Gingivitis, Psychological Factors and Quality of Life in Children.

PURPOSE: To evaluate the associations between gingivitis, emotional status and quality of life in children. MATERIALS AND METHODS: Sixty-four Brazilian students (11 to 12 years old) were examined for clinical and self-reported gingivitis. The participants were divided into two groups: those with gingivitis (n = 21) and controls (n = 43). Quality of life, anxiety and depression were measured using self-administered questionnaires. Saliva was collected 30 min after waking and at bedtime to measure the diurnal decline in salivary cortisol. The results were analysed using bivariate and multivariate analyses. RESULTS: There were significantly more female participants in the control group. Approximately 90% of the children with gingivitis had good oral hygiene and 10.5% had satisfactory oral hygiene. There was a significant positive correlation between anxiety and depression in both clinical groups. Anxiety was negatively correlated with quality of life in the control group. Depression was negatively correlated with quality of life and cortisol concentrations in the group with gingivitis, and with quality of life in the control group. Children with gingivitis were more likely to be older and males. CONCLUSIONS: Older children are more likely to experience gingival bleeding. The presence of gingivitis in children may be associated with worse psychological well-being, possibly compromising the quality of life.

Orthodontics and enamel demineralization: clinical study of risk factors.

UNLABELLED: The appearance of white spots on the vestibular surface of teeth fitted with brackets has been described as one of the potential iatrogenic effects of orthodontic treatment. These enamel demineralizations, more commonly known as "white spot lesions" (WSL), lead in some rare cases to the creation of true cavities, causing both esthetic and functional problems. The aim of our retrospective clinical study was to evaluate the incidence of the appearance of these WSL in a Moroccan orthodontic population and to determine possible associations with a number of risk factors. PATIENTS AND METHODS: The study was based on intraoral photographs of a pool of 69 patients who underwent orthodontic treatment with or without extractions in the DFO unit of the Rabat CCDT (Center for dental consultation and treatment). Patients with prostheses or WSL before the beginning of the study were excluded. Digital start- and end-of-treatment photos for each patient were compared by a single operator looking for the appearance of WSL on the vestibular surfaces of the incisors, canines, premolars and first molars. WSL were classed according to three degrees of severity: slight, severe and cavitation. Data were processed using SPSS 13.0 software. RESULTS: The results of the study showed that the prevalence of WSL in the sample was 66.7%, with a highly significant predominance of localization in the premolar/molar segment and in patients with poor oral hygiene. CONCLUSION: Poor oral and dental hygiene was identified as the most important risk factor for the development of white spots during multibracket orthodontic treatment.

The effect of oral care on intracranial pressure in critically ill adults.

A major goal in the care of patients with neurological problems is to prevent or minimize episodes of increased intracranial pressure (ICP). Elevations in ICP in response to nursing interventions have been acknowledged since the 1960s when ICP monitoring was first introduced in the clinical setting. Until recently, few studies have specifically examined the effect of oral care on ICP, and oral care and other hygiene measures were combined or not specified, prohibiting a direct interpretation of the influence of oral care alone on ICP. The purpose of this study was to describe the relationship between routine oral care interventions and the changes in ICP specifically focusing on the effect of intensity and duration of this intervention. Twenty-three patients with a clinical condition requiring ICP monitoring were enrolled over a 12-month period. Oral care provided by neuroscience intensive care nurses was observed and videotaped. Characteristics of the intervention were documented including products used, patient positioning, and duration of the intervention. A 1-5 subjective scale was used to score intensity of oral care. Wrist actigraphy data were collected from the nurses to provide an objective measure of intensity. Patient physiologic data were collected at 12-second epochs 5 minutes before, during, and 5 minutes after oral care. The mixed-effect repeated measures analysis of variance model indicated that there was a statistically significant increase in ICP in response to oral care (p = .0031). There was, however, no clinically significant effect on ICP. This study provides evidence that oral care is safe to perform in patients in the absence of preexisting elevated ICP.

