Laser-induced fluorescence in the diagnosis of pulp exposure and the influence of residual dentin thickness: An in vivo study.

PURPOSE: To clinically (a) determine whether laser-induced fluorescence (LIF) was able to assess pulp tissue health or disease in situations of pulp exposure; (b) evaluate the influence of different pulp tissue conditions upon LIF through dentin thicknesses of ≤1 mm; and (c) explore possible differences between the diagnostic performance of quantitative (q) and qualitative (ql) LIF. METHODS: 98 healthy subjects were scheduled for the treatment of caries. Three groups were established according to pulp tissue condition: Group A (n=30 teeth) (deep caries with healthy pulp tissue); Group B (n=30 teeth) (pulp necrosis); and Group C (n=30 teeth) (irreversible symptomatic acute pulpitis). The carious lesions were eliminated, and q and ql LIF measurements were made at two levels: measurement in dentin at < 1 mm from the pulp (A-D); and direct pulp exposure measurement (A-LP). In healthy pulp tissue at level A-LP, eight teeth with accidental pulp exposure were used. The Kruskal-Wallis test was used to evaluate the statistical significance of the differences in LIF readings among the three groups. The diagnostic performance of q and ql LIF in application to pulp tissue health or disease was assessed by calculating the sensitivity and specificity of the two tests at level A-LP. RESULTS: A significant correlation was observed between acute pulpitis and an increase in the q LIF values at level A-D (P= 0.004), but with no correlation to healthy pulp. Quantitative and qualitative LIF may be useful in diagnosing pulp tissue health or disease in situations of pulp exposure (A-LP).

A 50-year audit of published peer-reviewed literature on pit and fissure sealants, 1962-2011.

OBJECTIVE: Pit and fissure sealants have been used for many decades to prevent the initiation of caries on susceptible tooth surfaces. The purpose of this study was to analyze the peer-reviewed published scientific literature on pit and fissure sealants over the last 50 years. MATERIALS AND METHODS: On the PubMed database, all publications on pit and fissure sealants from 1962-2011 were extracted using the search phrase [(pit OR fissure) AND (sealant OR sealants OR adhesive)]. Details of all retrievals were individually entered into SPSS for analysis. RESULTS: A total of 2829 publications were found. The mean number of authors was 2.73 ± 1.90 (range = 1-23). Although single-authorship was the modal group with 32.1%, it had a sustained decrease from 75.0% for 1962-1971 to 17.6% for 2002-2011. On the contrary, publications with three or more authors increased from 8.3% to 47.3% during the same period. Human studies accounted for 88.6% and clinical trial was 11.9%, followed by reviews at 10.2% and randomized controlled trials at 6.9%. English was the language of reporting for 82.0% of the studies. CONCLUSION: It is anticipated that future research on pit and fissure sealants will focus on newer and more effective materials.

Dental sealant knowledge, opinion, values and practice of Spanish dentists.

BACKGROUND: Multiple guidelines and systematic reviews recommend sealant use to reduce caries risk. Yet, multiple reports also indicate that sealants are significantly underutilized. This study examined the knowledge, opinions, values, and practice (KOVP) of dentists concerning sealant use in the southwest region of Andalusia, Spain. This is a prelude to the generation of a regional plan for improving children's oral health in Andalusia. METHODS: The survey's target population was dentists working in western Andalusia, equally distributed in the provinces of Seville, Cadiz, and Huelva (N=2,047). A convenience sample of meeting participants and meeting participant email lists (N=400) were solicited from the annual course on Community and Pediatric Dentistry. This course is required for all public health sector dentists, and is open to all private sector dentists. Information on the dentist's KOVP of sealants was collected using four-part questionnaire with 31, 5-point Likert-scaled questions. RESULTS: The survey population demographics included 190 men (48%) and 206 women (52%) with an average clinical experience of 10.6 (±8.4) years and 9.3 (±7.5) years, respectively. A significant sex difference was observed in the distribution of place of work (urban/suburb) (p=0.001), but no sex differences between working sector (public/private). The mean±SD values for each of the four KOVP sections for pit and fissure sealants were: knowledge=3.57±0.47; opinion=2.48±0.47; value=2.74±0.52; and practice=3.48±0.50. No sex differences were found in KOVP (all p>0.4). Independent of sex: knowledge statistically differed by years of experience and place of work; opinion statistically differed by years of experience and sector; and practice statistically differed by years of experience and sector. Less experienced dentists tended to have slightly higher scores (~0.25 on a Likert 1-5 scale). Statistically significant correlations were found between knowledge and practice (r=0.44, p=0.00) and between opinion and value (r=0.35, p=0.00). CONCLUSIONS: The results suggest that, similar to other countries, Andalusian dentists know that sealants are effective, have neutral to positive attitudes toward sealants; though, based on epidemiological studies, underuse sealants. Therefore, methods other than classical behavior change (eg: financial or legal mechanisms) will be required to change practice patterns aimed at improving children's oral health.

Systemic diseases and oral health.

The US population is at the beginning of a significant demographic shift; the American geriatric population is burgeoning, and average longevity is projected to increase in the coming years. Elder adults are affected by numerous chronic conditions, such as diabetes, hypertension, osteoarthritis, osteoporosis, cardiovascular diseases, and cerebrovascular diseases. These older adults need special dental care and an improved understanding of the complex interactions of oral disease and systemic chronic diseases that can complicate their treatment. Oral diseases have strong associations with systemic diseases, and poor oral health can worsen the impact of systemic diseases.