Time Trends in Adolescent School Absences and Associated Bullying Involvement Between 2000 and 2019: A Nationwide Study.

Education is a central determinant of adolescent health. School absences and bullying involvement jeopardize wellbeing, mental health, and educational attainment. We analyzed time trends in school absenteeism over two decades and examined the association of absenteeism with bullying involvement.We analyzed data from the nationwide School Health Promotion study, with self-reported data from Finnish middle school students in grades 8 and 9 (ages 14-17, N = 1 000 970). Questionnaires assessed frequency of illness absences (IA), truancy, frequency of bullying victimization, bullying perpetration, and involvement in both bullying perpetration and victimization. Frequent school absences were defined as occurring on more than 3 days during the prior month (2000-2015), or at least weekly (2017-2019).Frequent IA increased from 12% to 2000 to 22% in 2015. In 2017-2019, frequent IA was reported by 3.5%. Frequent truancy declined from 9% to 2000 to 4% in 2015, and remained at 4% during 2017-2019. Bully victimization was reported at least weekly by 6.9%, perpetration by 5.4% and victimization-perpetration by 1.9% of participants in total. In a logistic regression model, every type of bullying involvement increased odds for both IA and truancy.Since bullying involvement was associated with both IA and truancy, particular concern should be raised for adolescents involved in bullying, and for their social and educational functioning. The concurrent increase in IA and decrease in truancy may reflect destigmatization of mental health problems or other changes in reporting absenteeism.

Radiation therapy strategies for skull-base malignancies.

INTRODUCTION: The management of skull base malignancies continues to evolve with improvements in surgical technique, advances in radiation delivery and novel systemic agents. METHODS: In this review, we aim to discuss in detail the management of common skull base pathologies which typically require multimodality therapy, focusing on the radiotherapeutic aspects of care. RESULTS: Technological advances in the administration of radiation therapy have led to a wide variety of different treatment strategies for the treatment of skull base malignances, with outcomes summarized herein. CONCLUSION: Radiation treatment plays a key and critical role in the management of patients with skull base tumors. Recent advancements continue to improve the risk/benefit ratio for radiotherapy in this setting.

Evaluation of fungal extracts to determine immunomodulatory properties.

BACKGROUND: Immunoglobulin E-mediated allergies have doubled in prevalence during recent decades in developed countries.This increase has been attributed, in part, to high hygiene standards, which have reduced exposure to microbes. The capacity of microbes to induce type 1 helper T cell (TH1) responses may imply suppression of TH2 responses. However, little research has been performed with fungal extracts. OBJECTIVES: To evaluate the TH1-inducing properties of fungal extracts. METHODS: A total of 24 fungal extracts, including Cetavlon-precipitated polysaccharides from different yeasts, molds, and mushrooms were prepared.The extracts were screened for production of interferon (IFN)gamma in human peripheral blood mononuclear cells. The active compounds were further purified by mild acid hydrolysis and by column chromatography and studied in human peripheral blood mononuclear cells. RESULTS: Expression of IFN-gamma was induced by several extracts. The strongest expression of IFN-gamma was induced by Candida albicans. The Cetavlon-precipitated mannans of fungi induced cytokine responses that were similar or superior to those induced by whole extracts, C albicans being the most potent inducer of IFN-gamma. Column chromatography-fractionated mild acid hydrolysis of Calbicans mannan was performed. Fractions containing oligosaccharides of 12-16 mannoses induced production of tumor necrosis factor. CONCLUSIONS: Several fungal extracts induce IFN-gamma. The most promising preparations were yeast-derived oligosaccharides. Further research should be focused on purification and eventual synthesis of the extracts.

Association between acid fumes in the work environment and dental erosion.

The effect of inorganic acid fumes from the work environment on the erosion of teeth was studied blindly. A sample of 186 workers was drawn from four factories. Among the 157 dentulous participants, 76 were working in departments containing acid fumes, and 81 had never worked under such conditions and were used as referents. Of the acid workers 18.4% had one or more teeth with erosion, and the corresponding figure for the referents was 8.6%. With a longer duration of exposure the proportion of subjects with erosion increased. The acid workers had more teeth with erosion than the referents, especially upper anterior teeth. The findings suggest that even today exposure to inorganic acid fumes from the work environment may increase the erosion of teeth, especially the upper anterior teeth, which are not continuously protected by saliva and the lips.

