Are alcohol containing mouthwashes safe?

Alcohol (ethanol) is a constituent of many proprietary mouthwashes. Some studies have shown that regular use of such mouthwashes can increase the risk of developing oral cancer. Recently, the evidence has been reviewed by two separate authors. The conclusions from these reviews are conflicting. In this paper, we reconsider the epidemiological evidence linking alcohol containing mouthwashes with an increased risk of oral cancer. The evidence is considered in term of sample size, strength of association, confounding variables and data collection. In addition, clinical studies comparing alcohol versus non-alcohol mouthwashes are evaluated. The evidence suggests that the alcohol component of mouthwashes affords little additional benefit to the other active ingredients in terms of plaque and gingivitis control. In view of this outcome and the hypothetical risk of oral cancer, it would seem prudent that members of the dental team advise their patients accordingly.

Brain alterations in crested versus non-crested breeds of domestic ducks (Anas platyrhynchos f.d.).

A comparison of brain size and brain composition was made between two uncrested duck breeds and Crested Ducks (CR) and between CR individuals that do possess crests and those that do not have the crest. Domestic ducks of the breed CR have allometrically larger brains than uncrested duck breeds. The crest inserts on a cushion of fat and connective tissue that is partly nourished by brain vessels via small holes in the skull. Through these holes, fat tissue may invade the brain cavity. Because the fat accumulations are sometimes hidden deep between the telencephalon, tectum, and cerebellum, they may be invisible macroscopically and, thus, give the impression of a large brain. The size of the crest, however, is not strictly correlated with fat accumulations in the brain, because 2 among 10 specimens of CR showed no fat body at all, and the investigation of 10 uncrested CR (ducks from the same genetic stock, but without the crests) also revealed fat accumulations in 6 specimens. After subtraction of the volume of the fat body, the brain volume of CR (crested and uncrested) was of equal size to that of "Hochbrutflugenten" and Pommeranian ducks, as was the volumes of most brain structures measured. Significantly smaller in CR were the olfactory bulbs, the prepiriform area, and the cerebellum, which was always situated in close proximity to the fat body in CR.

Visual perception and stimulus orientation in cattle.

The pupil in the eye of adult cattle is oval under contraction with the long axis nearly horizontal. Based on simple optophysical facts it is hypothesised that visual perception in such eyes is different for stimuli with vertically-separated details rather than stimuli with horizontally-separated details. This hypothesis was tested with three adult dairy bulls using an operant conditioning technique. The bulls had to discriminate a solid white line from broken white lines with decreasing interspaces. They solved this task better when the stimuli were presented vertically rather than horizontally. This result is discussed in terms of visual acuity and related to the topographical anatomy of the eye, particularly the pupil.

Cost-effectiveness study of a school-based sealant program.

A nonprofit private dental clinic provides free dental treatment for children up to the age of eighteen years. In order to expand its services to reach more children, a school-based sealant program using dental auxiliary personnel was organized. This paper evaluated the performance of the school-based program during 1991 by comparing the costs of the school-based program with the costs of the sealants placed in the clinic in twelve months. Costs were calculated based on 1991 expenditures, and effectiveness rates were estimated from dental literature on sealants. The cost of saving one tooth-surface from decaying within a six-year period at the school and the clinic was $65 and $42 with an average sealing time per tooth surface of 18 and 12.5 minutes, respectively. Despite the relatively lower cost of personnel, the school program cost was 35 percent higher than at the clinic. Nevertheless, if hidden costs, such as transportation, time off work, and waiting time for those attending the clinic were considered, costs could be comparable or even higher for the clinic. The main goal of this paper is to explore a methodology to compare programs of different nature, and critically evaluate the results.

Dental caries and fluorosis prevalence study in a nonfluoridated Brazilian community: trend analysis and toothpaste association.

The main purpose of this study is to compare data from previous surveys to current prevalence rates of dental caries and dental fluorosis in eleven- and twelve-year-olds in a non-fluoridated Brazilian community (< 0.2 ppm F). This study also assesses the possible association between use of fluoride toothpaste and the prevalence of dental caries and dental fluorosis. The sample subjects are randomly selected schoolchildren who were examined with a dental probe and buccal mirror under natural light. The intra-examiner error was calculated, using Kappa statistics (K tau 0.85). The results showed that between 1991 and 1997 there was a 56.7 percent decrease in the prevalence of dental caries and an 80.1 percent increase in dental fluorosis. Children with dental fluorosis were 1.75 times more likely to be free of caries (OR = 1.75-CI:0.43, 6.68). Children who started using fluoride toothpaste before the age of three were 4.43 times more likely to have dental fluorosis than those who started using it after the age of three (OR = 4.43-CI:0.51, 99.61). The results of the cross-sectional surveys conducted with schoolchildren in 1991, 1995, and 1997 suggest a continuing decrease in the prevalence of dental caries and an increase in the prevalence of dental fluorosis in this nonfluoridated Brazilian town.

