A 4-week randomized controlled trial evaluating plaque and gingivitis effects of an electric toothbrush in a paediatric population.

BACKGROUND: Few extended studies have explored oscillating-rotating (O-R) toothbrush efficacy in young children. AIM: To compare the efficacy between O-R and manual toothbrushes in reducing plaque and gingivitis after 4 weeks in children. DESIGN: This was a randomized, parallel-group, examiner-blind, clinical trial. In two 50-subject cohorts (3-6 years, primary dentition, parental brushing; 7-10 years, mixed dentition, self-brushing), subjects used Oral-B Kids O-R toothbrush per manufacturer's instructions or Paro Junior manual toothbrush in a customary manner. Plaque and Modified Gingival Index (MGI; primary variable) scores were assessed at baseline and Week 4 for all subjects and within each age group. RESULTS: Both toothbrushes significantly reduced whole mouth and posterior plaque and MGI versus baseline (p < .001). Combined groups: O-R showed greater plaque and MGI reductions versus manual for all measures (p ≤ .003). Three- to 6-year-olds: O-R demonstrated significantly (p < .032) greater whole-mouth (55.7%) and posterior (34.3%) plaque reductions at Week 4 versus manual. Seven- to 10-year-olds: O-R showed significantly (p < .001) greater whole-mouth (94.5%) and posterior (108.4%) plaque reductions and greater (p ≤ .016) whole-mouth (14.1%) and posterior (18.8%) MGI reductions versus manual. There were no adverse events. CONCLUSION: The O-R toothbrush, used per manufacturer's instructions, reduced plaque and gingivitis better than a manual toothbrush used in a customary manner among children.

Caries prevalence and water fluoridation in Israel: a cross-sectionalstudy.

OBJECTIVES: To assess the effect of Community Water Fluoridation (CWF) in the prevalence of dental caries and dental fluorosis in 12-year-old children living in Israel. Considering that CWF is important in the prevention of dental caries. Between 2002 and 2014, the water in communities of at least 5000 individuals was fluoridated. In 2014 CWF in Israel stopped. METHODS: Data on 12-year-old children from all areas in Israel from the national crosssectional epidemiological survey conducted in 2011-2012 were stratified by city water fluoridation and by city and school socio-economic status (SES). Two dependent variables were defined: (1) DMFT index -caries experience in the permanent dentition; (2) dental fluorosis in central incisors using the Thylstrup-Fejerskov (TF) classification of fluorosis. RESULTS: Data from 2181, 12-year-olds was analyzed. the average DMFT was 1.17+1.72 and 49% were caries free. Based on DMFT, the caries experience was significantly higher in nonfluoridated cities (1.38 vs. 0.98 in fluoridated cities) and there were more caries free children 56.4% in fluoridated cities vs. 40.6% in non-fluoridated. DMFT was higher in cities with lower SES than high SES (1.29 vs. 1.05 respectively, p<0.001) and there were less caries free children in low SES (44.5% vs. 53% in high SES cities, p<0.0001). Almost all the 10.3% of children with signs of fluorosis (scoring at least 1 in TF index), had questionable to mild fluorosis (9.3%). CONCLUSIONS: CWF is a cheap, simple method of dental health protection that reaches all socio-economic levels and cessation of water fluoridation reduced the health of Israel's children. CLINICAL SIGNIFICANCE: Water fluoridation provides substantial caries prevention, by reaching a substantial number of people. The relevance of this work is for policymakers to consider CWF as clinically proven method for reducing health inequalities.

Establishment of "Smiles": an innovative inclusive program for the promotion of oral health among preschool children.

