Evaluation of enzyme-linked immunosorbent assay for the determination of polycyclic aromatic hydrocarbons in house dust and residential soil.

Two commercially available enzyme-linked immunosorbent assays (ELISA) for total polycyclic aromatic hydrocarbon (PAH) and carcinogenic PAH (C-PAH) were evaluated. The testing procedures were refined for application to screening PAH and C-PAH in house dust and soil samples for human exposure studies. The overall method precision expressed as percent relative standard deviation (%RSD) of triplicate real world dust and soil samples was within +/- 29% (12-29%) for PAH ELISA and +/- 21% (5.9-21%) for C-PAH ELISA. Spike recoveries from real world dust/soil samples were 114 +/- 30% for phenanthrene from PAH ELISA and 120 +/- 8.2% for benzo[a]pyrene from C-PAH ELISA. The overall method accuracy for PAH and C-PAH assays cannot be assessed for multiple PAH components in dust/soil samples (which represent real-world samples), because of the assays' cross reactivities with other PAH components. Over 100 dust/soil samples from 13 North Carolina homes and 22 Arizona homes were analyzed by PAH and C-PAH assays, as well as by the conventional gas chromatography/mass spectrometry (GC/MS) method. Statistical analysis showed that dust/soil PAH data from ELISA and GC/MS methods are significantly different. In general PAH ELISA responses were higher than PAH GC/MS responses. The regression analysis showed that the linear relationship between ELISA and GC/MS measurements is not strong in the combined data. The relationship became stronger for the data from the same type of dust/soil samples. The screening performance of ELISA was evaluated based on the frequency distribution of ELISA and GC/MS data. The results indicated that the ELISA PAH and C-PAH assays cannot be used as a quantitative analytical tool for determining PAH in real-world dust/soil samples. However, the ELISA is an effective screening tool for ranking PAH concentrations in similar types of real world dust/soil samples.

The effectiveness of the yellow card warning system for paediatric cardiology patients.

Questionnaires were completed by the parents of 100 children with cardiac problems attending the regional paediatric cardiology clinic in Yorkshire. The parents' possession and knowledge regarding the use of a yellow card (warning parents and dentists of the need for antibiotic cover before certain dental treatment) was assessed. Only 57 per cent of parents reported that they had received a yellow card.

The plaque acidogenic response to carbohydrates of children from three ethnic groups in South Africa.

The plaque acidogenic response of children from three ethnic groups in South Africa to four different carbohydrates was investigated using the plaque sampling method. A total of 30, 12-year-old children, ten black, ten 'coloured' and ten white, completed this study. The foods tested were 10 per cent sucrose solution, maize porridge, strawberry flavoured yoghurt and banana. The blacks produced an intermediate plaque pH response to sucrose compared with the 'coloureds' and whites but the smallest response for the other carbohydrate challenges. It was concluded that a difference exists in the plaque acidogenic response to carbohydrate between the three ethnic groups and that this may in part account for differences in caries prevalences.

The effect of different concentrations of sugars in two foods (yoghurts and baked beans) on plaque pH.

The effect of different concentrations of sugars in two foods (strawberry yoghurt and baked beans) on plaque acidogenicity was investigated using plaque sampling with a 'Beetrode' electrode. Six varieties of yoghurt, four varieties of baked beans and positive and negative control solutions of 10 per cent sucrose and sorbitol, respectively, were tested on six volunteers, selected according to the guidelines agreed at the San Antonio Conference of 1985. Plaque was harvested immediately before a one minute challenge with the test condition and at 5, 10, 15, 20 and 30 minutes thereafter. Parameters investigated were minimum plaque pH reached after a one minute consumption/rinse of the test food or control solution, maximum drop in plaque pH and 'area of the Stephan curve below pH 6.5'. An Acidogenic Potential Index was calculated for each test food and the results did not suggest a linear relationship between sucrose concentration in a food and acidogenic potential.

Decontamination of dental unit water systems: a review of current recommendations.

It is now recognised that water delivered to dental handpieces and air/water syringes via dental unit water systems may become significantly contaminated with micro-organisms which originate from the incoming water supply and, to a lesser extent, with oral micro-organisms. The purpose of this article is to review the literature relating to the risks associated with contamination of dental unit water systems and methods which may be used to minimise these risks.

Do we still care about children's teeth?

The level of care for children over the past 5 years has become bimodal, with most children with low levels of dental caries having good maintenance care, but those with moderate to high caries receiving significantly poorer care. Capitation has led to supervised neglect for many children who develop dental decay. This is not at all unexpected considering the general lack of concern by the government and public dental services and the fact that the level of payment of GDPs is such that they cannot afford to treat children. The problems of the dental care of children in the UK are compounded by the lack of specialist paediatric dentists for the more difficult patient.

Postgraduate training for specialisation.