The facilitating role of mobile dental van programs in promoting professional dental education.

The main goal of the University of Texas Health Science Center (UTHSCSA) dental van programs is to provide training in delivering care to diverse segments of the population. The UTHSCSA is the Academic Health Center for all of South Texas, a region with 25% of the State's population and 60% Hispanic. About 60% of the region's counties are federally designated dental health personnel shortage areas. Interdepartmental efforts with the participation of dental hygiene, community dentistry, oral diagnosis, periodontics and general practice carried out two programs during the 1994-95 academic year. At the Saint Philip of Jesus Clinic, a charity clinic, and at the Willows Development Center for Severely and Profoundly Mentally Retarded, the dental van was used to provide preventive and restorative care. A questionnaire to measure the value of the programs indicated that students perceived them as important educational activities which increased their confidence in treating persons in the community, especially persons with disabilities. Program output was quantitatively assessed. An average of 8 preventive procedures, 7 fillings, 2 sealants and 1 extraction or referral were provided each working day. Eighty patients were seen at the Saint Philip Clinic (2.5 visits per patient) and 130 patients were seen at the Willows Development Center. Overall, 80 students and 6 faculty participated in providing screening, treatment and referral services. Dental van programs promote access to dental care and increase the visibility of dental schools within the university and community. Current tendencies to halt new program initiatives and phase out existing programs due to shifting financial priorities should be carefully considered in view of the 1995 Institute of Medicine (IOM) report on the future of dental education.

Clinical evaluation of a polyacid-modified resin used as a fissure sealant: 48-month results.

PURPOSE: To evaluate the incidence of occlusal caries and the rates of retention using Variglass VLC (polyacid-modified resin) as an occlusal sealant. MATERIALS AND METHODS: The sample consisted of 185 school children (6-8 yr-old), with sound unsealed permanent first molars. Sealants were applied on the upper and lower first molars from a randomly chosen hemiarch (N=370 teeth). The follow-up was conducted at 6, 12 and 48 months examining 343 (93%), 290 (78%) and 187 (51%) teeth, respectively. RESULTS: After 48 months, total retention of the material was noted in only 5% of the teeth. The presence of sealant in 2/3 and 1/3 of the pit extension was verified in 8% and 14% of the teeth, respectively, while 73% of the sealed teeth had no sealant present on the occlusal surface. Caries incidence, measured by the presence of dental caries and restorations, was 16% representing an annual increase of 4%.

Retention and caries prevention of Vitremer and Ketac-bond used as occlusal sealants.

PURPOSE: To assess the retention and caries incidence of Vitremer (resin-modified glass ionomer) and Ketac-bond (conventional glass ionomer cement), used as occlusal sealants, after 6 and 12 months placement. MATERIALS AND METHODS: The sample consisted of 200 school children, 6-8 years old with sound and unsealed permanent first molars. They were divided into three groups: (a) control group (n = 432 teeth); (b) Vitremer experimental group (n = 200 teeth), and (c) Ketac-Bond experimental group (n = 200 teeth). In the experimental groups, Vitremer was applied on teeth 16 and 46 whereas Ketac-Bond was applied on 26 and 36. RESULTS: The total retention rates for Vitremer after 6 and 12 months were 59% and 36%, respectively. For Ketac-Bond, the total retention rates were 24% and 15%, respectively. No dental caries was recorded during the 12 months for both experimental groups. When effectiveness was measured by sealant retention, there was a significant difference between Vitremer and Ketac-Bond after 6 (P < 0.01) and 12 months (P < 0.05). When effectiveness was measured by caries prevention, no significant difference was found between experimental groups, even when the sealants were partially or totally lost. There was no development of carious lesions after 1-year placement of sealants, but there was a significant difference between experimental and control groups (P < 0.01).

Prophylactic antibiotic therapy prior to dental treatment for patients with end-stage renal disease.

In the United States, there is a large and growing population of patients undergoing dialysis because of end-stage renal disease (ESRD). These patients present special management considerations for dentists, including antibiotic prophylaxis for the prevention of bacterial endocarditis (BE). ESRD patients, particularly those with an arteriovenous shunt for hemodialysis access, are predisposed to valvular endocarditis. Thus, BE prevention is the primary goal of antibiotic prophylaxis prior to dental or other invasive procedures in these patients. Bacteremia may predispose to infection of synthetic vascular access grafts, although this form of endovascular infection in ESRD patients has not been as well-characterized as BE. Antibiotic prophylaxis may be of some benefit for prevention of synthetic graft infections as well as BE. Poor dentist and physician compliance with BE prophylaxis regimens, as well as errors in dosing, timing, or duration of prophylaxis, have been reported. These problems are of particular concern in the treatment of chronically ill patients. In this article, we review the rationale for prophylactic antibiotic therapy prior to dental procedures in ESRD patients with vascular access. We also elaborate on the current American Heart Association guidelines for BE prophylaxis, and address special considerations for ESRD patients.