Efficacy of chlorhexidine varnish applications in the prevention of early childhood caries.

AIM: A prospective clinical study was conducted to evaluate the influence of 3-monthly applications of the chlorhexidine- containing varnish Cervitec on the colonisation of a child's oral cavity by mutans streptococci (MS) and on caries prevalence. METHODS: 200 children aged 11.7 +/- 0.7 months were examined. Children's caries risk was assessed on the basis of their MS scores in saliva. Out of the 48 children in whom a high caries risk (> or =10(5) CFU/ml) was expected, 23 were treated with Cervitec at 3-month intervals (CHX group). The remaining 25 children of the high-risk group received no treatment and served as controls (group C). All parents received detailed information on the prevention of early childhood caries. 172 children had completed the study after one year. RESULTS: During the course of the study the percentage of children with visible plaque on their maxillary incisors increased from 17.8% to 40.1% and the percentage of children given sweetened drinks in nursing bottles for the night rose from 16.3% to 18.0%. At the closure of the study 26.2% of the two-year-olds had salivary scores of MS > or =10(5) CFU/ml of saliva. The mean d(1-4)mft value increased from 0.05 -/+ 0.4 to 0.8 -/+ 2.9 and the mean d(1-4)mfs value rose from 0.08 -/+ 0.8 to 1.8 -/+ 5.9. No significant differences were demonstrable between the two-year-olds in groups CHX and C for colonisation of the oral cavity by MS or for d(1-4)mft values. In contrast the d(1-4)mfs values were significant lower in the CHX group as in the group C. CONCLUSION: Poor feeding habits and deficits in oral hygiene cannot be compensated by the application of Cervitec.

Molar incisor hypomineralisation in a group of children and adolescents living in Dresden (Germany).

AIM: This was to determine the prevalence of Molar Incisor Hypomineralisation (MIH) and to evaluate possible causes of these enamel defects. METHODS: The study group consisted of 2,408 10-17 year old children born during 1985-1992 and living in Dresden (Germany). Enamel defects were recorded using the modified DDE index. Children with enamel defects and their parents were invited for a re-examination to record the medical history of the children during the first 3 years of life; these children were matched by age with other children with apparently normal first molars (control group). RESULTS: 135 (5.6%) of the children had demarcated opacities in at least one first molar, i.e. MIH. A significantly higher prevalence of MIH was seen in children born between 1989 and 1991 compared with those born before and after that period (p<0.01). The number of children returning for the medical history questionnaire was low, 31 out of 135 responded (test group). Although there were no significant differences between the test and control groups in terms of peri and neonatal complications or other health problems, the low return precluded any definitive interpretation. CONCLUSION: The overall prevalence of MIH in this study was low by comparison with other previous epidemiological reports.

Total fluoride intake and urinary excretion in German children aged 3-6 years.

There have only been few investigations comparing total fluoride intake and the fluoride proportion excreted in urine in pre-school children. In addition, the results of available studies are conflicting. Total fluoride intake was assessed in 11 healthy children aged 3-6 years on 2 consecutive days and urinary fluoride excretion was determined. The duplicate-diet approach was used for the assessment of fluoride intake from solid and liquid foods. Fluoride intake from toothbrushing was calculated as the difference between the amount of fluoride in the paste put on the toothbrush and the drinking water (fluoride concentration 0.25 mg/l) used for rinsing vs. the fluoride amounts recovered in the toothpaste spat out and in the rinsing water. Use of fluoridated domestic salt and/or fluoride tablets was recorded. The children's intake of fluoride from food averaged 202.5+/-116.2 microg F/day. They swallowed an average amount of 273.9+/-175.6 microg F/day when brushing their teeth. Daily fluoride ingestion from all sources totalled 930.7+/-391.5 microg or 53.0+/-21.4 microg/kg body weight. On average 51.5% of the fluoride ingested was excreted in urine. The wide interindividual variation makes it necessary to evaluate the urinary excretion rate for fluoride in larger study populations with varied fluoride exposure.

[Investigation of caries occurrence and occlusal restoration in beginning school children in Erfurt compared to Marburg an der Lahn]. / Untersuching über Kariesbefall und Gebisssanierung bei Schulanfängern in Erfurt im Vergleich zu Marburg a.d. Lahn.

At the end of 1990 in the area of Erfurt 309 and in and around Marburg an der Lahn 348 school beginners were examined by one children's dentist under identical conditions. The results (milk teeth) showed that the caries incidence (dmfs) was comparable in both regions. However, the proportion of restored milk teeth tended to be higher in Erfurt than in Marburg. In addition, the differences in individual caries incidence were more marked. In Marburg there were more caries-free children, but children whose teeth had been damaged by caries were more seriously damaged than those in Erfurt.

