Dental Caries and Tooth Wear in a Byzantine Paediatric Population (7th to 10th Centuries AD) from Yenikapi-Constantinople, Istanbul.

Dental caries and wear are important conditions to record in archaeological collections. The aim of the present paper is to determine the frequency and distribution of dental caries and dental wear in a mediaeval Byzantine paediatric population in Yenikapi, Constantinople, Istanbul. The present research was carried out on the skeletal remains of 1 infant and 28 children with a total of 180 teeth (113 primary and 67 permanent teeth). The frequency of ante-mortem tooth loss in the sample was 1%. The total frequency of carious lesions in the sample was 2.2%. The frequency of dental wear was rather low (3.3%) exhibiting presence of dentin clusters mostly. The present study evaluated an archaeological collection with low dental wear and low dental caries prevalence indicating a fishing community.

Effect of Bifidobacterium bifidum containing yoghurt on dental plaque bacteria in children.

OBJECTIVE: The aim of the present study is to determine the possible effect of Bifidobacterium bifidum DN-173 010 on dental plaque of children. STUDY DESIGN: 52 children (25 F and 27 M), between the ages of 8-10, participated in the present study. The study had a double blind, randomized crossover design and the experimental period consisted of four consecutive time periods. During periods 2 and 4 (2 weeks each), children consumed 110 g probiotic fruit yogurt (Bifidobacterium DN-173 010 (1 x 10(10) cfu/g)), or a placebo fruit yogurt per day. Available supragingival plaque (24 h later) was collected from teeth 16, 11, 36 and 31 at baseline and at the end of periods 2 and 4. The counts of dental plaque mutans streptococci (MS) were evaluated using Dentocult SM (Strep Mutans). RESULTS: Changes of pre- and post-treatment levels of dental plaque MS were recorded for four consecutive sampling sites. There were no statistically differences between transition scores of test and placebo groups regarding different dental plaque sampling sites (p > 0.05) (unpaired t-test). CONCLUSION: Within the limitations of the present study, Bifidobacterium bifidum DN-173 010 has no effect on dental plaque MS levels in children.

A novel delivery system of probiotic drop and its effect on dental caries risk factors in cleft lip/palate children.

OBJECTIVE: The aim of the present study was to investigate the effect of the probiotic bacterium Lactobacillus reuteri on the levels of salivary mutans streptococci and lactobacilli in children with cleft lip/palate who used the novel drop containing L. reuteri. MATERIAL AND METHODS: The study group consisted of 19 operated cleft lip/palate children aged 4 to 12 years. The study had a double-blind, randomized crossover design, and the experimental period consisted of four consecutive time periods. During periods 2 and 4, consisting of 25 days each, parents were instructed that their children should consume 5 drops per day (0.15 to 0.20 g) of probiotic or placebo drops produced by the same manufacturer. The probiotic drop, BioGaia Reuteri drops, contained L. reuteri DSM 17938 and L. reuteri ATCC PTA 5289 (≥1 × 10(8) CFU/5 drops). The counts of salivary mutans streptococci and lactobacilli were evaluated using the CRT tests. The data were processed with NCSS 2007 software using chi-square and McNemar tests. RESULTS: There was no statistically significant (p > .05) reduction of salivary mutans streptococci and lactobacilli after 25 days of consumption of both drops. CONCLUSIONS: The novel drop containing L. reuteri may not reduce the levels of salivary mutans streptococci and lactobacilli in cleft lip/palate children.

Orofacial and dental injuries of snowboarders in Turkey.

BACKGROUND/AIMS: Snowboard riding has increased in popularity during the last decade and is also remarkable for its dramatic rise in association with serious injuries. The aim of this study was to evaluate the nature of dental or orofacial trauma in snowboard riders in Turkey, as well as to investigate if adolescent and young adult snowboard riders were aware of any protective measures. METHODS: An epidemiological survey was carried out through interviews with 86 snowboard riders in Turkey. RESULTS AND CONCLUSIONS: Seventeen snowboard riders had been affected by orofacial trauma. Results revealed that all snowboarders were aware of helmet protection whereas 50 out of 86 (58%) reported that they used them. It should be concluded that from the moment a youngster begins to practice snowboard riding, (s)he should be encouraged to wear a helmet and a properly fitted mouthguard as part of the necessary protection for them to safely enjoy their sport.