OBJECTIVES: To describe the planning stage and the first year of "Smiles," an innovative, inclusive oral health promotion program among preschool children, ages 3 to 5, encompassing the enhancement of daily toothbrushing skills, engagement of teaching staff and parents, and integration of a supportive environment of supervised toothbrushing in kindergartens. METHOD AND MATERIALS: The major components of the first year of the program included workshops with the teaching staff, working sessions with the preschool children, and workshops with the parents. Program participation, program cooperation, program satisfaction, and kindergarten teachers, kindergarten parents, and dental hygienists' attitudes towards this component of the program were recorded and evaluated. Minor components of the first year of the program included assimilation and integration of daily supervised toothbrushing in some of the kindergartens. Program participation, kindergarten teachers, kindergarten teachers' assistants, and kindergarten parents' attitudes towards this component of the program were recorded and evaluated. RESULTS: In total, 180 kindergartens, in nine locations across Israel, including 5,311 preschool children, their parents, and teaching staff, took part in the first year of the program. High levels of participation (80% and above), cooperation (9.55 to 9.78) and satisfaction (9.62 to 9.81) were recorded in the first year of the program. Kindergarten teachers, parents, and dental hygienists expressed high levels of support for continuing the program beyond its first year (9.86 to 10.00). Regarding the daily supervised toothbrushing model in the kindergartens, high levels of satisfaction (9.50 to 9.75) and willingness to continue the program (9.50-10.00) were recorded among kindergarten teachers, assistants, and parents. CONCLUSION: The "Smiles" program serves as an example of successful collaboration between many partners and stakeholders from different organizations, sectors, and government ministries, local authorities, kindergarten management and staff, parents, and the most important partners, the preschool children. Its adherence to the basic principles of health promotion, and its professional adjustment to early childhood with positive atmosphere of happiness, joy, and shared warmth, contributed to the success of the program.

Randomized clinical trial assessing anti-gingivitis efficacy of two stannous fluoride dentifrices and zinc/arginine dentifrice.

PURPOSE: To evaluate the anti-gingivitis efficacy of two bioavailable stannous fluoride (SnF2) dentifrices versus a zinc/arginine dentifrice and a negative control dentifrice, and to compare the plaque control benefits. METHODS: This was a single-center, randomized, controlled, four-treatment, parallel-group, double-blind, 3-month clinical trial. Healthy adult subjects with gingivitis were randomly assigned to one of four different dentifrice treatment groups: SnF2 dentifrice A, SnF2 (1,100 ppm F) + sodium fluoride (350 ppm F) + sodium hexametaphosphate (Procter & Gamble); SnF2 dentifrice B, SnF2 (1,100 ppm F) + sodium fluoride (350 ppm F) + citrate (Procter & Gamble); Zn/Arg dentifrice, zinc/arginine + sodium fluoride (1,450 ppm F) (Colgate-Palmolive); negative control dentifrice, sodium monofluoro-phosphate (1,000 ppm F) + sodium fluoride (450 ppm F) (Colgate-Palmolive). Subjects brushed with their assigned treatment dentifrice and an assigned manual toothbrush (Oral-B Indicator) for 1 minute, twice daily, for the duration of the study. Gingivitis was assessed at Baseline and at Weeks 2, 4 and 12 by calculating the total number of gingival bleeding sites using the Gingival Bleeding Index, and plaque was assessed at Baseline and at Week 12 using the Turesky Modified Quigley-Hein Index. A repeated measures model was carried out across Weeks 2, 4, and 12 to determine bleeding efficacy (total number of bleeding sites). An ANCOVA with baseline plaque as the covariate was used to evaluate plaque efficacy at Week 12. RESULTS: 161 subjects were randomized (mean age= 38.8 years). 154 subjects completed the study and 153 had evaluable data at Week 12. The mean (SD) number of Baseline bleeding sites overall was 78.74 (31.16) with no significant difference between groups (P= 0.537). SnF2 dentifrice A significantly reduced the number of bleeding sites relative to the negative control dentifrice at Weeks 2, 4 and 12 by 15.4%, 13.7% and 17.2%, respectively. SnF2 dentifrice B significantly reduced the number of bleeding sites relative to the negative control dentifrice at Week 4 by 13.9% (P= 0.041). Relative to the Zn/Arg dentifrice, SnF2 dentifrice A produced significantly greater reductions in gingival bleeding sites at Weeks 2, 4 and 12 by 23.4%, 17.2% and 20.9%, respectively (P≤ 0.007). SnF2 dentifrice B produced significantly greater bleeding reductions versus the Zn/Arg dentifrice at Weeks 4 and 12 by 17.4% and 14.4%, respectively (P≤ 0.035). The Zn/Arg dentifrice did not differ significantly in the number of bleeding sites (P≥ 0.127) or plaque (P= 0.175) relative to the negative control dentifrice. Both SnF2 dentifrices significantly reduced plaque levels (P≤ 0.029) relative to both negative control dentifrice and Zn/Arg dentifrice at Week 12. All dentifrices were well tolerated. CLINICAL SIGNIFICANCE: Two different SnF2 dentifrices showed significantly reduced gingival bleeding and plaque levels relative to a Zn/arginine dentifrice.

