The Prevalence and Associated Factors of Periodontal Disease among 35 to 44-year-old Chinese Adults in the 4th National Oral Health Survey.

OBJECTIVE: To assess the current periodontal status of 35 to 44-year-olds from the Chinese population and to analyse potential influence factors on periodontal disease. METHODS: The data of subjects were collected from both urban and rural areas of all 31 provinces, autonomous regions and municipalities of the mainland of China, as part of the 4th National Oral Health Survey. All subjects were aged 35 to 44 years old. In total, 4,410 subjects were enrolled in the present study. Each subject was asked to undergo a professional oral examination and to fill in a questionnaire. Periodontal health status was evaluated by probe bleeding, calculus, periodontal pocket depth and clinical attachment loss. The data were analysed using the chi-square test and binary logistic regression analysis. RESULTS: The prevalence of probe bleeding and calculus was 87.4% and 96.7% respectively among the 35 to 44-year-old population. Prevalence of shallow pockets (4 mm ≤ PD < 6 mm) and deep pockets (PD ≥ 6 mm) was 45.8% and 6.9% respectively among 35 to 44-year-old people. In addition, prevalence of clinical attachment loss (CAL > 3 mm) was 33.2%. Gender, educational level, smoking, teeth brushing frequency, dental floss and toothpick use were found relevant to periodontal condition. CONCLUSION: Periodontal disease was highly prevalent among 35 to 44-year-old Chinese adults. Gender, educational level, smoking, teeth brushing frequency, toothpick and dental floss use could be potential influence factors of periodontal health status.

Dental Caries Status and its Associated Factors among 3- to 5-year-old Children in China: A National Survey.

OBJECTIVE: To investigate the prevalence and severity of dental caries among pre-school children in China as part of the 4th National Oral Health Survey. METHODS: The sampling process was conducted with a multistage stratified cluster method. A total of 40,360 children aged between 3 and 5 years were recruited for this study. Each participant was clinically assessed according to the 5th edition of the oral health survey's basic methods recommended by the World Health Organization (WHO) and their parents or grandparents completed a questionnaire at a face-to-face interview. The status of dental caries was shown in the form of the mean dmft and the prevalence of dental caries. The logistic regression analysis was performed to study the relationships between the prevalence of dental caries and the selected variables. RESULTS: The prevalence of dental caries was 50.8%, 63.6% and 71.9% for 3-, 4- and 5-year-olds, respectively. The mean dmft was 2.28, 3.40 and 4.24, respectively. Logistic regression analysis showed that children who were mixed-fed had a higher chance of staying free of dental caries; children who had dessert before going to bed were associated with a higher probability of caries. CONCLUSION: The status of dental caries among preschool children in China is on the increase. The preschoolers' dental caries status related to their breastfeeding conditions within the first 6 months of life and their snacking habits.

Evaluation of Ion Release from Four Dental Sealants.

The purpose of this study was to determine the ion release from four commercially available pit-and-fissure sealants [3M Clinpro, 3M Concise™, BeautiSealant (BS), and GI FX-II)]. With each brand, 18 specimens were prepared. Their fluoride release in de-ionized water was measured by fluoride electrode, while the release of silicate (Si), aluminum (Al), sodium (Na), calcium (Ca), strontium (Sr), and phosphorus (P) was measured by inductively coupled plasma atomic emission spectroscopy (ICP-AES) on days 1, 3, 7, 14, 21, and 28. The result showed that fluoride was not released from 3M Concise™. GI FX-II displayed the largest fluoride release, which, however, dropped rapidly on day 3. 3M Clinpro exhibited less fluoride release than GI FX-II and BS did. At any time during the 28-day experimental period, GI FX-II released more Na than the other sealants (P<0.001). BS ranked the second in Na release, and a small amount of Na ions was released from the 3M Clinpro and 3M Concise™ samples. Al ions were only detected from BS and GI FX-II, but not from the 3M Clinpro and 3M Concise™. Additionally GI FX-II had the largest Si release among the four brands at any time during the experimental period (P<0.001). Ca ions were detected from 3M Clinpro and 3M Concise™, but not from GI FX-II. BS released more Sr than the other sealants at any time during the experimental period (P<0.001). All the samples released similar amounts of P continuously during these 28 days. In conclusion, based on the type and the amount of ion release, BS is the best pit-and-fissure sealant among the four brands.

Patterns and Risk Factors for White Spot Lesions in Orthodontic Patients with Fixed Appliances.