Development of edentulousness in Finland during the 1970's.

From a representative sample of 8000 persons aged 30 yr and over, 7190 were examined clinically. Thirty-one percent were edentulous, 23% of the men and 38% of the women. Results of our study were compared with seven other nationwide studies of edentulousness in Finnish adults made during the last decade. For subjects 35-64 yr old the rate of edentulousness was lowest in our clinical study. For those over 64 yr old the rates of edentulousness varied from 54% to 67%. In general, results obtained using interviews or questionnaires gave higher percentages for edentulousness than did the clinical study. Statistical evaluation of the differences in rates found in these studies did not show edentulousness to be either increasing or decreasing in Finland during the 1970's.

Knowledge of AIDS and HIV infection displayed by Tanzanian operating dental staff in 1988 and 1989: a follow-up study.

In many urban areas of Central and Eastern Africa 20-30 per cent of the sexually active population has been infected with HIV. It can be assumed that every member of the operating dental staff in Tanzania frequently treats HIV-positive patients. The knowledge of AIDS and HIV infection was investigated by Tanzanian dental teams in 1988 and 1989. In both years almost one quarter of the dental officers and half the other operating team members chose incorrect information about the methods of transmission of HIV. Several respondents named health care workers as belonging to a high risk group. Fever and loss of weight were known to be early symptoms of AIDS. In 1989, when asked to identify oral manifestations of HIV, one quarter of all the dental staff could not mention any of them. The findings of the study emphasise the need for urgent further education of dental teams in Tanzania.

PIP: Dental officers, assistant dental officers, and dental assistants attending the Tanzanian Dental Association Annual meetings in 1988 and 1989 in Dar es Salaam were administered pre tested questionnaires on transmission, early symptoms, high-risk groups, and oral signs of HIV infection. 44 completed the confidential questionnaires in 1988 and 45 did so in 1989. The clinical tasks of each group are similar, but their educational requirements vary. While all respondents were aware of at least 1 major means of transmission, 23% and 26% in 1988 and 1989 marked incorrect answers on transmission, most often by articles such as toothbrushes. The total score of correct responses was around 27 both years, and did not differ between groups. For the question on high-risk groups, there were 7 multiple choices that were all correct except female homosexuals. Respondents more frequently checked homosexual men, people with multiple sex partners, and prostitutes, with varying scores for the other high-risk groups as well as lesbians. A higher percentage of dental officers said they had more than 1 sex partner than did junior staff. Similarly, the question on early symptoms of AIDS was a multiple check-off, and respondents also chose symptoms with varying frequencies in both years. Most commonly checked symptoms were weight loss, diarrhea, and weakness. The question on oral signs in 1989 was an open fill-in type question. Dental officers were able to write 1.9 answers on average, staff 2.2, most often candida infections, ulcers and gingivitis. The least often cited signs were angular cheilitis, Kaposi's sarcoma, and leukoplakia. Many could not remember any oral signs. Since oral manifestations of AIDS appear early, and dental practitioners in Tanzania have no gloves or any means of sterilizing instruments except boiling, it is imperative that the knowledge base of dental staff be improved.

Rehabilitation with removable dentures among the dentate population in Finland.

The information available on the rehabilitation with removable dentures among dentate subjects is contradictory. In the present study, the most common type of rehabilitation was a complete maxillary denture with or without a partial one. Nineteen per cent of men and 27% of women belonged to this category. Partial denture(s) without a complete one were worn by 11% of men and 15% of women. The odds ratio of having partial denture(s) was significantly higher among women, among people with a medium level of income, with a regular dental attendance pattern, and with a shorter distance to the nearest dental clinic. The presence of a complete denture significantly decreased the odds ratio of having a partial denture. The effect of age was non-significant in the two youngest age categories. The odds ratio of having a single complete denture was significantly higher among women, among people with a medium level of income and with a shorter distance to the nearest dental clinic. The presence of a partial denture and belonging to the oldest age bracket decreased the odds ratio significantly. Regularity of use of dental services had a non-significant effect.