Randomised clinical study of plaque removal efficacy of an electric toothbrush in primary and mixed dentition.

BACKGROUND: Clinical investigations of electric toothbrushes in young children are limited. AIM: To assess plaque reduction efficacy of an oscillating-rotating electric versus manual toothbrush in a paediatric population in primary and mixed dentitions. DESIGN: In this randomised, single-brushing, 2-treatment, 4-period, replicate-use crossover study, subjects were divided into 2 age groups (3-6 years; 7-9 years) and assigned to a treatment sequence involving an Oral-B Kids electric brush and a manual brush control. Plaque was assessed pre- and post-brushing (Turesky Modified Quigley-Hein Plaque Index). Parents brushed the teeth of their children aged 3-6 years, whereas children aged 7-9 years brushed their own teeth under supervision. Plaque removal scores were analysed for brush differences in each age group separately using an analysis of covariance for crossover design. RESULTS: Forty-one children (n = 20, 3-6 years; n = 21, 7-9 years) completed the study. For the primary dentition in children 3-6 years, the electric brush reduced 32.3% more plaque than the manual brush (P = .005). For the mixed dentition in children 7-9 years, the electric brush reduced 51.9% more plaque than the manual brush (P < .001). CONCLUSIONS: An electric toothbrush reduced significantly more plaque than a manual toothbrush in 2 paediatric age groups.

Factors Associated with Dental Plaque, Gingivitis, and Caries in a Pediatric Population: A Records-Based Cross-Sectional Study.

This retrospective, cross-sectional study evaluated dental records of 1000 healthy children to determine factors associated with plaque, gingivitis, and caries. A logistic model for plaque and gingivitis (mild versus moderate/severe) and caries (yes/no) was carried out separately for each variable using the following potential factors: Age, Gender, Brush Type, Starting Age of Brushing, Brushing Frequency, and Bite Type. Data from 998 children (median age: 4 years, 10 months (range: 2.5-7 years)) were analyzed. Sixty-four percent were manual toothbrush users; 36% were oscillating-rotating electric toothbrush users. For plaque and gingivitis, but not caries, Brush Type was more impactful than Brushing Frequency. Age influenced the severity of plaque and gingivitis, with increases in the odds of having moderate/severe plaque or gingivitis associated with increasing age. The probability of caries increased until approximately age 5 and then decreased until age 7. Oscillating-rotating brush users were more likely to present with less plaque, gingivitis, and caries, with 6.0, 5.1, and 1.4 times greater odds of having mild (versus moderate/severe) plaque, less severe gingivitis, and being caries-free, respectively, than manual brush users. Similarly, brushing twice daily and starting brushing at an earlier age were associated with better oral health outcomes. Children with anterior bite abnormalities had increased odds of developing moderate/severe plaque and gingivitis than children with normal anterior bites. Gender was not a statistically significant factor associated with plaque, gingivitis, or caries. Children's oral health is influenced by toothbrush type, starting age of brushing, compliance with twice-daily brushing, and bite abnormalities.

A Randomized Controlled Clinical Trial to Evaluate the Efficacy of an Oscillating-Rotating Electric Toothbrush, a Stannous Fluoride Dentifrice, and Floss on Gingivitis.