OBJECTIVE: To evaluate the development and risk factors of white spot lesions (WSLs) in orthodontic patients with fixed appliances in a Chinese population. METHODS: A total of 202 subjects participated in the cross-sectional study. Clinical examination of the state of the entire labial (buccal) enamel surface was conducted under artificial light using a clinical mirror and an explorer. A face-to-face interview was conducted through a structured questionnaire to collect a range of information, including demographic data, family income, level of education, toothbrushing frequency, fluoride toothpaste usage and the use of a professional toothbrush (V type). RESULTS: WSLs appeared on 57.9% of the subjects after orthodontic treatment with fixed appliances; the mean tooth number of WSLs was 4.8. A higher prevalence was observed in subjects whose time of therapy was 17 months or longer (OR = 3.2, P < 0.050), and who had modified their unhealthy dietary habits (OR = 3.7, P < 0.001). Younger individuals or individuals who consumed food with sugar at least once a day during the course of their orthodontic treatment also exhibited a higher likelihood of experiencing WSLs. CONCLUSION: The prevalence of WSLs after orthodontic treatment with fixed appliances was relatively high in China. Clinicians should be aware of the risk factors of WSLs that may occur during the treatment period.

Dental caries and first permanent molar pit and fissure morphology in 7- to 8-year-old children in Wuhan, China.

To obtain the caries experience and, plaque accumulation severity and pit and fissure morphology in first permanent molars in 7-8 children in Wuhan, as a reasonable prediction of caries risk and preventive attention in the future, a convenient sample of five primary schools in the vicinity of the Wuhan University School and Hospital of Stomatology was drawn. Two calibrated examiners orally examined all present grade 2 children in the classroom, using standard caries plaque and tooth morphology criteria. Dental caries was scored at enamel (D(2)) and dentine (D(3)) for tooth and surface level. Independent variables were age, gender and school. Data analysis used analysis of variance and t-test. The sample comprised 1 043 7- and 8-year-olds. The prevalence of dental caries in permanent dentition was 8.7% and in primary dentition, 68.7%. Mean Decayed, Missing, Filled Teeth/S (DMFT/S) scores were 0.11 and 0.14, respectively. Mean dmft/s scores were 2.8 and 5.0. The d-component constituted 75% of the d(3)mft index, while enamel carious lesions constituted 36% of the total number of carious lesions (d(2,3)-component). Prevalence of medium and deep pits and fissures was 84.6%. Prevalence of medium and severe plaque accumulation was 67.4%. Prevalence of dental caries in the deciduous and permanent dentitions of 7- to 8-year-old children was high. Deep pits and fissures in high caries risk children should be sealed.

A comparative evaluation of the efficacy of two novel desensitising dentifrices.

A comparison of the desensitising efficacy of two commercially available dentifrices with different modes of action was conducted in a randomised, examiner-blind, two-arm, parallel group, 8-week, longitudinal clinical study. Dentifrice A, (Sensodyne Multi Action Iso-Active), contained 50000 ppm KNO(3) and 1450 ppm fluoride as NaF. Dentifrice B, Colgate Sensitive Pro-Relief, contained a combination of 80000 ppm arginine, bicarbonate, calcium carbonate, and 1450 ppm fluorine as NaMFP. Subjects (N = 110), stratified into two groups (N = 55), brushed twice-daily for 60 s, over an 8-week period. Sensitivity status, compliance, and safety were determined at 1, 2, 4, and 8 weeks. A fixed-effects ANCOVA statistical model was applied to the Intent-To-Treat population using a two-sided 5% significance level. After 8 weeks, the treatment groups using Dentifrice A and Dentifrice B exhibited mean reductions from baseline of 49% and 45% in air sensitivity visual analogue scale (VAS) score, 61% (both) in examiner-based Schiff Sensitivity score, and clinically significant reductions in tactile pain threshold; all reductions were statistically significant (P < 0.0001). Both treatment groups also exhibited significant reductions across all sensitivity measures at 1, 2, and 4 weeks (P ≤ 0.0059, Dentifrice A; P ≤ 0.0137, Dentifrice B).

[Study of dental caries and the influence of social-behavioral risk factors on dental caries of 1,080 15-year-old adolescents].

OBJECTIVE: To describe the dental caries of 15-year-old adolescents in Hubei province, and to determine the influence of various social-behavioral risk factors on dental caries in the population. METHODS: The survey employed a multistage, stratified, non-geometric proportional randomized sampling, representing adolescents aged 15-year-old in Hubei province. The epidemiological investigation of dental caries was made by clinical oral health examination. Oral health knowledge, attitude and behavior investigated by questionnaire. RESULTS: The prevalence and mean DMFT in 1,080 15-year-old adolescents in Hubei province was 24.4% and 0.45, respectively. 11.4% of the adolescents brushed their teeth at least twice a day, 33.1% of the adolescents ever visited the dentists. A significant higher prevalence of dental caries was observed in girls (OR = 1.70). In addition, those who visit dentists and those who the scores of the consumption of sugar drink were high tended to have a higher prevalence of dental caries. CONCLUSION: The dental caries prevalence of adolescents in Hubei province is low, but oral health habit of adolescents seems poor. Gender and consumption of sugar drink may be risk factors of dental caries.

