual, proximal and sulcal surfaces. The group fed the mixture of sucrose and isomaltulose had fewer lesions than the sucrose group on bucco-lingual surfaces after the 8 week experiment (P less than 0.01) and fewer bucco-lingual and proximal surfaces (P less than 0.01) after the 14 week experiment.

Palatinose--a sucrose substitute. Pilot studies.

Pilot studies on isomaltulose, (Palatinose), a sucrose substitute, including acid production in plaques, acid production in suspensions of dental plaque material or of Streptococcus mutans were performed, as well as studies on the effect of isomaltulose on glucan synthesis, by Strep. mutans. Also an experimental caries study in the rat was carried out in a few animals. The results indicated that isomaltulose is only slowly fermented in the oral cavity and that glucan formation from isomaltulose, if any, is very small. Sulcal caries only was found in rats challenged with isomaltulose. Since the animals developed very well on the isomaltulose diet and did not have stomach disorders, isomaltulose is considered to be of great interest as a sucrose-like, low-cariogenic and nontoxic sucrose substitute.

Effects of xylitol on the acid production activity from sorbitol by Streptococcus mutans and human dental plaque.

-A method for the determination of acid production from 20-25 mg (wet weight) of Streptococcus mutans and 12-33 mg (wet weight) of human dental plaque is described. After endogenous acid production had been followed, either sorbitol or xylitol or a mixture of sorbitol and xylitol (2:1) was added. After about ten minutes glucose, sucrose or Palatinose were added for a vitality test. Addition of xylitol to the bacterial suspension caused inhibition of acid production from sorbitol by Streptococcus mutans grown on sorbitol or a mixture of sorbitol and glucose. It was also observed that it had a similar effect on acid production from sorbitol in suspensions of dental plaque with few exceptions. On the other hand, Streptococcus mutans cells grown on glucose, sucrose and xylitol media, produced no or insignificant amounts of acid from sorbitol. Streptococcus mutans cells grown on media containing glucose, sucrose, sorbitol and a mixture of sorbitol and glucose generally formed a large amount of acid from glucose and sucrose after the addition of sorbitol and xylitol. However, Streptococcus mutans cells grown on a medium containing xylitol and the mixture of sorbitol and xylitol formed less acid from glucose. The acid production activity from sorbitol in suspensions of dental plaque after the xylitol addition was somewhat lower than the acid production from sorbitol alone (p less than 0.02).