Do American football players in Turkey protect themselves from dental or orofacial trauma?

BACKGROUND/AIMS: Dental and orofacial trauma in contact sports differs from other sources, as it is possible to prevent it and reduce the dental and orofacial trauma by using protection devices. The aim of this study was to evaluate the occurrence of dental or orofacial trauma in American football players of Turkey National League as well as to investigate if the players were aware of mouthguards (MGs) and had used any. MATERIAL AND METHODS: An epidemiological survey was carried out through interviews with 78 American football players in four clubs competing in Turkey National League. Thirteen players had already been affected by orofacial trauma. RESULTS AND CONCLUSIONS: Results revealed that 67 of 78 Turkish-American football players were aware of MG, while 46 of 78 players also demonstrated its use. It should be concluded that from the moment a youngster starts practising football, he should be encouraged to wear an MG to get used to the sensation and, would automatically consider it as a part of the game. A great responsibility lies on dentists, to inform their patients about the importance of wearing MG and the consequences, if it is not worn.

The prevalence of molar incisor hypomineralization (MIH) in a group of children in a highly polluted urban region and a windfarm-green energy island.

BACKGROUND: Children's developing teeth may be sensitive to environmental pollutants such as polychlorinated dibenzo-p-dioxins (PCDDs) and polychlorinated dibenzofurans. The term molar incisor hypomineralization (MIH) was introduced to describe the clinical appearance of enamel hypomineralization of systemic origin affecting one or more permanent first molars (PFMs) that are associated frequently with affected incisors. AIM: The aim of this study was to determine the prevalance of MIH in children from the most industrialized and polluted region and the most green-energy island of Turkey. DESIGN: In September 2007, a retrospective study was initiated in two elementary schools: one, a group of children (N = 153) who fitted the criteria from Tavsancil, Kocaeli (N = 109) and the other from Bozcaada island, Canakkale (N = 44). The soil samples were collected from selected regions in order to determine the contamination levels in a heavily industrialized area and a non-industrialized area. RESULTS: Prevalance of MIH in children in Bozcaada island was 9.1%, while prevalance of MIH was 9.2% in Tavsancil. The PCDD/F levels in soil samples collected from Bozcaada and Tavsancil were determined as 1,12 and 8,4 I-TEQ ng/kg dry soil, respectively (P < 0.001). CONCLUSIONS: In this preliminary study with a small study population, prevalence of MIH did not seem to be associated with the levels of PCDD/Fs in the environment.

Oral colonization by Lactobacillus reuteri ATCC 55730 after exposure to probiotics.

OBJECTIVE: The aim of this study was to investigate whether Lactobacillus reuteri ATCC 55730 can be detected in the oral cavity after discontinuation of administration of a product prepared with this bacterium. MATERIALS AND METHODS: The study consisted of three 2-week periods: clearance period, intervention period, and post-treatment period. Twenty-five volunteers consumed a chewable tablet of L. reuteri ATCC 55730 (10(8) cfu/tablet) during a 14-day trial period. Saliva samples were collected and cultured onto MRS agar after a clearance period of 2 weeks and then daily after a 2-week intervention period for as long as L. reuteri was found. Lactobacillus reuteri colonies were analysed in saliva samples. The analysis was performed using selective media for L. reuteri followed by confirmation using the specific detection of reuterin produced by L. reuteri. RESULTS: The number of L. reuteri carriers decreased gradually, and after 1 week only 8% of the subjects harboured the bacterium. After 5 weeks, L. reuteri was not detected in any of the subjects. CONCLUSION: Consuming L. reuteri for 2 weeks does not seem to be sufficient for permanent colonization of L. reuteri in the oral cavity.