OBJECTIVES: To evaluate the gingival health efficacy of an oscillating-rotating electric toothbrush, a stannous fluoride dentifrice, and dental floss in adults with mild-to-moderate gingivitis. METHODS: This was a single-center, randomized, controlled, examiner-blind, two-treatment, eight-week parallel group study in adults with at least 20 gingival bleeding sites. Eligible subjects were randomized equally to one of two groups: experimental oral hygiene group that included an Oral-B® oscillating-rotating electric toothbrush with round brush head (D20/EB20), Crest® stabilized stannous fluoride dentifrice (SnF2 1100 ppm F, NaF 350 ppm F), and Oral-B® Glide® floss; or regular oral hygiene control group that included a regular manual toothbrush (Oral-B® Indicator 35) and Crest® anti-cavity sodium fluoride dentifrice (NaF 1450 ppm F). Subjects followed manufacturer's instructions and used their assigned products over an eight-week period. Gingival health was measured at baseline, Week 4, and Week 8 using three assessments: Gingival Bleeding Index (GBI), number of bleeding sites, and Modified Gingival Index (MGI). Analysis of Covariance was used to compare gingival health between treatment groups. RESULTS: One hundred and twenty subjects, mean age 44 years (range: 21 to 74 years), were assessed at baseline (60 per group); 113 subjects (57 in control group, 56 in experimental group) completed the study with fully evaluable data. At baseline, the groups were balanced; overall means were 0.41 for GBI, 51.7 for bleeding sites, and 1.44 for MGI. Only the experimental group showed statistically significant reductions from baseline (p < 0.0001) for all three gingivitis assessments at both Weeks 4 and 8. At these time points, better gingival health for the experimental group was seen as significantly lower adjusted mean scores versus the control group (p < 0.0001) for all three assessments. Reductions in favor of the experimental group at Weeks 4 and 8, respectively, were 51% and 45% for GBI, 46% and 40% for number of bleeding sites, and 37% and 20% for MGI. The study treatments were well tolerated. CONCLUSIONS: Over an eight-week period, an oral hygiene routine with an oscillating-rotating electric toothbrush, stannous fluoride dentifrice, and floss significantly improved gingivitis compared to regular hygiene with a manual toothbrush and an anti-cavity sodium fluoride dentifrice.

Randomised clinical study of plaque removal efficacy of a power toothbrush in a paediatric population.

BACKGROUND: Clinical investigations of plaque removal efficacy of power toothbrushes in children are limited. AIM: To compare plaque removal of a power versus manual toothbrush in a paediatric population. DESIGN: This was a randomised, replicate-use, single-brushing, examiner-blinded, two-treatment, four-period crossover clinical trial in children 8-11 years of age. Subjects were randomly assigned to a treatment sequence involving an oscillating-rotating power toothbrush and a manual toothbrush control. Subjects brushed under supervision with a NaF dentifrice. Plaque was assessed pre- (baseline) and post-brushing using the Turesky Modification of the Quigley-Hein Plaque Index by two examiners. Plaque scores were averaged for mixed and permanent dentition on a per-subject basis and analysed using a mixed-model ancova for a crossover design. RESULTS: Forty-one subjects (mean 9.0 years) were randomised and completed the trial. Both the power brush and manual brush provided statistically significant mean plaque reductions versus baseline in all analyses (P < 0.001). For both examiners, plaque removal was significantly (P < 0.001) larger for the power brush in permanent and mixed dentitions. The interexaminer correlations for the permanent dentition were strong (ICC = 0.68-0.88) for pre-brushing plaque across all periods. CONCLUSIONS: An oscillating-rotating power toothbrush provided superior plaque reduction versus a manual toothbrush in children.

Oral health status among long-term hospitalized adults: a cross sectional study.