Assessing the effectiveness of a school-based oral health promotion programme in Yichang City, China.

OBJECTIVES: To assess the outcome of oral health promotion in schoolchildren over a 3-year period in Yichang City, Hubei, China. METHODS: In a cluster randomized controlled trial, the concept of the World Health Organization Health Promoting Schools Project was applied to primary schoolchildren. Seven intervention schools and eight control schools were randomly selected from one district by stratified cluster sampling. The study was conducted as a 3-year follow-up study. After 3 years, 661 children remained in the intervention group and 697 children in the control group. Data on dental caries, plaque accumulation, and sulcus bleeding were collected by clinical examination, while behavioural data were gathered by self-administered questionnaires. RESULTS: The 3-year net mean DMFS increment score was 0.22 in the intervention schools and 0.35 in the control schools (P < 0.013). A statistically significant difference in mean plaque (P < 0.013) and sulcus bleeding (P < 0.005) increment scores after 3 years was found between the two groups. Statistically significant higher scores were observed in restorations received and sealants placed, and a lower score in untreated dental caries, in children from the intervention group than the control group after 3 years (P < 0.01). In addition, more children in the intervention schools adopted regular oral health behavioural practices such as brushing their teeth at least twice a day, visiting the dentist within the past calendar year, and using fluoride toothpaste. CONCLUSION: The study suggests that the school-based oral health promotion was an effective way to reduce new caries incidence, improve oral hygiene and establish positive oral health behavioural practices in the targeted schoolchildren.

[Study on maternal periodontal diseases of the relationships between porphyromonas gingivalis, serum pro-immflamatory mediators and preterm low birth weight].

OBJECTIVE: To investigate the associations between periodontal diseases, presence of Porphyromonas gingivalis (P. gingivalis), serum levels of pro-inflammatory mediators and preterm low birth weight (PLBW). METHODS: 60 women (30 PLBW and 30 healthy women), were recruited after postpartum within 3 days in this case-control study. Periodontal measurements including plaque index (PI), bleeding index (BI), probing pocket depth (PD) and clinical attachment loss (CAL) were assessed. The subgingival plaque was collected before periodontal examination and analysed by polymerase chain reaction (PCR) for the presence of the 16S rRNA gene specific to P. gingivalis, while the venous and umbilical cord blood specimens collected were determined by enzyme-linked immunosorbent assay (ELISA). RESULTS: The PLBW cases had a poorer oral conditions and the presence of P. gingivalis was found in a higher proportion in the PLBW than the healthy pregnant (56.7% vs. 30.0%, P < 0.05). Both of the presence of periodontitis and P. gingivalis have been found to be associated weakly with a shorter gestational age and a lower birth weight (P < 0.05). The levels of IL-1beta, IL-6 and prostaglandin-E2 (PGE2) in both of the blood samples showed higer levels between the PLBW and normal groups (P < 0.01). The IL-1beta and PGE2 levels in maternal serum were higher with a severe periodontal disease in the PLBW group (P < 0.01). CONCLUSION: There may be a possible link between periodontal diseases and PLBW.

Clinical evaluation of a dentifrice containing calcium sodium phosphosilicate (novamin) for the treatment of dentin hypersensitivity.

PURPOSE: To evaluate the efficacy of a dentifrice containing calcium sodium phosphosilicate (NovaMin) study versus a placebo and a commercially-available SrCl2 containing dentifrice for the treatment of dentin hypersensitivity. METHODS: This was a 6-week, randomized, parallel-arm, double-blind clinical study. 71 subjects ranging in age from 21 to 56 years old completed the study. Evaporative and thermal stimuli were used to measure pain using a VAS scale. Measurements were obtained at baseline, 2 weeks and 6 weeks. RESULTS: The placebo and the NovaMin groups showed a statistically significant decrease in sensitivity by both measures after 6 weeks (P < 0.05). The SrCl2 group showed a statistically significant decrease from baseline at the 2-week time point, but not at the 6-week time point for the evaporative stimulus. The percent reduction in sensitivity at 6 weeks for the NovaMin test group was 35% for air and 39% for cold water stimulus, versus 11% for air and 22% for cold water for the SrCl2 paste. The reductions for the placebo paste were 21% for the air stimulus and 18% for water. A cross tabulation measure of the reduction in sensitivity at each time point for all three treatments showed that the NovaMin product was more effective than either of the other products. For the air stimulus in the NovaMin group, 58% of subjects improved at each time point compared with 26% for the SrCl2 group and 20% for the placebo group. These results demonstrate that the NovaMin dentifrice was more effective at reducing sensitivity compared with a commercial dentifrice and placebo control.