Factors relating to usage patterns of amalgam and resin composite for posterior restorations--a prospective analysis.

OBJECTIVES: This study prospectively analyzed the use of amalgam and resin composite posterior restorations placed by general dentists in relation to dentist, patient and cavity factors. METHODS: One thousand posterior restorations placed by a representative sample of general dentists working in the Ministry of Health (MOH), Kuwait, during routine clinical practice were included. Information about the restorations was recorded using a survey questionnaire. Descriptive statistics and multivariate logistic regression analysis were used to determine the factors associated with the use of amalgam versus tooth coloured restoratives. RESULTS: Dentists chose amalgam for 30.8% of the 1000 restorations. Dentists with longer work experience (>15 years) were more likely to choose amalgam (OR=2.61, 95% CI=1.06, 6.40). Younger dentists (≤30 years) were less likely to choose amalgam (OR=0. 45, 95% CI=0.26, 0.77). Amalgam was more likely to be chosen for patients with poor oral hygiene (OR=1.58, 95% CI=1.08, 2.32) and a higher number (≥4) of restorations (OR=1.44, 95% CI=1.07, 1.94) with large cavity sizes (OR=6.33, 95% CI=3.88, 10.32). Tooth-coloured restorations were more likely to be chosen for cavities of smaller sizes. CONCLUSIONS: The use of resin composite materials as the dominant choice among dentists in Kuwait reflects the trend worldwide. Nevertheless, clinicians still find a use for amalgam in posterior load-bearing teeth and in the high-caries risk population. CLINICAL SIGNIFICANCE: The findings give insight into factors influencing material usage under different clinical conditions and provides information about the perceived deficiencies or shortcomings of resin composite materials in a general dental practice setting. This information can be useful for identifying perceived barriers to the usage of newer restorative materials and finding ways to overcome them.

Effect of academic stress on plaque and gingival health among dental students of Moradabad, India.

OBJECTIVE: Stress has an adverse effect on oral health and is a risk factor for plaque-associated diseases. The present study aims to assess the effect of academic stress on plaque and gingival health among dental students of Moradabad, India. METHODS: Fifty eligible dental students (age 18 - 22 years) undergoing university examinations participated in the study. Students were examined for plaque index (PII) and gingival index (GI) scores during and after their examinations. Stress levels (using the DASS 21 questionnaire) and oral hygiene behavior were also assessed during and after university examinations and the data were subjected to statistical analysis. RESULTS: The average PII and GI were 1.213 and 0.944, respectively, during examinations and 0.845 and 0.467, respectively, after examinations. The average stress scores were 15.66 and 9.94 during and after examinations, respectively. Eighty-eight percent of the students brushed once and 12% of the students brushed twice during the university examinations, whereas 76% brushed once and 24% of the students brushed twice after their examinations. Thirty-four percent of the subjects rated their thoroughness of brushing as good during university examinations whereas the percentage increased to 80% after the examinations. All the differences were found to be statistically significant. CONCLUSION: Students appearing for the university examinations showed increased stress levels. Moreover, under conditions of stress, the students generally neglected their oral health care and adverse effects on their plaque and gingival scores were observed. Thus, it might be concluded that academic stress has an adverse effect on plaque levels and gingival status in students.

Oral hygiene in children with Down's syndrome.

The clinical examination comprised 62 children with Down's syndrome: 12 children had low grade mental retardation, 36 children--moderate grade mental retardation and 14 children--high grade mental retardation. The study showed that oral hygiene was unsatisfactory and was found to be dependent upon the grade of mental retardation. Most children had birth weight over 2,500 g. Besides, also birth length was found to be dependent upon the grade of mental retardation. In most families the child with Down's syndrome was the last baby born among other healthy siblings. Educational career in children with Down's syndrome was found to be dependent upon the grade of mental retardation.