Reduction of salivary mutans streptococci in orthodontic patients during daily consumption of yoghurt containing probiotic bacteria.

Previous studies have suggested that probiotic supplements in dairy products may affect the oral microbial ecology, but the effect in orthodontic patients has not previously been reported. The aim of the present study was to examine whether short-term consumption of fruit yogurt containing probiotic bifidobacteria would affect the levels of salivary mutans streptococci and lactobacilli in patients with fixed orthodontic appliances. A double-blind, randomized crossover study was performed and 24 healthy adolescents (12-16 years) undergoing orthodontic treatment were followed over four periods. During periods 2 and 4 (2 weeks each), the subjects ingested 200 g fruit yogurt containing Bifidobacterium animalis subsp. lactis DN-173010 (2 x 10(8) colony forming units/g) once daily or a control yogurt without viable bacteria. Periods 1 and 3 were run-in and wash-out periods of 1 and 6 weeks, respectively. Salivary mutans streptococci and lactobacilli were enumerated with chair-side kits before and after the yogurt consumption periods. Pre- and post-treatment values within each regimen were compared with a two-tailed marginal homogeneity test for categorical data. A statistically significant reduction of salivary mutans streptococci was recorded after probiotic yogurt consumption (P < 0.05), which was in contrast to the control yogurt. No significant alterations of the salivary lactobacilli counts were observed. Short-term daily consumption of fruit yogurt containing Bifidobacterium animalis subsp. lactis DN-173010 may reduce the levels of mutans streptococci in saliva during orthodontic treatment with fixed appliances.

Short-term effect of ice-cream containing Bifidobacterium lactis Bb-12 on the number of salivary mutans streptococci and lactobacilli.

OBJECTIVE: Probiotic bacteria are thought to reduce the risk of some infectious diseases. The aim of the present study was to examine whether or not short-term consumption of ice-cream containing bifidobacteria can affect the salivary levels of mutans streptococci and lactobacilli in young adults. MATERIAL AND METHODS: A double-blind, randomized crossover study was performed and 24 healthy subjects (mean age 20 years) were followed over 4 periods. During periods 2 and 4 (10 days each), they ingested 100 ml (53 g) ice-cream containing Bifidobacterium lactis Bb-12 once daily or a control ice-cream without viable bacteria. Periods 1 and 3 were run-in and washout periods, respectively. Salivary mutans streptococci and lactobacilli were enumerated with chair-side kits at baseline and immediately after the intervention period. RESULTS: A statistically significant reduction (p<0.05) of salivary mutans streptococci was recorded after consumption of the probiotic ice-cream. A decline of high mutans streptococci counts was also seen after intake of the control ice-cream, but the difference compared to baseline was not statistically significant. The salivary lactobacilli levels were unaltered after both regimes. CONCLUSIONS: Daily consumtion of ice-cream containing probiotic bifidobacteria may reduce the salivary levels of mutans streptococci in young adults.

The erosive potential of different malt drinks: an in vitro and in situ study.

OBJECTIVES: Whereas the potential effect of acidic drinks in the etiology of dental erosion is well recognized the role of malt drinks is unclear. The primary aim of the present study was to compare the in vitro erosive effect on enamel produced by different aromated malt drinks. A secondary objective was to compare their erosive effects in situ with those determined in vitro. MATERIALS AND METHODS: To select the malt drink for the study in situ, six commercially available malt drinks were examined for erosive potential in vitro. The study in situ was a single centre, 2-period, 2-treatment crossover study to compare the erosive effect of a commercially available malt drink (Test), with that of natural spring water (Control), over 10 day periods on 10 healthy volunteers. Subjects wore upper removable appliances containing two human enamel specimens from 9 a.m. to 4 p.m. The regimen of intake of the drinks was 250 ml at midday. Measurements of enamel loss were made on samples after 5 and 10 days by profilometry. RESULTS: The in situ study showed a statistically significant difference in erosive potential between the test and control beverages. No specimen exposed to the control beverage displayed appreciable erosion. Erosion occurred with the test drink, but to a variable degree between subjects. CONCLUSIONS: Malt drinks should be considered as potentially erosive as the results for enamel specimens exposed to the test beverage in the clinical study showed a degree of erosion that varied greatly between different participants. It is likely that under these conditions an increase in the degree of erosion would be observed in children and young people who consume malt drinks.