Background. Many Long-Term Care (LTC) institutionalized patients are the most frail and functionally dependent among the geriatric population and have significant oral health disparities.They often suffer from dental neglect due to limited access to appropriate professional dental care. These patients have chronic health situations and are treated with medications, which increase their risk of oral diseases. Despite the growth in elderly population in Israel, there is insufficient data regarding their oral health status and treatment needs. Objective. To describe the oral health status of the LTC hospitalized adults in a geriatric and psychiatric hospital in Israel. Methods. Data was recorded from LTC hospitalized adults with a physical and/or mental disabilities in a cross-sectional research design, which included general health anamnesis and clinical oral examination. Variables included gender, medicines, oral hygiene (OH), using dentures, number of caries lesions and residual teeth. Univariate analyses included Pearson χ (2) and t-test analyses. Multivariate analyses included logistic and linear regressions while the outcome variables were categorical OH index and number of carious cavitations, number of residual teeth and carious teeth percentage. Results. 153 participants were included in the study with a mean age of 65.03 ± 18.67 years. 31.3% of the patients were edentulous, and only 14% had partial or full dentures. Females had a significantly higher number of caries cavitation than males (P = 0.044). The number of caries cavitation was higher among patients with poor OH (P < 0.001) and when taking Clonazepam (P = 0.018). Number of residual teeth was higher in the fair OH group (P < 0.001). Carious teeth percentage was higher among the poor OH group (P < 0.001).

Set7/9 impacts COL2A1 expression through binding and repression of SirT1 histone deacetylation.

Type II collagen is a key cartilaginous extracellular protein required for normal endochondral development and cartilage homeostasis. COL2A1 gene expression is positively regulated by the NAD-dependent protein deacetylase Sirtuin 1 (SirT1), through its ability to bind chromatin regions of the COL2A1 promoter and enhancer. Although SirT1/Sox9 binding on the enhancer site of COL2A1 was previously demonstrated, little is known about its functional role on the gene promoter site. Here, we examined the mechanism by which promoter-associated SirT1 governs COL2A1 expression. Human chondrocytes were encapsulated in three-dimensional (3D) alginate beads where they exhibited upregulated COL2A1 mRNA expression and increased levels of SirT1 occupancy on the promoter and enhancer regions, when compared to monolayer controls. Chromatin immunoprecipitation (ChIP) analyses of 3D cultures showed augmented levels of the DNA-binding transcription factor SP1, and the histone methyltransferase Set7/9, on the COL2A1 promoter site. ChIP reChIP assays revealed that SirT1 and Set7/9 form a protein complex on the COL2A1 promoter region of 3D-cultured chondrocytes, which also demonstrated elevated trimethylated lysine 4 on histone 3 (3MeH3K4), a hallmark of Set7/9 methyltransferase activity. Advanced passaging of chondrocytes yielded a decrease in 3MeH3K4 and Set7/9 levels on the COL2A1 promoter and reduced COL2A1 expression, suggesting that the SirT1/Set7/9 complex is preferentially formed on the COL2A1 promoter and required for gene activation. Interestingly, despite SirT1 occupancy, its deacetylation targets (ie, H3K9/14 and H4K16) were found acetylated on the COL2A1 promoter of 3D-cultured chondrocytes. A possible explanation for this phenotype is the enrichment of the histone acetyltransferases P300 and GCN5 on the COL2A1 promoter of3 D-cultured chondrocytes. Our study indicates that Set7/9 prevents the histone deacetylase activity of SirT1, potentiating euchromatin formation on the promoter site of COL2A1 and resulting in morphology-dependent COL2A1 gene transactivation.

Incidence of cholesterol in periapical biopsies among adolescent and elderly patients.

INTRODUCTION: Cholesterol clefts are common histologic findings in periapical biopsies; they have a reported incidence in periapical periodontitis of up to 44%. Cholesterol crystals are also recognized in advanced atherosclerotic plaques in humans. Male sex, genetic abnormalities, and age have been associated with advanced atherosclerotic lesions. Among these nonmodifiable risk factors, age is the most dominant. The aim of the study was to evaluate if age is also linked to cholesterol deposition in periapical periodontitis. METHODS: The database of biopsy reports obtained between 2006 and 2009 was searched for specimens diagnosed as radicular cysts or periapical granulomas. Only data relating to biopsies obtained from adolescent (13-21 years old) and elderly (over 60 years old) patients were selected. The biopsies were examined by a pathologist under a light microscope (Zeiss, Jena, Germany) at magnifications of 40×-200×. The available material was scanned for the presence of cholesterol clefts and foamy cells in radicular cysts and granulomas. RESULTS: A total of 41 specimens were collected in the adolescent group and 48 specimens in the elderly group over a 4-year period. A higher incidence of cholesterol was found in the elderly group compared with that in the adolescent group (odds ratio = 6.857). CONCLUSIONS: The highly significant incidence of cholesterol deposits in periapical biopsies among elderly patients may be a possible cause for the lack of repair. The mechanism for cholesterol accumulation is probably similar to the process leading to atherosclerosis and coronary artery disease. Statin administration may be advantageous for the treatment of persistent lesions. A clinician should be aware of the risk for persistent lesions after endodontic treatment in elderly patients.