Dental students' knowledge of AIDS and HIV infection in Helsinki, Finland, and in Dar es Salaam, Tanzania.

The purpose of this investigation was to study the knowledge about HIV infection and AIDS among dental students in Helsinki, Finland, and in Dar es Salaam, Tanzania. All respondents knew that HIV is not transmitted via hand-shaking, drinking water, or breathing air. More than half of the students in both countries did not know that HIV can be transmitted via breast-feeding. A higher proportion of students in Dar es Salaam than in Helsinki believed that all HIV-positive persons will get AIDS. Tanzanians recognized the early symptoms of HIV infection better than the Finnish students. Many students in both countries did not mention bisexual men as belonging to the high-risk group. Most of the dental students in Dar es Salaam but only one in five in Helsinki believed that dentists belong to the at-risk group.

Wearing of removable partial dentures in relation to dental caries.

Using a representative sample of 5028 dentulous Finnish adults the occurrence of dental caries was studied among removable partial denture (RPD) wearers and non-wearers. Of the subjects wearing no RPD(s) 61.4% had one or more carious teeth, among those wearing a single RPD the figure was 60.5% and among those wearing RPDs in both jaws 62.7%, respectively. When sociodemographic background, other oral status measures than caries and oral health care habits were simultaneously controlled, subjects wearing RPDs in both jaws had slightly increased (P less than 0.05) probability of having one or more carious teeth compared to those with no RPD(s). Subjects with a single RPD did not have a statistically significantly increased probability of having carious teeth. Among those 3075 subjects who had one or more carious teeth the wearing of one or two RPDs did not significantly increase the number of carious teeth. Because the subjects wearing RPDs in both jaws were seen to have a slightly increased risk of having caries, this confirms the view that dentists should emphasize good oral hygiene habits and regular dental attendance among RPD wearers.

Wearing of removable partial dentures in relation to periodontal pockets.

Using a representative sample of 5028 dentulous Finnish adults the occurrence of periodontal pockets was studied separately for the maxillae and the mandibles among removable partial denture (RPD) wearers and non-wearers. RPD(s) were worn in 11.2% of the 3444 maxillae with at least four natural teeth remaining, and in 7.7% of the 4706 corresponding mandibles (P less than 0.001). Periodontal pockets were more frequently observed in maxillae than mandibles. Wearing of RPDs highly significantly (P less than 0.0001) increased the odds of having periodontal pockets in general (4 mm or more) as well as the odds of having deeper periodontal pockets (exceeding 6 mm). This phenomenon was observed both in the maxillae and in the mandibles. These results suggest that wearing of RPD is a threat to periodontal tissues and that dentists should take care to frequently recall their patients fitted with RPD(s). During the recall visits more attention should be paid to the periodontal conditions of patients wearing RPD(s).

Familial hypodontia associated with Dupuytren's disease.

A three-generation Finnish family exhibited hypodontia associated with Dupuytren's disease (contracture). Of the known 32 members of the family, contracture has been diagnosed thus far in 5 individuals, 4 of these also with hypodontia. No other connective tissue involvement was found. For comparison, three other families were studied, also showing incomplete penetrance of hypodontia. Bearing in mind the genetic isolation of the Finnish population, this finding may be coincidental. The possibility of partially common genetic background cannot, however, be excluded.

Black-pigmented Bacteroides spp. in human apical periodontitis.