Role of "Video Assisted Lecture" on Changing Albanian Undergraduate Students' Opinion Regarding Pain-free Dental Injections in Children.

AIM: To evaluate the effectiveness of video assisted lecture in changing the opinions of dental students toward pain-free dental injections in children. METHODS: The fifth-year students (n:62) of University of Medicine of Tirana, Faculty of Dental Medicine participated in the study. The study was conducted in two stages: first a Theoretical lecture (Stage 1), "Pain-free Local Analgesia Techniques in Children" was provided, and was followed by a second lecture supported by video recordings of real clinical cases (Stage 2). Students' opinions were evaluated by means of a short survey administered before the lectures, after the theoretical lecture, and after the video assisted lecture. RESULTS: Before the study, only 47.9% of students believed in the possibility (agree and definitely agree) of pain-free local anesthesia in children, whereas after the study, the percentage had risen to 67.7% (p=0.0001). Baseline opinions of students changed significantly after the video-assisted lecture (p=0.0001). However, there is no statistical difference between mean scores of theoretical lecture (Stage 1) and video-assisted lecture (Stage 2). CONCLUSIONS: Theoretical lecture (Stage 1) was found to be significantly effective in changing the opinions regarding "Pain-free dental injections in children," however, a video based dental education (Stage 2) was found to be relatively effective in supporting the change in dental students' opinion.

Probiotic and prebiotic influence beyond the intestinal tract.

Probiotics and prebiotics have long been appreciated for their positive influences on gut health. Research on the mechanisms and effects of these agents shows that their impact reaches beyond the intestine. Effects on the microecology and pathology of the oral cavity, stomach, and vaginal tract have been observed. Likely mediated through immune influences, systemic effects such as reduced severity of colds or other respiratory conditions, impact on allergy incidence and symptoms, and reduced absences from work or daycare have also been noted. These observations, among others, suggest a broader spectrum of influence than commonly considered for these unique substances.

Fruit yogurt: any erosive potential regarding teeth?

OBJECTIVE: The capability of drinks and foods to resist pH changes brought about by salivary buffering may play an important role in the dental erosion process in children. The aim of the present study was to test fruit yogurt, a popular snack for children, and the degrees of saturation (pK-pl) with respect to hydroxyapatite and fluorapatite to determine their erosive potential. METHOD AND MATERIALS: A variety of fruit yogurt was tested. To test the pH, 8 readings were taken with a pH electrode for each yogurt. Calcium content was detected by atomic absorption spectrophotometer, phosphorus by the inductively coupled plasma method, and fluoride content by ion chromatography. The degrees of saturation of hydroxyapatite and fluorapatite were calculated by use of a computer program. Statistical analysis was performed using 2-tailed analysis of variance (P < .05) and a post hoc test (Tukey) to determine differences between groups. RESULTS: The pH of each fruit concentrate was significantly different, except for banana yogurt. Except for the phosphorus content of raspberry yogurt, the calcium and phosphorus content for each fruit concentrate were significantly different. Fluoride levels were the same for all yogurts tested, and the degrees of saturation of hydroxyapatite and fluorapatite was positive, indicating supersaturation. CONCLUSION: It could be stated that fruit yogurt has no erosive potential.

Glass fiber-reinforced composite resin as fixed space maintainers in children: 12-month clinical follow-up.