[Social psychological barriers to compliance in group and individual prophylaxis]. / Sozialpsychologische Barrieren zur Compliance in der Gruppen- und Individualprophylaxe.

In a long-term study of 700 school children attitudes and behaviour related to dental hygiene were registered and collated with findings on caries and oral hygiene. The data indicating developments in the 12 - 14 year old group showed that youths are well informed about the condition of their teeth, but are increasingly unwilling to accept treatment and advice offered by dentists. Potential barriers to compliance with prophylactic and therapeutic measures are a lack of success in school studies, insufficient accentuation of independence in the educational and child-raising process and a lack of communication between dentist and youths.

[Salt fluoridation--present knowledge, results, experiences]. / Zur Speisesalzfluoridierung--aktueller Stand, Ergebnisse, Erfahrungen.

On the occasion of the introduction of salt fluoridation in Germany a survey of international results and experiences of salt fluoridation is given. Recommendations for successful caries prevention result from salt consumption dates and previous practice of dental prevention.

[Caries risk in youth from sociopsychological viewpoint]. / Kariesrisiko Jugendlicher aus sozialpsychologischer Sicht.

Attitudes and behavioural patterns to dental health were recorded by standardized questionings of 900 juveniles aged between 12 and 16 years. Health-related behaviour corresponds with demographic and sociopsychological factors. Education within the family is very important for the development of a healthy way of life. Experiences of juveniles with dental care essentially determine their curative and preventive compliance. Juveniles with a negative attitude towards dental health require as a potential caries risk group special attention in health advising and dental care.

[Studies on juveniles' education for health of teeth and mouth. 2. Juveniles' knowledge of dental health and behavior]. / Studien über die Erziehung Jugenlicher zur Zahn- und Mundgesundheit. 2. Mitteilung: Jugendliche über ihr Wissen zur Zahngesundheit und ihre Verhaltensweisen.

General recommendations about healthy way of life and dental health are well-known to juveniles aged 12 to 16; but detailed information which completes and reinforces this general knowledge in a useful way is to a large extent lacking. Knowledge and behaviour of juveniles correlate with age, sex and success at school. An important role in developing a healthy way of life plays the family education. Point of contact for the dentist is the upgrading of dental screenings by a conform-intensive arrangement of these direct and very individual consultations.

[Juveniles' education for oral health. 1. Juveniles' position to health of teeth and stomatological care in children]. / Studien über die Erziehung Jugendlicher zur Zahn- und Mundgesundheit. 1. Mitteilung: Einstellung Jugendlicher zur Zahngesundheit und zur kinderstomatologischen Betreuung.

About one forth each of juveniles aged between 12 and 16 years which have been questioned in a written form to the topic of health declare a particular positive attitude towards a healthy way of live or a negative attitude towards dental health. The compliance of juveniles to dental care is influenced both by sex, age, achievements at school, family, group integration and their motivation structure and by paedodontics care.

[Longevity of amalgam fillings in permanent teeth of minors]. / Zur Standzeit der Amalgamfüllungen im jugendlichen permanenten Gebiss.

The longevity of 3,300 amalgam fillings was tested with 1,165 juvenile minors at the age of 16 to 17, born in 1967-69. Up to the closing of peadontic care it was necessary to renew 25 percent of all amalgam fillings once or several times. After a manual trituration the renewing rate was more than the double of hight. Fillings applied between 6 and 9 years of life must be renewed to 37 percent during 5 years; fillings applied between 9 and 11 years of life were renewed to 25 percent. Differences between fillings applied at the High School and in the territory, respectively, have not been registered.

[Critical evaluation of the results of systematic pedodontic care]. / Kritische Bewertung von Sanierungsergebnissen systematischer kinderstomatologischer Betreuung.

The authors present and comment upon the clinical and radiological findings obtained from 1200 children in the framework of a caries-statistical cross-sectional study. The statistical data are subdivided into: state of oral rehabilitation, extent of oral rehabilitation, frequency of the different kinds of filling and endodontic treatment measures.

[Efficiency criteria and priorities in school age pedodontic care]. / Uber Bewertungskriterien und Schwerpunkte kinderstomatologischer Betreuung im Schulalter.

On the basis of findings in 1200 individuals aged between 7 to 16 years, the authors indicate priorities of dental care in the different age-groups. Apart from other criteria, the readiness for treatment and the disciplined behaviour of the children and adolescents during treatment may be used for assessing the dentist's achievements.

[Does dental care influence the progression of caries in children and adolescents?]. / Beeinflusst die Gebisssanierung den Karieszuwachs bei Kindern und Jugendlichen?

The caries-statistical date from 1.500 subjects aged between 7 and 16 years showed that the caries incidence in children and adolescents who had received complete dental treatment was by 31% lower, after two years, than that in children and adolescents who had not received complete dental treatment. Thus, the restorative functions of single fillings are completed by a complex preventive aspect.