[A two-year randomized clinical trial of 1.23% fluoride foam on dental caries increment in primary teeth].

OBJECTIVE: To evaluate the effect of bi-annual professional application of 1.23% fluoride foam on caries reduction in the primary dentition over a two-year period. METHODS: In a double-blind, cluster-randomised, placebo-controlled trial, 392 children aged 3 - 4 years from 15 classes were randomly assigned to two groups on a school class basis. The experimental group (8 classes) received a bi-annual fluoride foam application, and the placebo control group (7 classes) received the placebo. The analysis of caries increment was based on the class as the unit of analysis. The independent-samples t tests were performed to compare the differences in caries indices at baseline and caries increments between the two groups. RESULTS: The mean caries increment in foam group was 3.8 dmfs while it was 5.0 dmfs in the placebo control group, resulting in 24.2% caries reduction (P < 0.05). The experimental group had a 37.6% caries reduction on approximal surfaces compared with the placebo control group (P < 0.01). Although the mean dmfs increment of bucco-lingual surfaces was lower in the experimental group than that in the control group, it was not statistically significant (P > 0.05). No significant difference in the mean caries increment was observed on occlusal surfaces between the two groups (P > 0.05). CONCLUSIONS: Bi-annual professional application of fluoride foam was effective in reducing the increment of dental caries in the primary teeth.

Anti-gingivitis effect of a dentifrice containing bioactive glass (NovaMin) particulate.

BACKGROUND: The objective of this pilot clinical trial was to evaluate the anti-gingivitis and anti-plaque effects of a dentifrice containing bioactive glass (NovaMin) compared with a placebo control dentifrice in a 6 weeks clinical study. METHODS: The study design was a randomized, double-blinded, controlled clinical trial. One hundred volunteers took part in the study and were matched for plaque index (PLI), gingival bleeding index (GBI), age and gender. The protocol was reviewed and approved by the Ethical Committee of the University. The subjects received a supragingival prophylaxis to remove all plaque, calculus and extrinsic stain. Following the baseline examination, subjects were instructed to brush with their assigned dentifrice and toothbrush. The PLI and GBI were determined for the baseline and 6 weeks. The data were analysed using a repeated-measures anova conducted on the two dependent measures to compare the effect between the test and control group. RESULTS: Ninety-five subjects finished the study. The results showed that the PLI (baseline=1.54, 6 weeks=1.29) and GBI (baseline=1.14, 6 weeks=0.47) were significantly reduced, respectively, over the 6 weeks period in the test group (p<0.001 for each measure). There was a 58.8% reduction in gingival bleeding and a 16.4% reduction in plaque growth. There was no difference of the PLI (baseline=1.60, 6 weeks=1.57) and GBI (baseline=1.18, 6-week=1.02) over the 6 week period in the control group. CONCLUSION: This study demonstrated that a dentifrice containing NovaMin significantly improves oral health as measured by a reduction in gingival bleeding and reduction in supragingival plaque compared with a negative dentifrice over the 6 weeks study period.

[A three-year evaluation of the effectiveness of the school-based oral health education program].

PURPOSE: The aim of this study was to evaluate the oral health outcomes of a school-based oral health education (OHE) programme on children, mothers and school teachers. METHODS: The WHO Health Promoting Schools Project was applied to primary schoolchildren in 3 experimental and 3 control schools in Hongshan District, Wuhan City, with a 3-year follow-up. The data were analyzed by means of the SPSS/PC+ system. Differences in changes over-time between the two groups were compared using the independent samples t test for mean scores as the clinical variables while Chi-square test was applied for categorical variables. RESULTS: The f/F components were higher among children in the experimental group than in the control group (P < 0.01) and the gingival bleeding score was significantly lower. The increase in the proportion of children with toothbrushing at least twice a day was about 26% for the experimental group and 19% for the control group (P < 0.05); dental visits within the previous year grew higher among the experimental group than in the control group (P < 0.01). The proportion of mothers who cleaned their child's teeth weekly was significantly higher for the experimental group as compared to the control group (P < 0.01). CONCLUSIONS: This study suggested that school-based OHE had positive effects on gingival bleeding score and oral health behaviour in children, and as well as oral health knowledge and attitudes in mothers and teachers.