PURPOSE: The purpose of this clinical evaluation was to assess fixed space maintainers for child patients whose missing primary molars were replaced with space maintainers made with everStick during a 12-month follow-up period. EverStick is a semi-manufactured product made of glass fibers, thermoplastic polymer, and light-curing resin matrix for reinforcing the dental polymer. METHODS: Twenty-three clinical cases presented in this paper were evaluated in the Department of Pediatric Dentistry, Marmara University, Istanbul, Turkey. EverStick was used as part of a space maintainer on occasions where 1 or 2 teeth were lost in either the maxillary or mandibular arch. RESULTS: This study showed that the glass fiber-reinforced composite resin space maintainers functioned well during a mid-term evaluation. CONCLUSIONS: Clinical advantages of everStick include: (1) cost and time savings; (2) no need for a cast model; (3) no second visit; (4) easy to apply; (5) reliable adhesive bonding; (6) no metal allergy; (7) easy to clean; (8) natural feel; and (9) esthetically desirable.

Dental erosion among children in an Istanbul public school.

The aim of this study was to evaluate the prevalence, clinical manifestations, and etiology of dental erosion among children. A total of 153 healthy, 11-year-old children were sampled from a downtown public school in Istanbul, Turkey comprised of middle-class children. Data were obtained via: (1) dinical examination; (2) questionnaire; and (3) standardized data records. A new dental erosion index for children designed by O'Sullivan (2000) was used. Twenty-eight percent (N=43) of the children exhibited dental erosion. Of children who consumed orange juice, 32% showed erosion, while 40% who consumed carbonated beverages showed erosion. Of children who consumed fruit yogurt, 36% showed erosion. Of children who swam professionally in swimming pools, 60% showed erosion. Multiple regression analysis revealed no relationship between dental erosion and related erosive sources (P > .05).

Feeding, artificial sucking habits, and malocclusions in 3-year-old girls in different regions of the world.

PURPOSE: The way babies and young children are reared is important to their health and development. Extensive breast-feeding has also been shown to reduce the development of artificial sucking habits like digit or pacifier-sucking. The aim of this study was to determine feeding methods, artificial sucking habits, and the presence of malocclusions in 3-year-old girls living in different regions of the world. METHODS: Children from the following countries were involved in the present study: (1) Brazil (Porto Alegre); (2) Japan (Niigata); (3) Mexico (Mexico City); (4) Norway (Oslo); (5) Sweden (Falköping); (6) Turkey (Istanbul); (7) and the United States (Iowa City, Iowa). During the interview and examination, the following variables were evaluated and registered: (1) breastfeeding and bottle-feeding; (2) duration and frequency; (3) sucking habits; (4) posterior and anterior crossbites; and (5) other malocclusions/normal occlusion. RESULTS: The prevalence of breast-feeding was very high in all groups, ranging between 78% and 98%. The prevalence of bottle-feeding in the different areas was also high. Except for Iowa City, the prevalence of digit-sucking was relatively low. Pacifier-sucking is fairly popular in most areas, with the exception of Niigata. The prevalence of normal occlusion in different cities ranged from 38% to 98%. CONCLUSIONS: There are considerable differences in feeding, as well as artificial sucking habits, in different areas of the world and at different periods.

Four year Evaluation of Proximal Resin Infiltration in Adolescents.

AIM: Resin infiltration of proximal lesions is a new approach to stopping caries progression. Therefore, the aim of the present study was to evaluate four-year efficacy of proximal infiltrates in adolescents. MATERIALS AND METHODS: In ten adolescents, a total of 21 proximal infiltrates (ICON® (DMG, Germany) were applied to initial proximal lesions of permanent incisors and premolars according to the manufacturer's instruction. The clinical quality of resin infiltration was assessed at 1 week, 1, 2, 3 and 4 years after the treatment and the evaluation of the therapeutic effect was analyzed by radiographs. RESULTS: Ten patients were followed up clinically for four years. The majority of the infiltrated lesions were located on permanent incisors. Teeth which were proximally infiltrated did not exhibit dental plaque and gingival bleeding in most cases. At annual recalls, plaque scores remained constant. The gingival status remained steady and no differences in tooth shape and contour were detected. Discoloration was detected in four teeth (19%) in 1st year recall and was constant at annual intervals. The radiographic evaluation of the bitewing radiographs showed no progression in 21 lesions (100%) from baseline to the 4-year recall. Overall oral hygiene of the patients was satisfactory. CONCLUSION: In conclusion, proximal infiltration is an effective prophylactic measure in adolescents.