With the prospect of changes brought about through the Mouatt Report and the European Union, calls for a more flexible approach to teaching dentistry are being made. This article describes a postgraduate dental education system that involves modules and credits set up at the University of Leeds. The new system moves away from the more traditional methods of educating post-graduate students.

The acidogenic potential of herbal baby drinks.

The acidogenic potential of a range of commonly available herbal baby drinks was assessed on the basis of their ability to depress plaque pH in vivo in 10 adult volunteers using the plaque harvesting technique. In addition the pH and inherent acidity of each drink was also analysed in vitro. Solutions of 10% sucrose was used as a positive control and full fat milk served as a negative control as it has traditionally been recommended as a safe drink. Three of the six test drinks had a low pH though most had a low titratable acidity. All drinks, except herbal tea, on rising led to a significant drop in the plaque pH to near critical pH value of 5.5. Most drinks were also more acidogenic than milk and some behaved essentially similar to a 10% sucrose solution. The area under the curve below the resting pH was highest for apple and raspberry herbal drink (20.51 +/- 3.66) and was the least for herbal tea (0.00) compared with the 10% sucrose control (22.01 +/- 2.87) and milk (0.07 +/- 0.14). It was concluded that most herbal drinks tested, especially those with added fruit, can lead to a significant acid production in the plaque and therefore have a potential to cause demineralisation of the enamel.

Congenital erythropoietic porphyria--oral manifestations and dental treatment in childhood: a case report.

Congenital erythropoietic porphyria is a rare condition resulting from an inborn error in prophyrin metabolism. This deficiency leads to hemolytic anemia, photosensitivity, blistering of the skin, and deposition of red-brown pigments in the bones and teeth. The literature regarding the dental aspects of this disorder is briefly reviewed and the preventive, restorative, and esthetic dental management of a 4-year-old child with congenital erythropoietic porphyria is described.

The dental status of asthmatic British school children.

PURPOSE: This study was performed to determine the prevalence of dental disease in British school children with asthma. METHODS: A convenience sample of 100 asthmatic children (aged 4-16 years) was examined for dental caries, periodontal condition, and tooth surface loss. School children, equated for age, sex, race, and socioeconomic status were chosen for comparison. Children were divided into two age ranges; 4-10 and 11-16 years. A significant difference was found in DMFT (0.96 vs. 0.31) and DMFS (1.37 vs. 0.37) between the 4-10-year-old asthmatic children compared with healthy control children. RESULTS: In the 11-16-year age range, the asthmatic children had a DMFT and DMFS of 2.48 and 3.39 compared with the control children who had a DMFT and DMFS of 1.11 and 1.97 respectively. Asthmatic children had significantly more plaque, gingivitis, and calculus compared with the control group. There was a significant difference in the severity and number of teeth affected by tooth surface loss affecting labial surfaces of the anterior teeth and occlusal surfaces of the posterior teeth of asthmatic children. CONCLUSIONS: It was concluded that asthmatic children have more decay affecting their permanent teeth, poorer periodontal status, and more tooth surface loss than healthy controls.

A prospective clinical trial comparing preformed metal crowns and cast restorations for defective first permanent molars.

AIM: This study investigated two methods for the restoration of permanent molars affected by amelogenesis imperfecta (AI) or severe enamel defects. METHODS: A prospective clinical trial was carried out on 17 subjects affected by AI or severe enamel defects of first permanent molars. A split mouth design was used so that each right or left permanent molar in both jaws was restored using either a preformed metal crown (SSC) or a cast adhesive coping (CAC). Subjects were followed for up to 24 months and assessed for longevity and quality of the restorations. Sequential analysis was used to compare longevity. RESULTS: Records for 42 restorations (19 SSC; 23 CAC) were kept. The split mouth design was possible on 24 occasions (right versus left=14; maxilla versus mandible=10). Three restorations, one SSC (at 6 months) and two CAC (at 2 and 19 months) failed and required replacement. There was no significant statistical difference between the two types of restorations. CONCLUSION: While there was no difference between the two restorations for quality and longevity, the SSC was considerably cheaper to use and needed only one visit, but more tooth tissue was lost in preparation and fitting. The CAC was significantly more expensive but left nearly all of the tooth crown intact. The choice of which restoration to use is indicated by the immediate and long-term needs of each individual patient.

Anxiety related to dental general anaesthesia: changes in anxiety in children and their parents.