Oxygen deprivation affects the antimicrobial action of LL-37 as determined by microplate real-time kinetic measurements under anaerobic conditions.

Some agents, including Escherichia coli and group A Streptococcus pyogenes cause infections in oxygen depleted sites. LL-37 is a human host defence peptide shown previously to play an important role in controlling infections caused by these bacteria. However, the effect of oxygen levels on the antimicrobial activity of LL-37 remains obscure. In order to test the effect of oxygen (or lack thereof) on LL-37's activity against E. coli and S. pyogenes, a method for adapting commonly used microtiter plates for real-time growth-kinetic (and growth-inhibition) measurements under anaerobic conditions was developed. Using the proposed method, anaerobic conditions were attained in the microplate within 30 min and were maintained for at least five days. Anaerobiosis was further confirmed by comparing the growth of two anaerobic oral species (Porphyromonas gingivalis and Fusobacterium nucleatum) in anaerobic compartments of microtiter plates versus aerobic ones. Both species grew only in the anaerobic compartments of the plates as indicated by the growth curves generated. The sensitivities of E. coli and S. pyogenes to LL-37 were tested under anaerobic conditions and compared to those in aerobic ones. The oxygen facultative E. coli grew to a higher density under aerobic conditions and its sensitivity to LL-37 was increased under anaerobiosis. The microaerophilic pathogen S. pyogenes grew faster and to a higher density under anaerobic conditions and was much more resistant to LL-37 under oxygen deprivation. Our results suggest that resistance to antimicrobial agents of microbes infecting anaerobic-microaerophilic sites should be tested under oxygen-restricted conditions.

Dental hygienists in Israel: employment evaluation, job satisfaction, and training implications.

Fundamental changes have occurred in dental services for children in Israel that are likely to affect workforce needs for dental hygienists. The aim of this study was to describe the employment situation and job satisfaction of a sample of dental hygienists in Israel, to estimate associated variables, and to discuss corresponding possible implications for training programs after these changes. An e-mailed questionnaire sent to all dental hygienists in the Israeli Dental Hygienists Association list included questions about respondents' demographic background, years of experience, working hours, desire to work in an alternative occupation, and sense that they were valued within the dental community. The response rate was 20.7 percent. The responses showed that dental hygienists worked, on average, in 2.11 different working venues, 23.64 hours/week, and 12.34 hours in the private sector. Almost 63 percent of the respondents were willing to add working hours as a dental hygienist, preferably in the private sector. Also, 38.2 percent of the respondents worked in an extra non-dental hygienist job (mean=7.05 hours/week). These dental hygienists reported a high level of job satisfaction. After regression analysis, a high number of working venues, years of experience, and hypothetically choosing again to be a dental hygienist were found to be significant indicators of job satisfaction (R(2)=0.491). It is important that dental hygienists be satisfied and willing to expand their activities. Legislative changes may require reorientation and refocusing of dental hygiene education programs.

The association between demographic and oral health-related quality of life factors and dental care attendance among underprivileged older people.

AIM: In order to identify whether demographic and oral health-related quality of life factors are associated with dental care attendance among an underprivileged older population, a comparison was performed between people who have and have not attended dental care. METHODS: A cross-sectional purposive sample of 344 older underprivileged people comprised the study population. The dependent variable was dental care attendance. The 14-item version of the Oral Health Impact Profile index (OHIP-14) was used as the independent variable, together with other social and general variables, using a structured interview. RESULTS: The variables that were significantly associated with dental care attendance were family status (not married, the highest attendance), dwelling location (living at home, the highest attendance), caregiver (family member, the highest attendance), place of birth (Western countries, the highest attendance) and income (pension, the highest attendance). Sex, welfare support, functional ability, education, age and OHIP-14 were not associated with dental care attendance. CONCLUSIONS: Attending dental care was not associated with oral health-related quality of life measured by OHIP-14. Several socioeconomic variables were strongly associated.