Glass fiber reinforced composite resin space maintainer: case reports.

PURPOSE: Glass fiber reinforced composite resins (GFRCR) are new to the pediatric dental market and can be an alternative to conventional space maintenainers. GFRCRs have been developed for dental applications during the past several years. This preliminary clinical study described the treatment of patients whose missing primary molars were restored with everStick, a semimanufactured product made of glass fibers, thermoplastic polymer, and lightcuring resin matrix for reinforcing dental polymer. METHODS: everStick was applied as a space maintainer when there was a loss of 1 or 2 teeth in the maxillary or mandibular arch. RESULTS: This study showed that the GFRCR space maintainers functioned well during a short period. The clinical advantages of the GFRCR space maintainers were that they: provided cost and time savings; did not require a cast model; did not require a second visit; were easy to apply; provided reliable adhesive bonding; provided long-term retention; were used when there was an indication of metal allergy; were easy to clean; had a natural feel and were esthetic. CONCLUSIONS: GFRCR space maintainers can be a new alternative to the conventional space maintainers used in pediatric dentistry.

History of water fluoridation.

Fluoride, the milestone element of pediatric dentistry, as well as modern dentistry, has been utilized for the last six decades in practice. Researchers all over the world have used fluoride in several forms in the prevention of tooth decay. Today, we are aware that most of this work has involved clinical research with children. It is particularly pertinent that the subject be adequately presented in the field of pediatric dentistry. In 1940's and 1950's were the years of ten-year studies, where caries reductions were first described. The industry of systemic fluoridation, public campaigns and advertisements became popular mostly in western world in 1960's and 1970's. The fluoridated dentifrices and changes of dentifrice formulations were established in 1980's. Many stated that children should receive one form of systemic fluoride and appropriate forms of topical fluoride in 1990's. Analyses showed that maximum protection against caries is obtained when teeth erupt into an environment with low concentrations of ionic fluoride. The similarity in caries reductions obtained in water fluoridation studies and long-term studies with topically administered fluoride regimens, including fluoride-containing dentifrices, indicates that the pre-eruptive effect of fluoride is of borderline significance relative to the more significant post-eruptive effect. It has taken a long time to show that water fluoridation and topical fluoride programs were thus important measures for the control of caries at the community level. Today, we are aware of the fact that the trio of diet, dentifrice and supplementation should exceed the optimal levels.

Use of Pre-Injection Diffusion of Local Anaesthetic as a Means of Reducing Needle Penetration Discomfort.

AIM: To determine if pre-injection diffusion of local anaesthetic solution influences the discomfort of needle penetration in the palate. METHODS: A placebo-controlled, randomised, double-blind split-mouth investigation was conducted. 25 healthy adult volunteers were recruited and each received two needle penetrations in a random order during one visit. The penetration sites were 1 cm from the gingival margin of the first maxillary premolars on each side of the mouth. 30 gauge-13 mm needles which were attached to syringes that contained either 2% lidocaine with 0.125mg/ml epinephrine or physiological saline were used. For each penetration an operator encouraged a drop of solution to appear at the end of the needle and placed this drop with the bevel of the needle flat on the palate for 20 seconds. The discomfort was noted on a 100 mm visual analogue scale with end points marked "No pain" and "Unbearable pain". RESULTS: There was no significant difference in penetration discomfort between solutions, (mean VAS = 26.80±19.36mm for lidocaine and 26.20±18.39mm for saline) however the 2nd penetration was significantly more uncomfortable than the first (mean VAS = 31.00±19.84 mm and 22.00±16.65 mm respectively). CONCLUSION: Pre-injection diffusion of local anaesthetic solution did not influence the discomfort of needle penetration in the palate.