The incidence of black-pigmented (BP) Bacteroides spp. in 62 human dental root canal infections (35 acute and 27 clinically asymptomatic cases of apical periodontitis) in 57 adults was studied. Altogether 37 strains of BP Bacteroides were found in 31 infections, always in mixed anaerobic infections. Two different BP Bacteroides species were present in six infections. B. intermedius was most frequently isolated (15 of 62 canals; 24%) followed by B. denticola which was present in 12 cases. Asaccharolytic BP Bacteroides species, B. gingivalis and B. endodontalis, were found in eight cases. BP Bacteroides species were found both from symptomatic and asymptomatic infections, but there were also several symptomatic cases from which BP Bacteroides species were not isolated. B. gingivalis and B. endodontalis were present only in acute infections, B. intermedius was found both in symptomatic and asymptomatic infections, and B. denticola occurred mostly in asymptomatic infections. BP Bacteroides species were isolated initially from 9 of the 11 teeth with symptoms at 1 week, but only from 22 of the 51 teeth that were symptomless at 1 week. Two strains of B. denticola were resistant to penicillin G at a concentration of 2.4 micrograms/ml, but the MIC of penicillin G for all other strains was 0.6 micrograms/ml or lower. Forty-two randomly selected patients received penicillin V (oral administration, 650 mg, three times daily) during the first week of endodontic therapy. Penicillin had no effect on the occurrence of symptoms after 1 week compared with the control group (20 patients).

Dental findings in osteogenesis imperfecta: I. Occurrence and expression of type I dentinogenesis imperfecta.

Sixty-eight patients with osteogenesis imperfecta (OI) classified according to Sillence were evaluated for dentinogenesis imperfecta (DI). Orthopantomograms of 51 of the 68 were examined. Type I DI was recognized in 22 patients from 16 families. DI was observed in 4/45 patients with type I OI, in one of two patients with type III, and in 13/16 patients with type IV OI. Four of the five patients with an unidentified type of OI had DI. The expression of type I DI was variable. Discoloration and pulpal obliteration were the major manifestations. Teeth from 14 patients from 12 families were studied histologically. Eight of the 14 patients were from six families who had clinical and/or radiographic evidence of DI. Irregularity of the dentin matrix and tubular pattern in the circumpulpal dentin and normal mantle dentin were observed. Interfamilial variability was greater than intrafamilial variability. The expression of DI was mild in one family with type I OI. There was no further relation between the type of OI and the severity of DI.

Facultative gram-negative enteric rods in persistent periapical infections.

A bacteriological investigation has been made in two cases of persistent periapical infections. Neither of the two infections responded to root canal therapy including penicillin or penicillin and erythromycin. Samples were taken aseptically for bacteriological examination through and root canals. Chloroform-washed, sterile paper points were used for sampling. Cultivation was performed immediately at chairside on Kanamycin-Vancomycin laked blood agar (KVLB) and blood agar supplemented with menadione, cysteine and glucose for anaerobic incubation and chocolate agar for aerobic incubation. Enterobacter cloacae was only isolate in case 1; Klebsiella pneumoniae and enterococci were found in case 2. Obligately anaerobic bacteria were not found. The treatment was successful after antibiotic therapy based on susceptibility testing of the isolates. The route of infection by facultative enteric rods is discussed.

Isolation and ultrastructure of Bacteroides sp. with external cell-wall layer (S-layer) in periapical osteitis.

Bacteroides sp. was isolated in human periapical osteitis and shown to be biochemically closely related to B. ruminicola ssp. brevis and B. capillus. Electron microscopic examination revealed an external cell-wall layer (S-layer). The fractionation of cells by various methods gave partially purified sheets corresponding to the observed layer with a hexagonal molecular arrangement.

Ultrastructure of a novel anaerobic gram-positive nonsporing rod from dental root canal.

A novel anaerobic Gram-positive rod, strain ES4C, was isolated from a dental root canal infection. The isolate did not produce acids from carbohydrates and showed no glycosidase activity. Most biochemical reactions were identical to Clostridium malenominatum with the exception of the production of three aminopeptidases. In addition, no spores were detected. A tetragonally arranged surface layer was consistently found by electron microscopy. The ultrastructure of closely related Eubacterium spp. was also studied, but no crystalline surface structures were found. The physiologic and ultrastructural characteristics of ES4C did not allow identification as any known species. The periapical lesion responded to routine root canal therapy, but after 18 months observation the radiologic signs indicated partial healing only.