Teeth and implant surroundings: clinical health indices and microbiologic parameters.

OBJECTIVE: Dental implants and peri-implant tissue are susceptible to disease conditions that may lead to implant loss. The objective of the present study was to describe teeth and implant surroundings as well as clinical health indices and oral microbiologic parameters. METHOD AND MATERIALS: A group of 83 adults (42 men and 41 women) were enrolled in the study. Clinical assessments of dental implants and contralateral natural teeth included dental plaque, gingival inflammation, and bleeding on probing. Microbiologic assessments included bacterial culture, light and phase contrast microscopy, and DNA probe hybridization for a panel of 14 target microorganisms. Clinical and microbiologic data were compared by paired t test and ANOVA. P < .05 was considered statistically significant. RESULTS: The Plaque Index for the implants was 1.85 ± 0.47, whereas the score for natural teeth was significantly higher, 2.15 ± 0.52. Compared to the samples obtained from the dental implants, the samples from natural teeth demonstrated significantly higher total bacterial cell numbers (P < .05). Consistent with the clinical measures of dental plaque, significantly higher numbers of oral bacteria, including aerobic and anaerobic bacteria, were found in dental plaque samples from teeth (aerobic 5.648 ± 0.512, anaerobic 6.243 ± 0.535, P < .0001) compared to implants (aerobic 5.430 ± 0.541, anaerobic 5.917 ± 0.523, P < .0001). In addition, there were significantly higher numbers of anaerobic (6.243 ± 0.535 and 5.917 ± 0.523, P < .0001) than aerobic (5.648 ± 0.512 and 5.430 ± 0.541, P < .008) bacteria for samples from teeth and implants, respectively. CONCLUSION: Clinical and microbiologic analyses provide consistent findings that suggest differences in quantity of plaque and bacterial species between teeth and dental implants. For long-term treatment success, the importance of plaque control and oral hygiene of both periodontal and dental implant therapy is emphasized.

Psychological distress and social support are determinants of changing oral health status among an immigrant population from Ethiopia.

OBJECTIVES: To examine associations between psychosocial profile (psychological distress and social support) and changing oral health status (dental caries and periodontal disease), among a group of immigrants from Ethiopia to Israel. METHODS: Three hundred and forty immigrants, aged 18-75 years, with a mean age of 38.4±13.5 years, comprised the study population and were followed over a 5-year period. Dental caries was recorded employing the DMFT index. Periodontal health status was recorded employing the Community Periodontal Index (CPI). Participants were interviewed using a structured written questionnaire which included two validated psychosocial scales, for psychological distress and social support. Bivariate and multivariate analyses were performed. RESULTS: Among subjects with psychological distress, the adjusted mean caries (DMFT) increment in 2004-2005, since baseline (1999-2000), was 3.52±0.19 when compared to 0.35±0.15 among subjects with no psychological distress (P<0.001). Correspondingly, the percentage of people with increased periodontal pockets was 40%, when compared to 7%, respectively (P<0.001). In multiple linear regression analysis employing the DMFT as a continuous variable, and in multiple logistic regression analysis employing the DMFT as a dichotomous variable (% caries versus % caries-free), the four variables that reached statistical significance as predictors of caries status were previous caries experience, psychological distress, social support, and age. Gender, income, and education were not significantly related to current caries prevalence. In a multiple logistic regression analysis, the three variables that reached statistical significance as predictors of periodontal disease (shallow and deep pockets) were previous periodontal disease experience, psychological distress, and age. Social support, gender, income, and education were not significantly associated with periodontal disease prevalence. CONCLUSIONS: This study presents persuasive evidence that supports the role of psychological distress and social support as determinants of changing oral health levels, among a low socioeconomic, relatively homogenous immigrant minority population.

A 6-month study of the effects of 0.3% triclosan/copolymer dentifrice on dental implants.