AIM: To examine the anxiety levels of children referred for dental general anaesthesia and their parents at various key points of the referral and anaesthetic procedure. METHODS: Structured interviews and anxiety measures were conducted with 50 children attending the Department of Paediatric Dentistry, Leeds Dental Institute, and progressing to general anaesthetic (GA) and their parents. Interviews were conducted with parents and children prior to initial assessment, following assessment and prior to a GA. Anxiety was measured at each interview, using the Visual Analogue Scale for parents and the Venham's Picture test for children. A fourth telephone interview was conducted with parents one week after the GA when the degree of upset caused to parents and children by the procedure was evaluated. RESULTS: Anxiety of children remained constant at each interview. Parent and child anxiety were not related. There was a rise in parent anxiety following initial assessment in those families attending in response to a routine referral and progressing to GA (p<0.05). There was a further rise in parent anxiety in these families immediately prior to the GA itself (p<0.001). Parent upset was strongly related to their anxiety at each of the three interviews prior to the GA (p<0.01, 0.05 and 0.001 respectively) and to the distress of their child (p<0.02). Child distress was strongly related to anxiety at each of the three interviews prior to the GA. CONCLUSION: The anxiety levels of children did not appear to change throughout the whole GA assessment and treatment process. Parent anxiety rose significantly following assessment and again just prior to the GA. Factors contributing to parent upset post treatment were child upset and pre treatment parent anxiety levels. Children who were most anxious prior to GA found the procedure most distressing.

Restoration of decayed primary incisors using strip crowns.

Caries of the primary incisors is a common problem that can be arrested if recognized early enough. However, the arrested decay is unsightly. Celluloid 'strip' crown forms, used with composite resin, now allow the restoration of even the most badly decayed primary incisors. The authors describe this quick and efficient technique.

Potential cariogenicity of starches and fruits as assessed by the plaque-sampling method and an intraoral cariogenicity test.

The cariogenicity of starches and fruits was investigated by measuring acidogenicity (plaque sampling) and enamel demineralization. Test foods were oranges, apples, bananas, Cornflakes, Branflakes, Weetabix, Alpen (no added sugar), white bread, wholemeal bread, rice, and spaghetti, with positive and negative controls of sucrose and sorbitol. Plaque sampling indicated that all the foods were less acidogenic than sucrose, but only significantly so (p < 0.05), as follows: maximum drop in plaque pH: all foods; minimum plaque pH reached: Cornflakes, Branflakes, and wholemeal bread; cH area: wholemeal bread. All foods produced enamel demineralization. The low pH of oranges and apples caused more demineralization than sucrose. Overall, the foods were less cariogenic than sucrose, but more than sorbitol.

Dental health and salivary Streptococcus mutans levels in a group of children with heart defects.

One-hundred children aged 2-16 years who were attending the Outpatients Department of the Yorkshire Regional Cardiac Centre were examined for dental caries, gingivitis, plaque and calculus. A control group of 100 children was also examined. A saliva sample was taken from each child in the study group to assess the level of Streptococcus mutans colonization. Comparing study and control groups, dental caries experience (dmft) was significantly higher only in the primary teeth of 5-9-year-old children in the study group, and there were no significant differences in gingivitis, plaque or calculus. The S. mutans count was found to be positively correlated to the number of decayed teeth in the study group.

Integration of methods for determining the acido/cariogenic potential of foods: a comparison of several different methods.

Assessment of the acido/cariogenicity of 11 fruits and cereals was carried out using methods recommended at the San Antonio Conference: plaque pH by sampling (PS), indwelling electrode (IDE) and intra-oral cariogenicity test (ICT), together with additional tests of the total carbohydrate content of salivary expectorants, acid anion profiles of plaque, liberated maltose in plaque, total food carbohydrate and fluoride concentration. All foods within each test were compared with sucrose and sorbitol as positive and negative controls. Results for foods were ranked against sucrose for cH area under the curve for PS, for mean ratio [H+] of food versus sucrose (IDE) and mean change in indenter penetration length in enamel after exposure (ICT). Results showed that different rankings of foods were obtained with each method, with a greater degree of commonality for PS and ICT versus IDE. Factor analysis identified liberated maltose in plaque, area below the curve (PS), total food carbohydrate and plaque pH drop (PS) as being important in determining the potential cariogenicity of foods. It was concluded that each of the methods was of value and could be used to assess potential acido/cariogenicity of foods. The recommendation that it was desirable that at least two methods should be used was confirmed.

The effect of different concentrations of citrate in drinks on plaque pH.

The effect of 0.1, 0.2 and 0.4% citrate in 10% sucrose solutions on the plaque pH in vivo was tested in 20 volunteers using the plaque harvesting technique. Results showed that the pH response for the three test solutions with citrate was significantly less compared with that for 10% sucrose (positive control) alone (p < 0.05). Mean areas under the pH curve were: sorbitol (negative control) 0.02, citrate 0.2% 5.30, citrate 0.4% 6.24, citrate 0.1% 6.94 and 10% 12.69. The cariogenic potential index of all the citrate test drinks was almost half compared with a 10% sucrose solution (p < 0.05). It was concluded that the addition of relatively low levels of citrate in a sucrose solution reduces the acidogenic response in the plaque.