AIM: Supportive therapy to maintain dental implants is increasingly important. This study examined the effect of a 0.3% triclosan/2% copolymer dentifrice on oral biofilms and gingival inflammation (GI) on dental implants and peri-implant tissues. MATERIALS AND METHODS: One hundred and twenty adults with a dental implant and contra-lateral tooth were enrolled in this 6 month, double-blind, two-treatment, parallel group study. Sixty subjects were randomly assigned to a triclosan/copolymer dentifrice test group and 60 subjects to a fluoride dentifrice control group and instructed to brush twice daily for 6 months. At baseline, 3, and 6 months, a calibrated dentist assessed dental plaque, GI and collected supragingival dental plaque for microbiological analysis. RESULTS: Subjects in the triclosan/copolymer group demonstrated significantly lower levels of dental plaque, gingivitis, and bleeding on probing at 3 and 6 months at both the implant and contra-lateral tooth compared with the fluoride group (p<0.05). There were significantly fewer Gram-negative anaerobes in the triclosan/copolymer group (p<0.05) including >90% reductions in Aggregatibacter actinomycetemcomitans, Campylobacter rectus, Eubacterium saburreum, Fusobacterium nucleatum, Porphyromonas gingivalis, Prevotella melaninogenica, Solobacterium moorei, and Tannerella forsythia. CONCLUSIONS: Twice daily use of a triclosan/copolymer dentifrice may enhance dental implant maintenance by reducing dental plaque and GI.

Dental students' attitudes and behavior toward smoking cessation as part of their professional education.

BACKGROUND: Dental professionals have a major role in promoting tobacco use cessation (TUC). PURPOSE: The objective is to assess dental students' knowledge, attitudes, behavior, and perception regarding their potential expected role. METHODS: Self-administered anonymous questionnaires were used for all students of the Jerusalem Dental Medicine School. RESULTS: Among 275 responding students, 17% reported smoking. Most students reported asking patients about smoking, counseling against smoking, and advising to quit. Only a minority reported providing antismoking educational material, suggesting nicotine replacements, and arranging follow-ups. Most students did not consider a list of suggested potential obstacles (lack of resources, not their role, etc.) as true barriers. Analysis by stage of studies revealed significant differences in reported TUC strategies and positive attitudes and decreases in perceived potential obstacles. CONCLUSIONS: These results indicate specific and practical areas for promoting antismoking intervention. Dental schools need to emphasize their role in preparing the next generation with a clear dedication toward TUC.

Psychological distress and self-perception of oral health status among an immigrant population from Ethiopia.

OBJECTIVES: To examine the association between psychological distress (PD) and perception of oral health status among a group of Ethiopian immigrants compared to the 'gold standard' of clinical diagnosis. DESIGN: Three hundred and forty Ethiopian immigrants, aged 18 years or more, were interviewed using a version of the Self-Reporting Questionnaire (World Health Organization) for the assessment of psychological status and perceived dental and periodontal health status. Clinical data for dental and periodontal health status were used as the 'gold standard' against the self-perceived assessment scores among the PD and no psychological distress (NPD) groups. These were compared for sensitivity and specificity. RESULTS: One hundred and thirty-five subjects (40%) presented PD. Seventy-eight percent of the PD subjects reported a negative dental health status, as compared to 42% of the NPD subjects. Seventy-three percent of the PD subjects reported a negative periodontal health status, as compared to 44% of the NPD subjects (p<0.001). The sensitivity for self-perceived dental health status among the PD subjects was found to be 0.78 and the specificity was found to be 0.40, as compared to 0.59 and 0.69, respectively, among the NPD subjects (p<0.001). The sensitivity for self-perceived periodontal health status among the PD subjects was found to be 0.78 and the specificity was found to be 0.40, as compared to 0.59 and 0.58, respectively, among the NPD subjects (p<0.001). CONCLUSION: Results demonstrate that PD may modify self-perception of health status. Self-perceived health and disease should be an integral element in the continuum of professional clinical health assessment and subsequent health care planning. The relevance of PD is evident in this immigrant ethnic group and should be considered and further studied in other at-risk minority communities.